Taken off Metformin..now diet and exercise
JaneKnoll1
Posts: 406 Member
I am doing a happy but a little nervous dance here!
Yesterday was my 3 month check up and during that time my metformin was reduced to 250 in the morning and 250 at night. My A1C was 5.6. When I was on 1000mg daily (Jan-April) it was 5.5.
My doctor is super happy with my exercise, weight, general health and A1C and he wants to try me with only diet and exercise. Of course I was thrilled but just a tad nervous. July is my next checkup. I wonder how much my A1C will rise...I want to keep it in the 5s. My ideal would he 5.5 but not sure how that will go.
For anyone doing it with diet and exercise alone, did you reduce your carbs a bit more or? I am around 40-45 per meal and doing maintenance. I would love to hear thoughts on this. I am seeing how I get on with no changes to my diet for this week....see how my body reacts. Anyway, my year anniversary for diabetes diagnosis is next week. I have done all sorts of lifestyle changes and have lost all my weight. A dose of fear at diagnosis was a huge motivator lol!! Hope you all have a fabulous day and if you have thoughts let me know. My doctor advised me to keep doing what I am doing.
Yesterday was my 3 month check up and during that time my metformin was reduced to 250 in the morning and 250 at night. My A1C was 5.6. When I was on 1000mg daily (Jan-April) it was 5.5.
My doctor is super happy with my exercise, weight, general health and A1C and he wants to try me with only diet and exercise. Of course I was thrilled but just a tad nervous. July is my next checkup. I wonder how much my A1C will rise...I want to keep it in the 5s. My ideal would he 5.5 but not sure how that will go.
For anyone doing it with diet and exercise alone, did you reduce your carbs a bit more or? I am around 40-45 per meal and doing maintenance. I would love to hear thoughts on this. I am seeing how I get on with no changes to my diet for this week....see how my body reacts. Anyway, my year anniversary for diabetes diagnosis is next week. I have done all sorts of lifestyle changes and have lost all my weight. A dose of fear at diagnosis was a huge motivator lol!! Hope you all have a fabulous day and if you have thoughts let me know. My doctor advised me to keep doing what I am doing.
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I am 100% diet-managed for now, although I have been experiencing unacceptable high fasting readings.0
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That's awesome news!2
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Congratulations! That is indeed awesome.2
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Thank you Melissa and cdebracy!! Today is my first day in a year that I haven't taken metformin.1
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The occasional >149. :ohwell:JaneKnoll1 wrote: »
I should have mentioned that I was previously Metformin- and insulin-dependent (separately).0 -
That is truly wonderful Jane. No words of advice, but my past supervisor, who had been overweight for a long time, developed diabetes, high blood pressure, high cholesterol, and a host of other illnesses. He joined Weight Watchers, started running every day. Lost a ton of weight and all, and I mean all his problems disappeared. His doctor took him off all his meds, he's looking great, one year later. Oh, and he was on insulin as well as Metformin.
Great job, you should be so proud of yourself.
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Thanks for your support, Judy!! I feel my motivation is as good as ever...I don't remember feeling as good as this for years and years!! It's a feeling I want to keep. I am cheering for you on your journey too and I am sure you will be successful in your quest to get those sugars stable and reducing your other issues! Hugs and thanks!!! Going running as soon as my oatmeal digests lol!!0
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You have done a fabulous job on getting off them! Those fasting numbers can be a bear!!! Stay the course and keep healthy!! Thanks for your support!
The occasional >149. :ohwell:JaneKnoll1 wrote: »
I should have mentioned that I was previously Metformin- and insulin-dependent (separately).0 -
JaneKnoll1 wrote: »For anyone doing it with diet and exercise alone, did you reduce your carbs a bit more or? I am around 40-45 per meal and doing maintenance. I would love to hear thoughts on this.
Hi. I'm down from 2000g to 500-1500mg Metformin (depending on my BG readings).
I have found that for only 500mg to suffice, I have to incorporate a couple 16-hour fasts per week and keep:- net carbs below 50g per day, and
- protein below 100g per day (excess above that seems to get converted to glucose in my case)
I couldn't get away with 40g net carbs per meal ... unless I only ate once a day. Drat.
Obviously, your mileage may (and probably does) vary!
