Just started medication for Type 2

[Shadynook]

Hi my names Kate I’m 70 and have been pre-diabetic for about 6 years controlling it with diet and exercise. About 3 years ago I lost about 2 stone (weighed 12stone) and managed to reverse it. The weight gradually went up, put about a stone back on, couldn’t stick to 800 calories a day!! Had a blood test a couple of weeks ago and my blood glucose was slightly elevated (5.8) doctor advised I contact the diabetic nurse. She advised me to start medication as blood sugar has been rising gradually over last couple of years. I’d heard quite a lot of bad reports about Metformin so she prescribed Dapagliflozin 10mg. Been taking them for 4 days and Cranberry capsules as side effect can be UTI and thrush. I have been feeling quite nauseous and no appetite, tired and slight palpitation. I have recently started taking Lisinopril for high blood pressure. Took about 6 different medications before I found one that didn’t have awful side effects.
I am trying to accept that I need to be on diabetic medication to protect my organs, eyes, feet, etc but I do wish I could manage it with diet and exercise. Anyone else on this medication?

 

[PattiEvans]

Hello @Shadynook did the nurse give you any dietary advice? you don't have to live on 800 calories. However I am sure some of the T2s will be along soon to give more specific advice. Welcome and ask lots of questions

 

[rebrascora]

Hi and welcome

Can you clarify that reading as 5.8 and what sort of test was done... ie a finger prick or a sample from your arm sent off to the lab? The reason I ask is that 5.8 would be a perfectly reasonable Blood Glucose reading in the non diabetic range. My guess is that it is an HbA1c test and the result is perhaps 58.... which is slightly elevated (48 is the red line for a diabetes diagnosis) I am surprised that they have started you on medication at that level although I guess you told them that you were struggling to maintain control through diet and exercise.

I wonder what sort of dietary advice you were following and if perhaps the forum could help you to improve that so that you don't need the medication. Unfortunately NHS dietary advice for diabetes is not always helpful and of course the last year with the pandemic and lockdowns has made people more inclined to comfort eat, so totally understandable that you put some weight back on.

If you can give us an idea of the sort of things you typically eat for breakfast, lunch and evening meal, we could perhaps see where your problem areas are and suggest swaps for lower carb alternatives.

Many people don't appreciate that diabetes is not just about sugar but all carbohydrates we consume, which get broken down into glucose by our digestive system and migrate into our blood stream where they are not as efficiently removed to provide energy as a non diabetic person. So bread, pasta, rice and potatoes, even the healthy wholemeal/brown/sweet versions will spike our BG levels as will the natural sugars in fruit. Reducing portion size of these complex carbs as well as the cakes and biscuits and sweets will make a big difference to your diabetes management. To make up for the loss of bulk from our plates and reduced calories we eat more leafy green veg and a bit more fat. The great thing about fat is that it takes much longer to digest than carbs and provides good slow release energy so it keeps you feeling full for longer, it slows the rate at which the carbs you do eat release their glucose and it tastes good, so it doesn't feel like you are being deprived... therefore it becomes a sustainable way of eating longer term. For instance, I have real double cream in my morning coffee instead of milk. Cream is lower carb than milk, gives me energy and makes me feel indulged! Then I have creamy whole milk Greek style natural yoghurt for breakfast with a few berries which are some of the lowest car fruits.... typically about 6-8 raspberries or at the moment rhubarb from the garden stewed with a little sweetener and root ginger. I also have chopped nuts or mixed seeds in my yoghurt and sometimes a sprinkle of cocoa or cinnamon.

Lunch might be an omelette with whatever I have in the fridge but usually includes onion and mushrooms and cheese with a variety of other veg and/or meat with a large salad and creamy cheese coleslaw. (I don't buy anything low fat these days and I now have the figure I had in my 20s and feel 20yrs younger and fitter than I have for many years.... eating more fat and less carbs

Dinner might be meat or salmon (generally fatty meat/oily fish) with green veg (usually with a good knob of biutter or a dollop of cream cheese) or maybe just a chunk (or two) of some nice cheeses with a glass of red wine and/maybe some soup (no bread) which is what I had last night (avoiding soups with potato or pasta).

Best of all I don't feel hungry even if I skip lunch, so I don't find it difficult to stick to and I have more energy.

Anyway, that is just what works for me. Many people here find a BG meter invaluable in working out which foods and what portion size of carbs works for them and their diabetes and it can be highly individual, so I would absolutely advocate that to give you knowledge to control your BG levels through diet. I appreciate that you are currently on dapa but there is no reason why that has to be for life if you are able to find a sustainable way of eating which will control your BG levels. Many members here have come off medication once they got their diet figured out and working for them.

 

[everydayupsanddowns]

Welcome to the forum @Shadynook 🙂

Sorry to hear about your diagnosis. Sounds like you did amazingly to lose that weight, what a shame it wasn’t sustainable for you. We have members who have managed to follow the 800cal approach for weight loss, but I think it is a strategy that needs careful handling when transitioning to a maintenance phase.

The ‘gliflozins’ do seem to cause nausea and a loss of appetite in some people.

