Worrying advice from my GP surgery!!!

[beticbob32]

Hello everyone,

This is my first posting, but may sound alarm bells ringing!!!

My surgery called me today, informing me that my recent HbA1c is 10.4%. The practice manager then tells me that my GP has tripled my dose of Metformin from 500mg to 1500mg per day.

I am concerned about this advice / instruction for the following reasons:

1, two weeks ago I underwent corticosteroid injection of my left shoulder for impingement. Research shows that post injection rises in blood sugar levels can reach levels concurrent with hyperglycaemia.
2, for the last two months I have been on the healthiest diet I have ever eaten; based on the slimming world plan, whereby my intake is totally non processed, lots of fresh fruit & vegetables, no pastry etc. Prior to starting this regime my eating was reasonably healthy. Total weight loss so far is 3 stone. I also drink two litres of still water per day and have minimal alcohol intake.
3, my own blood sugar measurements are within the normal range.

I feel absolutely fine regarding my diabetes, with no adverse symptoms.

My previous HbA1c was 6.5%, thas was about 12 months ago.

I have booked an appointment to see another GP within the practice for tomorrow morning to discuss the above. I am upset and annoyed that a Doctor can make such a rash diagnosis on a single blood test, and then to prescribe without taking a recent history!!! Comments are most welcome.

 

[Neil Walters]

The test is not biased over the last two weeks though it is showing he situation over he last 3 months or so so there must be something else going on?


Diagnosed Type II 1998 1 x 80 mg Gliclazide, 4 x 500mg Metformin and 1 x 100mg Sitagliptin - HbA1c - 48 mmol/mol

 

[mo1905]

Neil is correct. You're certainly right to question but the blood test is a 3 month avg, not just a blip.


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[Daibell]

Hi. Sorry, but I would be guided by the HBa1C as your GP has. It is way too high possibly due to the steroids, although you have only been on them for 2 weeks? I think your GP is sensible to have increased your Metformin to help. There is a conflict between your blood sugar readings and the HBa1C which needs some explanation. What is your total daily carb intake and your current BMI. Your weight loss shows your diet is having some effect. You may want to ask for another HBa1C shortly to eliminate any errors and possibly accurately record your sugar readings each day taken 2 hours after main meals and then discuss these with the GP.

 

[SamJB]

Take a look at a post I made a while ago:

viewtopic.php?f=1&t=42836&hilit=what+your+hba1c+actually+means&start=0

Around 8% of your HbA1c comes from the most recent 2 weeks and around 50% from the mist recent month. That being said, your levels must have been off the scale to increase your HbA1c from 6.5 to 10.5% in such a short time span. So I'd suggest it may be something other than the injection you had for your shoulder that has caused the HbA1c increase.

Do you have a meter? If so what have been your readings?

 

[hanadr]

When did you last check your meter?
If you don't have test solution, ring your meter supplier for them. they are usually free.

 

[Paul_c]

I would have delayed having the HbA1c done. I was put on steroids for a week shortly before my annual review, I noticed what happened to my blood sugar levels that week and the week after coming off them (they were in the 9's before meals instead of nicely between 5.5 & 6.0) and delayed responding to the request to make my appointment for my review until a whole 8 weeks had gone by after having finished the steroids.

 

[Sid Bonkers]

I would have delayed having the HbA1c done. I was put on steroids for a week shortly before my annual review, I noticed what happened to my blood sugar levels that week and the week after coming off them (they were in the 9's before meals instead of nicely between 5.5 & 6.0) and delayed responding to the request to make my appointment for my review until a whole 8 weeks had gone by after having finished the steroids.

Oral steroids affect bg levels way more than a locally injected steroid injection, theyre not the same thing at all, injected steroids may have a small affect on bg levels but not enough to give an HbA1c increase of 4% after a fortnight.

I would agree with others beticbob and say that your levels are not normal if you have an HbA1c of 10.4%. However tripling your Metformin will have only a slight effect as even the max dose of Metformin 1000mg twice daily will only help to reduce bg levels by between 1 and 2 mmol/L.

I would suggest you look at your diet and reducing some of the carbs you are eating that will have a much bigger effect on your bg levels than another 1000mg of Metformin :thumbup:

Edited: spelling

 

[4ratbags]

Wow that is a bit of a jump in your HbA1c but it is an even bigger jump in metformin. When I was diagnosed in Feb my HbA1c was 13.9% and I was only started off on 500 metformin and it was increased to 850 metformin two weeks later and that is where it has stayed and my HbA1c is down to 7% now. Definitely question why the metformin has tripled that is just nuts. Congrats on the weight loss by the way, hopefully you can get it sorted out with the GP.