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I'm primarily diet controlled. (I'm on 500 mg Metformin ER. Too low a dose to be doing much of anything - but my doctor put me on it as a stepping stone to what he expected would be 2000 mg, since he never expected I would follow through on dietary control. Little did he know . . . Once I get other health matters in order (breast cancer diagnosis last Monday - I'll consider whether to stay on it - ironically there is new evidence that it helps prevent cancer!)
My blood glucose normalized within 3 days of diagnosis - I can still count on two hands the number of times I've exceeded 140. My A1c went form 7.2 to 5.7 at my first (5-month) follow-up. It was only that high because I have a heaping helping of dawn phenomenon). I limit carbs to 20 grams in a 3 hour period (the amount I found I could tolerate by testing each new food to see my BG response). (I have not added exercise to my routine, but expect to this summer.)
I'm actually in the process of trying to induce remission, based on some exciting research from the UK. My BG has dropped, since the start of this experiment, from a steady average of 107 (for the past 6 months) to 97 for the past 4 weeks (the length of time I've been on the new regime). Simultaneously I've increased the number of carbs I'm eating to up to 33 grams in a 3 hour period. It isn't a MyfitnessPal friendly diet, so I won't go into specifics, but if you're curious you can look at my diary or do a google search for my user name +diabetes + remission. (Not being coy, or trying to sell anything - just trying to stay within the MFP rules.)
I may (or may not) achieve remission - but if I don't, I'm confident that I can completely manage my blood glucose by carefully monitoring my carb intake.1 -
Wow you are inspirational and I have read about metformin maybe preventing cancer too. No doubt you will do amazing with fighting against cancer diagnosis @neohdiver. You kicked diabetes ton the curb and I have no doubt you will do the same. I definitely will google the info. You can have a look at my diary if you are interested..it's open to all. My very best wishes to you for good health and happiness...and when do you start your treatment?1
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JaneKnoll1 wrote: »Wow you are inspirational and I have read about metformin maybe preventing cancer too. No doubt you will do amazing with fighting against cancer diagnosis @neohdiver. You kicked diabetes ton the curb and I have no doubt you will do the same. I definitely will google the info. You can have a look at my diary if you are interested..it's open to all. My very best wishes to you for good health and happiness...and when do you start your treatment?
Thanks!
I'll have surgery the week of May 16 or 23. We're waiting genetic tests that will dictate whether a lumpectomy or a bilateral mastectomy is the best option. (If I don't need a bilateral mastectomy, there is no outcome difference between lumpectomy and mastectomy on the affected side.) After that - radiation for 4-6 weeks (if I have a lumpectomy). Chemo is not likely (but was put back on the very edge of the table based on a tumor-specific genetic test they will likely order once it is removed.
I get to talk to the dietician tomorrow to help sort out when/whether I need to change my diet prior to surgery.
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I love your can do attitude!! That is so important in everything we do!! All my best wishes...you will kick it...I just know it!!!JaneKnoll1 wrote: »Wow you are inspirational and I have read about metformin maybe preventing cancer too. No doubt you will do amazing with fighting against cancer diagnosis @neohdiver. You kicked diabetes ton the curb and I have no doubt you will do the same. I definitely will google the info. You can have a look at my diary if you are interested..it's open to all. My very best wishes to you for good health and happiness...and when do you start your treatment?
Thanks!
I'll have surgery the week of May 16 or 23. We're waiting genetic tests that will dictate whether a lumpectomy or a bilateral mastectomy is the best option. (If I don't need a bilateral mastectomy, there is no outcome difference between lumpectomy and mastectomy on the affected side.) After that - radiation for 4-6 weeks (if I have a lumpectomy). Chemo is not likely (but was put back on the very edge of the table based on a tumor-specific genetic test they will likely order once it is removed.
I get to talk to the dietician tomorrow to help sort out when/whether I need to change my diet prior to surgery.0 -
great news1
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Thanks Margaret!!! I am seeing a dietician in a couple of weeks and she is going to review my diet and help with maintenance and make a plan based on all my running, swimming etc and calorie needs along with T2D considerations
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Congratulations on doing such a great job!!! I never used to be able to tolerate that many carbs and I don't know if it's the weight loss (now 74 lbs) or the exercise or just what but I am fairly strict with what I eat and not too much junk ask lots of Healthy fats.JaneKnoll1 wrote: »For anyone doing it with diet and exercise alone, did you reduce your carbs a bit more or? I am around 40-45 per meal and doing maintenance. I would love to hear thoughts on this.