Sorry to hear what a tough time you’ve had finding medications that suit you.

 

[Shadynook]

Hi and welcome

Can you clarify that reading as 5.8 and what sort of test was done... ie a finger prick or a sample from your arm sent off to the lab? The reason I ask is that 5.8 would be a perfectly reasonable Blood Glucose reading in the non diabetic range. My guess is that it is an HbA1c test and the result is perhaps 58.... which is slightly elevated (48 is the red line for a diabetes diagnosis) I am surprised that they have started you on medication at that level although I guess you told them that you were struggling to maintain control through diet and exercise.

I wonder what sort of dietary advice you were following and if perhaps the forum could help you to improve that so that you don't need the medication. Unfortunately NHS dietary advice for diabetes is not always helpful and of course the last year with the pandemic and lockdowns has made people more inclined to comfort eat, so totally understandable that you put some weight back on.

If you can give us an idea of the sort of things you typically eat for breakfast, lunch and evening meal, we could perhaps see where your problem areas are and suggest swaps for lower carb alternatives.

Many people don't appreciate that diabetes is not just about sugar but all carbohydrates we consume, which get broken down into glucose by our digestive system and migrate into our blood stream where they are not as efficiently removed to provide energy as a non diabetic person. So bread, pasta, rice and potatoes, even the healthy wholemeal/brown/sweet versions will spike our BG levels as will the natural sugars in fruit. Reducing portion size of these complex carbs as well as the cakes and biscuits and sweets will make a big difference to your diabetes management. To make up for the loss of bulk from our plates and reduced calories we eat more leafy green veg and a bit more fat. The great thing about fat is that it takes much longer to digest than carbs and provides good slow release energy so it keeps you feeling full for longer, it slows the rate at which the carbs you do eat release their glucose and it tastes good, so it doesn't feel like you are being deprived... therefore it becomes a sustainable way of eating longer term. For instance, I have real double cream in my morning coffee instead of milk. Cream is lower carb than milk, gives me energy and makes me feel indulged! Then I have creamy whole milk Greek style natural yoghurt for breakfast with a few berries which are some of the lowest car fruits.... typically about 6-8 raspberries or at the moment rhubarb from the garden stewed with a little sweetener and root ginger. I also have chopped nuts or mixed seeds in my yoghurt and sometimes a sprinkle of cocoa or cinnamon.

Lunch might be an omelette with whatever I have in the fridge but usually includes onion and mushrooms and cheese with a variety of other veg and/or meat with a large salad and creamy cheese coleslaw. (I don't buy anything low fat these days and I now have the figure I had in my 20s and feel 20yrs younger and fitter than I have for many years.... eating more fat and less carbs

Dinner might be meat or salmon (generally fatty meat/oily fish) with green veg (usually with a good knob of biutter or a dollop of cream cheese) or maybe just a chunk (or two) of some nice cheeses with a glass of red wine and/maybe some soup (no bread) which is what I had last night (avoiding soups with potato or pasta).

Best of all I don't feel hungry even if I skip lunch, so I don't find it difficult to stick to and I have more energy.

Anyway, that is just what works for me. Many people here find a BG meter invaluable in working out which foods and what portion size of carbs works for them and their diabetes and it can be highly individual, so I would absolutely advocate that to give you knowledge to control your BG levels through diet. I appreciate that you are currently on dapa but there is no reason why that has to be for life if you are able to find a sustainable way of eating which will control your BG levels. Many members here have come off medication once they got their diet figured out and working for them.

Hi Barbara - thank you so much for your reply and it was a HbA1c blood test so the reading must have been 58. I must admit during the last 12/18 months I have eaten ‘normally’ ie white bread rice pasta ice cream cake biscuits crisps but all in moderation!! I can be very strict with myself when I put my mind to it, I’ve done it before and can do it again. I think your eating plan would be very achievable and I could make it a diet for life! I know it would have to be if I want to control my BG without meds.
I had to become quite forceful with this particular diabetic nurse about 2 years ago as she insisted I go on meds and I really didn’t want to. I ended up walking away so it would give me pleasure to show her I can do it!!
If I follow a similar diet to yours and not the very strict 800 diet how do I get off the meds? She said she will do tests in 3 months but if my BG has dropped will she think it’s the meds rather than change in diet/exercise? I walk most days, briskly for at least 30 minutes as I live in the countryside and only have to cross a road and I’m in beautiful fields.
I do appreciate your interest and look forward to your reply.
Kate x

 

[Leadinglights]

As your HbA1c is not massively high you could perhaps suggest you be given the opportunity to try by diet for the three months. From what you say by cutting or reducing those foods you have been eating and making some low carb substitutions should make a huge difference along with your positive attitude to tackling the situation. It is better to reduce your levels slowly as rapid glucose reduction can cause vision problems for some people.

 

[rebrascora]

So pleased you feel motivated to get on top of your diet again.

I think you have 2 options:-

You stop taking the medication with or without discussion with your Health Care Professionals.

You take the medication for 3 months alongside your improved diet and then if your results are good, you negotiate a cessation of the medication for the next 3-6 months with an agreed HbA1c test at the end of that period to check how you are doing.

