Disappointed, A1c up and back on Glucophage.
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KetoGirl83
Posts: 546 Member
Went to the doctor yesterday and my A1c (a measure of blood sugars) actually went up since last check 3 months ago. Not terribly, just from 5.5 to 5.6.
BUT it is a step in the wrong direction and those 3 months include one of zero carb where blood sugars were better than average (doc doesn't know about that) so something is not going well. It's those darn fasting numbers that refuse to get controlled and who knows whatever happens during the night.
It also explain (some) why weight has been going down so slooooowly (±2kg~5lbs /month).
I'm not on medication and would like to keep that way but perfect blood sugars are important to prevent diabetic degenerative problems so I'm back on Glucophage (metformin). I'll try the extended release formula and see what happens.
I'm feeling disappointed, tired and depressed. Avoiding medication was the whole reason for my drastic diet change.
BUT it is a step in the wrong direction and those 3 months include one of zero carb where blood sugars were better than average (doc doesn't know about that) so something is not going well. It's those darn fasting numbers that refuse to get controlled and who knows whatever happens during the night.
It also explain (some) why weight has been going down so slooooowly (±2kg~5lbs /month).
I'm not on medication and would like to keep that way but perfect blood sugars are important to prevent diabetic degenerative problems so I'm back on Glucophage (metformin). I'll try the extended release formula and see what happens.
I'm feeling disappointed, tired and depressed. Avoiding medication was the whole reason for my drastic diet change.
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So you are on metformin?
That is a great drug.
I used to be type 2 and worked with my Dr to reverse it
A key in the process was cardio, high heart rate cardio that burns glycogen out of your system.
You may want to consider doing high intensity cardio and HIIT. It really was the thing that helped me get down to 85 as my fasted blood sugar level and low 5's for A1C
I hope to be in the high 4's next time
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@professionalHobbyist thank you for the encouragement.
It was a hit because I see everywhere that T2 is reversed or at least controlled by low carb alone. I know metformin is the least evil of the diabetic drugs but I would very much prefer to take no drugs.
It's been such an effort, I stopped eating every one of my favourite foods, changed my whole diet, and now eat mostly foods that I never had before and still don't like. It was all worth it, as long as that allowed me to keep the no drugs rule. But to have A1c going up after being for 8 months on less than 50g carbs/day, usually less than 20g? What's left, zero carb for life?
I understand the value of high intensity cardio for glycogen control and have been trying my best. Sadly, my best is really not much. I have absolutely no endurance and a few minutes of barely cardio is my highest effort. High intensity would have me on my way to the cardiac ward.
I'm feeling depressed and out of control. I'll be having a few days vacation and was planning to relax a bit, perhaps eat a bit more fruit and vegetables. But no, it's a heat wave and I'll be having steak.
Ok, rant over, sorry about that. Had to take it out.0 -
I am not a T2, but have been borderline at several points in my life. Interestingly, not when overweight, like I have been now for 20 years (though never this heavy) but twice from pregnancies and intermittently since age of 5.
It might not be related to eating per se, but hormonal regulation that is outside your control. If you can't add the higher intensity exercise, or longer duration, then don't think of Metformin as a defeat. Your numbers are SO CLOSE to perfect. It is what will save your eyes, your heart, prevent peripheral neuropathies, etc., etc. You have taken control of your eating and your health and future. You are not failing.
You are an inspiration to me.0 -
Actually, the hormonal bit mentioned above might play in. Next time, have them check your hormones and thyroid (related). It can affect all of this. Inositol is a supplement (B8) that can help balance hormones, but I don't know what all it might conflict with (only conflicts I've found are hormonal medications)... Worth an ask.0
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Sorry to hear how challenging it all is
I guess you can do your best and that is the best you can do
If you can slot build up exercise capacity maybe that can bring new hope to you
I started at 325+ pounds and and in the 190's now
I could not do more than walk a short distance at first.
And since we are talking hormones, it was explained to me that people often have a hormone dump around 3-4 in the morning as a part of a normal night of sleep.