Hi. I'm down from 2000g to 500-1500mg Metformin (depending on my BG readings).
I have found that for only 500mg to suffice, I have to incorporate a couple 16-hour fasts per week and keep:- net carbs below 50g per day, and
- protein below 100g per day (excess above that seems to get converted to glucose in my case)
I couldn't get away with 40g net carbs per meal ... unless I only ate once a day. Drat.
Obviously, your mileage may (and probably does) vary!
I keep keep my protein lower than 100 too...fats lol don't ask haha!
Anyway, my best wishes for your continued healthy journey. We can do this!!!!1 -
@JaneKnoll1
Sounds like you've found the magic wand!
Be careful to take dieticians' advice in context - from what I've heard from others, they may be constrained to follow USDA recommendations (which are too high in carbs for my pancreas!).
On the other hand, i did once have access to a dietician who was quite happy to start from the premise that a low-carb diet is necessary in many cases. (Unfortunately for me, but great for her, she left for NP school!)1 -
Thanks Ralf! Now I eat every 3 hours and averaging 40 carbs per meal/snack. I am shocked that I can eat that amount and by the 3 hour mark (when I have to eat again) it's returned to 4.4-5.3 (79.4-95.6) it's a bit higher after dinner but I eat the snack and my average fasting for this week is 4.9 so that makes me happy. I think the trick must be to keep carbs very consistent through the day at each snack and meal. I never/barely snacked before this....I was too afraid my sugar would be driven up and not have time to return to normal. At the two hour post meal mark sometimes it's mid to high 6 but rapidly falls after that..not sure that is optimal but that's what is happening. Telling tale is going to be my next doctors visit in end of July for A1C and checkup. Crossing my fingers that my post meal values are not going to drive it up. I hope hope I can manage without metformin but I will do whatever to keep healthy. My main goal.@JaneKnoll1
Sounds like you've found the magic wand!
Be careful to take dieticians' advice in context - from what I've heard from others, they may be constrained to follow USDA recommendations (which are too high in carbs for my pancreas!).
On the other hand, i did once have access to a dietician who was quite happy to start from the premise that a low-carb diet is necessary in many cases. (Unfortunately for me, but great for her, she left for NP school!)
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Update (just trying to contain my sprawl to one thread!)
I have now stopped the Blood Sugar Diet at 6 weeks, rather than 8, so that I can give my body what it needs to fight cancer and recover from surgery.
I was diagnosed with diabetes on Oct 2 with an A1C of 7.2 (firmly in the diabetic range - the cutoff for diabetes is 6.5).
As part of stopping the diet, I did a home OGTT. Normal BG, at 2 hours, is as high as 139; prediabetes as high as 199, and diabetes is anything over 200. At 2 hours, my BG was 161. So it is not just my imagination that over the past 6 weeks I have managed to partially reverse my diabetes.
So - once I get this pesky breast cancer taken care of - I'll do a second (full) 8 weeks to see if I can push it completely into remission.
Moving from intense dietary management toward remission feels good!1 -
JaneKnoll1 wrote: »Now I eat every 3 hours and averaging 40 carbs per meal/snack. I am shocked that I can eat that amount and by the 3 hour mark (when I have to eat again) it's returned to 4.4-5.3 (79.4-95.6) it's a bit higher after dinner but I eat the snack and my average fasting for this week is 4.9 so that makes me happy. I think the trick must be to keep carbs very consistent through the day at each snack and meal. I never/barely snacked before this....I was too afraid my sugar would be driven up and not have time to return to normal. At the two hour post meal mark sometimes it's mid to high 6 but rapidly falls after that..not sure that is optimal...I have now stopped the Blood Sugar Diet at 6 weeks, rather than 8, so that I can give my body what it needs to fight cancer and recover from surgery. ...
So - once I get this pesky breast cancer taken care of - I'll do a second (full) 8 weeks to see if I can push it completely into remission.
Now there's some inspiration!
@JaneKnoll1 - Kudos - words can hardly convey the bounds of my envy! (Your numbers, with your diet and without the first gram of metformin, might be mine only in another life.)
@neohdiver - Congrats on your progress. What does your current diet consist of?
Keep us posted on your progress, eh?
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@RalfLott I'm still sorting that out.
Since I'd been low carb since October, in order to do the OGTT I needed to eat between 100 and 150 carbs a day since the last day of the diet and the test today.
Because of the upcoming surgery, I need to be eating somewhere between 1200 and 1500 calories a day (I don't know exactly what maintenance will be - my scale says it is around 2000 calories, but I know it is not that high).
My plan (until I'm healed from surgery is to eat a higher calorie version of the blood sugar diet (largely Mediterranean style - colorful veggies, healthy fats, avoid starchy & sweet carbohydrates, include non-starchy ones). Higher carbs than I was eating before the 6 weeks on the blood sugar diet, but still relatively low. How many will depend on what my meter tells me I can tolerate. Best guess, maximum of 30-40 net carbs in a 3 hour window (depending on the kind of carbs - more of pulses, fewer simple carbs).
I haven't worked out whether I'll continue the 16:8 fasting. The dietitian at my old doctor's office suggested I needed to be eating relatively constantly. I don't trust that she is expressing health concern, as opposed to an ADA propagated prejudice. On the other hand, what the last few days have shown me is that if I want to eat higher carbs (including more pulses), I may need to spread them out over more hours merely because I have to have time to back off of a higher BG level back to something below 80 - or the next thing I eat adds to the remaining glucose from the prior. (I was rigidly eating a fixed quantity of carbs every 3 hours in a 12 hour window to get ~120 carbs in, and my body never had a chance to recover.)
Can't wait to see what my A1C is tomorrow morning - based on the numbers I've been recording (and adding some for dawn phenomenon that I don't always catch), it should be 5.3-5.43 -
Your attitude is amazing and you are inspirational!!0
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My plan (until I'm healed from surgery is to eat a higher calorie version of the blood sugar diet (largely Mediterranean style - colorful veggies, healthy fats, avoid starchy & sweet carbohydrates, include non-starchy ones). Higher carbs than I was eating before the 6 weeks on the blood sugar diet, but still relatively low. How many will depend on what my meter tells me I can tolerate. Best guess, maximum of 30-40 net carbs in a 3 hour window (depending on the kind of carbs - more of pulses, fewer simple carbs).
I haven't worked out whether I'll continue the 16:8 fasting. The dietitian at my old doctor's office suggested I needed to be eating relatively constantly. I don't trust that she is expressing health concern, as opposed to an ADA propagated prejudice. On the other hand, what the last few days have shown me is that if I want to eat higher carbs (including more pulses), I may need to spread them out over more hours merely because I have to have time to back off of a higher BG level back to something below 80 - or the next thing I eat adds to the remaining glucose from the prior. (I was rigidly eating a fixed quantity of carbs every 3 hours in a 12 hour window to get ~120 carbs in, and my body never had a chance to recover.)
@neohdiver - Your coments have me wondering...
For most of us T2Ds, there must be formulas for balancing the dietary what-and-when variables that affect BG - carb- and protein-abstinence and fasting (leaving aside non-dietary factors like weight loss, sleep, meditation, meds, nutritional needs of other medical conditions, etc.) - that will keep our BG under control and allow us to avoid the complications of T2D.
I feel pretty sure that if I ate only fat, my BG wouldn't spike, and if I ate only a teaspoon of maple syrup every two days or a drop every two hours, the long-term effect on my BG probably won't be conspicuous. But those aren't very useful formulas....
Did you make inroads toward finding a formula that let you eat as many carbs as possible without pushing your BG too high? (Or did the recipe you've described here pretty much fit the bill?)
Let us know how your A1c turns out.
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My plan (until I'm healed from surgery is to eat a higher calorie version of the blood sugar diet (largely Mediterranean style - colorful veggies, healthy fats, avoid starchy & sweet carbohydrates, include non-starchy ones). Higher carbs than I was eating before the 6 weeks on the blood sugar diet, but still relatively low. How many will depend on what my meter tells me I can tolerate. Best guess, maximum of 30-40 net carbs in a 3 hour window (depending on the kind of carbs - more of pulses, fewer simple carbs).