So I would have higher sugar upon waking and then burn it all off to normal with my morning treadmill time
Then I could start burning off fat!0 -
@jennybird99 thank you, that is so sweet! I know my numbers are not bad, the doc used that same expression "almost perfect". But she doesn't know that I eat VLC. They're (considered to be) good results for someone eating SAD or the high carb diet prescribed to diabetics, not for someone who eats almost no carbs. Because that is an average number it can mean stable sugars (as for someone with normal non diabetic blood sugar) and most docs see no further. But I know that my values during the day are good so to have that average means that during the night I have probably both very highs and lows, and that is not good. Bernstein (a famous diabetes doc who is himself T1 diabetic) puts no risk for diabetic complications at A1c 4.5, certainly no higher than 4.8.
@KnitOrMiss thank you. I have to insist, they definitely don't like suggestions/requests from patients. "So, and where have you seen that? Doctor Google again?", said in a condescending tone, is a typical answer.
@professionalHobbyist it is so great to see examples like yours. VLC has been working for me too and it is the only thing that ever did. I will prevail, this whining is temporary.
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what is your fasting insulin level? Watch Dr. Sarah Hallberg on youtube. Great TED talk on how she manages her patients with insulin resistance and diabetes.
How many carbs are you eating/day? You have to find your sweet spot for carb level.0 -
(((((KetoGirl83)))))
It will get better because you will be better!
Hang in there0 -
KetoGirl83 wrote: »@jennybird99 thank you, that is so sweet! I know my numbers are not bad, the doc used that same expression "almost perfect". But she doesn't know that I eat VLC. They're (considered to be) good results for someone eating SAD or the high carb diet prescribed to diabetics, not for someone who eats almost no carbs. Because that is an average number it can mean stable sugars (as for someone with normal non diabetic blood sugar) and most docs see no further. But I know that my values during the day are good so to have that average means that during the night I have probably both very highs and lows, and that is not good. Bernstein (a famous diabetes doc who is himself T1 diabetic) puts no risk for diabetic complications at A1c 4.5, certainly no higher than 4.8.
@KnitOrMiss thank you. I have to insist, they definitely don't like suggestions/requests from patients. "So, and where have you seen that? Doctor Google again?", said in a condescending tone, is a typical answer.
@professionalHobbyist it is so great to see examples like yours. VLC has been working for me too and it is the only thing that ever did. I will prevail, this whining is temporary.
:noway: I'd drop that doctor like a ton of bricks and get a new one (in fact, I've done exactly that on several occasions). Doctors are not gods and any who act that way don't deserve your business.
Inositol has been well-studied and there are a number of studies published on PubMed about it, though, if you want to print them out for a sort of "read it and weep" gesture, though. This is a good place to start (with various links to the studies -- http://examine.com/supplements/Inositol/).
Thankfully, Inositol is pretty cheap and available over the counter, so it doesn't really matter what the doctor has to say about it. They won't be a barrier to getting it should you decide to try it.It also explain (some) why weight has been going down so slooooowly (±2kg~5lbs /month).
Am I understanding this right? You're losing 5lbs a month and saying it's slow enough that you think something is wrong?
5lbs a month is 1.25lb a week, which is actually a good pace (and falls within the 1-2lb/week recommendation).0 -
You all lovely ladies -and gentleman, are awesome. Thank you so much for being here and being so supportive.
I don't know my fasting insulin and I also don't know about inositol. But I will find out!
Thank you all so, so much!
::flowerforyou::0 -
Dragonwolf wrote: »KetoGirl83 wrote: »@jennybird99 thank you, that is so sweet! I know my numbers are not bad, the doc used that same expression "almost perfect". But she doesn't know that I eat VLC. They're (considered to be) good results for someone eating SAD or the high carb diet prescribed to diabetics, not for someone who eats almost no carbs. Because that is an average number it can mean stable sugars (as for someone with normal non diabetic blood sugar) and most docs see no further. But I know that my values during the day are good so to have that average means that during the night I have probably both very highs and lows, and that is not good. Bernstein (a famous diabetes doc who is himself T1 diabetic) puts no risk for diabetic complications at A1c 4.5, certainly no higher than 4.8.