I haven't worked out whether I'll continue the 16:8 fasting. The dietitian at my old doctor's office suggested I needed to be eating relatively constantly. I don't trust that she is expressing health concern, as opposed to an ADA propagated prejudice. On the other hand, what the last few days have shown me is that if I want to eat higher carbs (including more pulses), I may need to spread them out over more hours merely because I have to have time to back off of a higher BG level back to something below 80 - or the next thing I eat adds to the remaining glucose from the prior. (I was rigidly eating a fixed quantity of carbs every 3 hours in a 12 hour window to get ~120 carbs in, and my body never had a chance to recover.)
@neohdiver - Your coments have me wondering...
For most of us T2Ds, there must be formulas for balancing the dietary what-and-when variables that affect BG - carb- and protein-abstinence and fasting (leaving aside non-dietary factors like weight loss, sleep, meditation, meds, nutritional needs of other medical conditions, etc.) - that will keep our BG under control and allow us to avoid the complications of T2D.
I feel pretty sure that if I ate only fat, my BG wouldn't spike, and if I ate only a teaspoon of maple syrup every two days or a drop every two hours, the long-term effect on my BG probably won't be conspicuous. But those aren't very useful formulas....
Did you make inroads toward finding a formula that let you eat as many carbs as possible without pushing your BG too high? (Or did the recipe you've described here pretty much fit the bill?)
Let us know how your A1c turns out.
I am making a distinction between dietary management and remission.
For dietary management, it is a matter of continuously testing new items to see how I react. From October through late March, I could pretty much tolerate up to 20 net carbs in any 3 hour window. I set my tolerance for BG elevation (140), and if anything bumped it over that limit I either cut the quantity or didn't eat it again. Once I'd tested something, it went in my predictable foods so I didn't need to test every time I ate it. Protein and fat don't seem to directly impact my blood glucose (aside from the ability to buffer slightly higher carbs - or to drop a higher blood glucose down if I need to.) Alcohol, on the other hand, gives me about a 30 gram gain in carb tolerance during the period when my liver is processing the alcohol. (So, for a special occasion, I could have a glass of wine that would give me the ability to also eat a piece of bread without bumping my blood glucose up.)
What I'm working on now is remission - on a daily basis being able to eat whatever I feel like eating without elevating my blood glucose. I appear to be halfway there (from diabetes down to prediabetes). Now that I'm convinced I have made progress, I am hopeful I can make it the rest of the way. The ability to eat whatever I feel like doesn't mean I will. Just like remission for any other disease, if I achieve it I expect to always be on the verge of tipping back over into active disease - so I would exercise my ability to eat what I feel like only occasionally.
As to the other factors - sleep deprivation and stress definitely have a negative impact on my blood glucose. Sleep deprivation I can't do much about at the moment (I started the semester with a 30% increase in work over what was already impossible to manage. I calculated it would take me 80 hours a week just for grading - and that turns out to be an underestimate. Then I started down the cancer diagnosis path, which has eaten up more than 20 hours a week for the past month and a half. Grades are due in 2 days - I have no option but to be sleep deprived.) Stress, on the other hand, I dramatically reduced by firing my doctor (I would have loved to keep her and fire her administrative staff - but that was not an option.)0 -
Let us know how your A1c turns out.
Not as well as I'd hoped - it was 5.6 (only .1 below last time). I'm surprised, since I thought I'd done a better job of catching representative dawn phenomenon samples so my meter average would be closer to the A1c. Oh well - it is normal, at any rate.0 -
Protein and fat don't seem to directly impact my blood glucose (aside from the ability to buffer slightly higher carbs - or to drop a higher blood glucose down if I need to.)
@neohdiver - Thanks.
I was not aware of any food one can eat to lower BG. How does this work?0 -
Protein and fat don't seem to directly impact my blood glucose (aside from the ability to buffer slightly higher carbs - or to drop a higher blood glucose down if I need to.)
@neohdiver - Thanks.
I was not aware of any food one can eat to lower BG. How does this work?