@KnitOrMiss thank you. I have to insist, they definitely don't like suggestions/requests from patients. "So, and where have you seen that? Doctor Google again?", said in a condescending tone, is a typical answer.
@professionalHobbyist it is so great to see examples like yours. VLC has been working for me too and it is the only thing that ever did. I will prevail, this whining is temporary.
:noway: I'd drop that doctor like a ton of bricks and get a new one (in fact, I've done exactly that on several occasions). Doctors are not gods and any who act that way don't deserve your business.
Inositol has been well-studied and there are a number of studies published on PubMed about it, though, if you want to print them out for a sort of "read it and weep" gesture, though. This is a good place to start (with various links to the studies -- http://examine.com/supplements/Inositol/).
Thankfully, Inositol is pretty cheap and available over the counter, so it doesn't really matter what the doctor has to say about it. They won't be a barrier to getting it should you decide to try it.It also explain (some) why weight has been going down so slooooowly (±2kg~5lbs /month).
Am I understanding this right? You're losing 5lbs a month and saying it's slow enough that you think something is wrong?
5lbs a month is 1.25lb a week, which is actually a good pace (and falls within the 1-2lb/week recommendation).
I love that article, @Dragonwolf, but it still disturbs me to how there is no mention of the Inositol interfering with hormonal birth control, yet, clearly, from my own personal experience, it does this to quite scary effects. I'm sure I can't be isolated in that. I never had the issue with the pill form until I jumped my dosage significantly, but even the 600 mg dosage in powder form after a week or two starts to have the same interactions. There is no way I can get anywhere close to the recommended dosages for the mitigation of any issues this helps with. SO FRUSTRATING...0 -
Two thoughts here. First, it's important to understand that while A1c is sometimes described as a snapshot of the previous 3-4 months of blood glucose activity, the fact is that it's heavily weighted toward only the previous two weeks. So if your BG has been even somewhat higher over the past few weeks, it will influence the results.
Second, I agree completely with professionalHobbyist's suggestion for exercise. Any exercise, even 5 minutes of light cardio a few days a week, will have an impact. Stronger muscles use glucose more efficiently. You don't need to start with a lot of strenuous HIIT (I didn't), but you should be doing some sort of activity to optimize your system.
On a final note, I'm surprised your doctor is suggesting you start on a drug when your A1c is only 5.6. Mine was 12.5 at one point last year (it's now 5.4), and even then my doctor suggested I try some dietary changes before he would consider a prescription. 5.6 is not high. It's just a tad above what's considered non-diabetic. But that's kind of what doctors do, isn't it?
Personally, I think you're doing great, and if you can somehow manage to get a little exercise in, you could easily get yourself into the normal range.0 -
I found this interesting. http://chriskresser.com/why-hemoglobin-a1c-is-not-a-reliable-marker/0
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KetoGirl83 wrote: »Went to the doctor yesterday and my A1c (a measure of blood sugars) actually went up since last check 3 months ago. Not terribly, just from 5.5 to 5.6.
BUT it is a step in the wrong direction and those 3 months include one of zero carb where blood sugars were better than average (doc doesn't know about that) so something is not going well. It's those darn fasting numbers that refuse to get controlled and who knows whatever happens during the night.
It also explain (some) why weight has been going down so slooooowly (±2kg~5lbs /month).
I'm not on medication and would like to keep that way but perfect blood sugars are important to prevent diabetic degenerative problems so I'm back on Glucophage (metformin). I'll try the extended release formula and see what happens.
I'm feeling disappointed, tired and depressed. Avoiding medication was the whole reason for my drastic diet change.
I wish I had your numbers.
Dan the Man from Michigan
Keto / IF / Sedentary0 -
KetoGirl83 wrote: »I'm not on medication and would like to keep that way but perfect blood sugars are important to prevent diabetic degenerative problems so I'm back on Glucophage (metformin). I'll try the extended release formula and see what happens.
Everyone who keeps asking why she's on medication with her numbers is that she is preventing degenerative problems, to which I read in that she has genetic tendency or added risk for these issues. If that's not the case, I apologize...0 -
Most of us with diabetes are trying to prevent degenerative problems. What I'm failing to understand is why her doctor feels the need to put her on metformin with borderline numbers. That by itself makes no sense.KnitOrMiss wrote: »Everyone who keeps asking why she's on medication with her numbers is that she is preventing degenerative problems, to which I read in that she has genetic tendency or added risk for these issues. If that's not the case, I apologize...
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Yeah, my endo agreed with me stopping metformin with my A1c of 5.1%, Estimated Mean Plasma Glucose of 104, Fasting Glucose of 92, and Fasting Insulin of 7.1 (was 9 about a year prior) - whereas my PCP flipped out on me. She positively couldn't believe my endo allowed me to stop the Metformin (well, I had stopped it 4-6 weeks before the tests, but he was okay with me staying off it), and she was flipping out - even though she had never run a fasting insulin test herself. (All numbers have been up and down slightly from previous tests, but small increments.)
A year before was CICO diet. Six months before was maintenance, and I'd been low carb 3 months before these tests.
My A1c had been 5.1% a year before, and 5.3% six months before, so it was back down slightly.
EMPG was 97 back in 2011; 104 a year before, and 111 six months before.
Fasting glucose has steadily gone up slowly since 81 in 2009 to 90 six months before this test. Doc wasn't as concerned about this since A1c is still showing improvement.
My fasting insulin, as said above was 9 a year prior, 7.6 six months prior, so trending down with my weight losses, regardless of method.
So looking at it, Keto made my numbers go up in some areas, but down overall, so I don't really know what all these numbers mean. I do have risk of diabetes in my family, but the Metformin was added due to my insulin resistance, not diabetes risk, and more due to symptoms than bloodwork (combination, but was symptom driven...)
@KetoGirl83 It looks like our numbers are similar.... Have you been diagnosed as diabetic or prediabetic? I'm just curious....0 -
KetoGirl said she did not know fasting insulin number. That would be an important number to know. I am new to the LC diet specifically to reduce my overall blood sugars. The last few weeks have drastically lowered my numbers but overnight fasting level is still too high and was hoping for answers on this thread. In my research, I did find one article I'd like to share since I thought it made a lot of sense: http://www.healthline.com/diabetesmine/thriving-with-too-little-making-the-most-of-your-test-strips#1
Basically, it states there is no way only 1 test strip a day is going to give you useful info and that the fasting level can be very different than during the day glucose levels. At the end of the article, the author recommends following a 3 day track, using 21 of those insurance covered test strips to get a clear picture of exactly how your body responds to actual food, exercise and overnight effects including Dawn Phenomenon. Well written and thought it might help someone looking for a few answers.0 -
My dr let me know that many people have a 4:00 am hormone dump. That will cause my number to be maybe 110 when my A1C tests at 5.2.
He said not to worry so much about that as the A1C. Losing weight and fat burning raises glucose but lowers A1C
He was right about all that because my type 2 diabetes has been reversed
I'm normal now after 3 years as type 2
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LynnSullivan1 wrote: »KetoGirl said she did not know fasting insulin number. That would be an important number to know. I am new to the LC diet specifically to reduce my overall blood sugars. The last few weeks have drastically lowered my numbers but overnight fasting level is still too high and was hoping for answers on this thread. In my research, I did find one article I'd like to share since I thought it made a lot of sense: http://www.healthline.com/diabetesmine/thriving-with-too-little-making-the-most-of-your-test-strips#1
Basically, it states there is no way only 1 test strip a day is going to give you useful info and that the fasting level can be very different than during the day glucose levels. At the end of the article, the author recommends following a 3 day track, using 21 of those insurance covered test strips to get a clear picture of exactly how your body responds to actual food, exercise and overnight effects including Dawn Phenomenon. Well written and thought it might help someone looking for a few answers.
That is interesting. It doesn't take long to conclude that testing once per day an cycling through the possible test times provides almost no useful information. Since I'm controlled with diet only and regular in my eating and activity levels, I began doing a set of six once per week and some clearer patterns emerged. Going to a set of 21 once every 3 weeks is intriguing but a bit scary.
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