Not everyone reacts the same way, but nuts - particularly almonds - drive my BG down. If I want to be sure I'm safe to eat a large salad, and my BG is over 100, I'll eat 15 oz or so of almonds and it will drop about 20 points within 30 minutes or so.
I can also sometimes buffer higher carb things by combining them (or preceding them) with cheese. It is not as reliable - but works maybe half the time.
Alcohol temporarily turns off the glucose factory in my liver, so taken alone it will drop my blood glucose. Taken with a meal, it drops about 30 carbs worth of glucose out of the picture - so the meal-time elevation is only from the carbohydrates I'm consuming - not the background level of glucose my liver is pumping out all the time to keep me from going hypo.
Those 3 things work the same way for quite a few (but not all) people with diabetes - I found them on my own by experimenting and then I started comparing my experience with others' (especially with the alcohol, since it had the opposite effect I expected when I drank a relatively sweet white wine).
I'm not sure what is going on with the nuts (combination of fat, carb, and protein - and purely a drop in BG). With the fat it spreads out the glucose processing so it occurs over a longer period of time but doesn't get as high.1 -
You are a sourceProtein and fat don't seem to directly impact my blood glucose (aside from the ability to buffer slightly higher carbs - or to drop a higher blood glucose down if I need to.)
@neohdiver - Thanks.
I was not aware of any food one can eat to lower BG. How does this work?
Not everyone reacts the same way, but nuts - particularly almonds - drive my BG down. If I want to be sure I'm safe to eat a large salad, and my BG is over 100, I'll eat 15 oz or so of almonds and it will drop about 20 points within 30 minutes or so.
I can also sometimes buffer higher carb things by combining them (or preceding them) with cheese. It is not as reliable - but works maybe half the time.
Alcohol temporarily turns off the glucose factory in my liver, so taken alone it will drop my blood glucose. Taken with a meal, it drops about 30 carbs worth of glucose out of the picture - so the meal-time elevation is only from the carbohydrates I'm consuming - not the background level of glucose my liver is pumping out all the time to keep me from going hypo.
Those 3 things work the same way for quite a few (but not all) people with diabetes - I found them on my own by experimenting and then I started comparing my experience with others' (especially with the alcohol, since it had the opposite effect I expected when I drank a relatively sweet white wine).
Well, that is pretty interesting! I understand lowering the glycemic content of a meal by thinning out the carbs with fats, fiber, and protein. But the idea that nuts could drive down your BG is a new one. Could you eat some almonds after fasting for, say, 4-6 hours, and have your BG drop?
Also, how much alcohol do you need to do the trick?
Thx again!
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Almonds keep my BS stable...I don't think it drives it down but it keeps it lower than if I don't eat them. 1 oz daily...it's about 24 almonds!!You are a sourceProtein and fat don't seem to directly impact my blood glucose (aside from the ability to buffer slightly higher carbs - or to drop a higher blood glucose down if I need to.)
@neohdiver - Thanks.
I was not aware of any food one can eat to lower BG. How does this work?
Not everyone reacts the same way, but nuts - particularly almonds - drive my BG down. If I want to be sure I'm safe to eat a large salad, and my BG is over 100, I'll eat 15 oz or so of almonds and it will drop about 20 points within 30 minutes or so.
I can also sometimes buffer higher carb things by combining them (or preceding them) with cheese. It is not as reliable - but works maybe half the time.
Alcohol temporarily turns off the glucose factory in my liver, so taken alone it will drop my blood glucose. Taken with a meal, it drops about 30 carbs worth of glucose out of the picture - so the meal-time elevation is only from the carbohydrates I'm consuming - not the background level of glucose my liver is pumping out all the time to keep me from going hypo.
Those 3 things work the same way for quite a few (but not all) people with diabetes - I found them on my own by experimenting and then I started comparing my experience with others' (especially with the alcohol, since it had the opposite effect I expected when I drank a relatively sweet white wine).
Well, that is pretty interesting! I understand lowering the glycemic content of a meal by thinning out the carbs with fats, fiber, and protein. But the idea that nuts could drive down your BG is a new one. Could you eat some almonds after fasting for, say, 4-6 hours, and have your BG drop?
Also, how much alcohol do you need to do the trick?
Thx again!
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