Whilst I appreciate that HCPs do what they think is best to treat your condition, diabetes is something which is best managed day by day and meal by meal by the patient with support from their medical clinicians and you do have a say in that treatment plan. No one can force you to take medication, just like they can't force you to follow a particular diet. You are an important participant and in fact should be the leading partner in your diabetes treatment. HCPs are used to being in charge and they often don't like it when the patient challenges that, but it is their role to support you and you have a right to decide on your treatment.
If your HbA1c was high, like 70+, it would be another matter, but 58 doesn't put you in the danger zone and is certainly within reach of prediabetic if not normal levels in the 3 month period. You could also argue that you have reduced your levels through diet and exercise previously, so you have shown that you can do it. Where you failed before was not finding a sustainable diet and this was likely through lack of appropriate advice/knowledge. Hopefully we can help you figure out a way to make it an enjoyable new way of life, rather than a "diet".

Good luck whatever you decide. If you don't want to confront the nurse with a decision to stop the medication you could send an email or letter explaining your decision and the reasoning behind it (ie. that you are suffering with side effects (nausea etc) and have had success with lifestyle changes before but that the nature of the last year, lockdown etc. has caused you to slip a bit with your healthy choices but that you are now motivated to improve your diet and exercise plan again and feel that a hiatus in medication would not be unreasonable for a 3 month period to give you that opportunity. That you are happy to review your treatment plan at the end of that time and if no progress has been made, then reassess the medication situation. It might sweeten it a bit to end by saying that you very much appreciate their help and support with your diabetes management and look forward to showing some good progress when you next see them.

If you don't already have a BG meter, it would be a good idea to get yourself one so that you can self monitor and not just get an idea of how well your lifestyle changes are working but also use it to tailor your diet to your body's individual tolerance for different types of carbs.... and it can vary significantly from one diabetic person to another. The two meters most often recommended by people who self fund on the forum for reliability and economy of use are the Gluco Navii or the Spirit Healthcare Tee2. Both can be purchased online and it is important to buy at least 2 extra pots of test strips and a box of lancets with the meter kit as you will go through quite a few test strips in the first few weeks. A system of testing before and 2 hours after each meal will help to show you which meals are OK and which have too many carbs for your body to cope. It can also help to motivate you to get back on track when you slip by seeing the negative impact that poor food choices have on your levels. If you need more advice and support on this aspect, the forum will help you. We often liken trying to control diabetes through diet without a BG meter as like driving without a speedometer. You don't realise you have got it wrong until a speeding fine comes through the door or your annual HbA1c gives you a rude awakening!

Good luck! You have done it before so no reason why you can't do it again, but this time perhaps armed with a tool to help you and a bit more useful information to sustain it

 

[Ditto]

Hello and welcome. 🙂

 

[Drummer]

What a pity you did not get the information every type two ought to be given at diagnosis - you problem is carbohydrate.

I don't need medication and I went from a Hba1c of 91 to 47 in 80 days after diagnosis.
All I did was cut down on carbohydrate and I used a glucose meter - I find the Spirit Healthcare Tee 2+ cheap to use and it seems accurate. I cut out high carb foods, found that beans and peas caused spikes, and got down to 8mmol/l after eating. Without changing anything else I then reduced further, so I suspected I'd got it beaten. I now seem to have a Hba1c stuck at 42 - but my glucose levels are always normal.

 

[Shadynook]

So pleased you feel motivated to get on top of your diet again.

I think you have 2 options:-

You stop taking the medication with or without discussion with your Health Care Professionals.

You take the medication for 3 months alongside your improved diet and then if your results are good, you negotiate a cessation of the medication for the next 3-6 months with an agreed HbA1c test at the end of that period to check how you are doing.

Whilst I appreciate that HCPs do what they think is best to treat your condition, diabetes is something which is best managed day by day and meal by meal by the patient with support from their medical clinicians and you do have a say in that treatment plan. No one can force you to take medication, just like they can't force you to follow a particular diet. You are an important participant and in fact should be the leading partner in your diabetes treatment. HCPs are used to being in charge and they often don't like it when the patient challenges that, but it is their role to support you and you have a right to decide on your treatment.
If your HbA1c was high, like 70+, it would be another matter, but 58 doesn't put you in the danger zone and is certainly within reach of prediabetic if not normal levels in the 3 month period. You could also argue that you have reduced your levels through diet and exercise previously, so you have shown that you can do it. Where you failed before was not finding a sustainable diet and this was likely through lack of appropriate advice/knowledge. Hopefully we can help you figure out a way to make it an enjoyable new way of life, rather than a "diet".

Good luck whatever you decide. If you don't want to confront the nurse with a decision to stop the medication you could send an email or letter explaining your decision and the reasoning behind it (ie. that you are suffering with side effects (nausea etc) and have had success with lifestyle changes before but that the nature of the last year, lockdown etc. has caused you to slip a bit with your healthy choices but that you are now motivated to improve your diet and exercise plan again and feel that a hiatus in medication would not be unreasonable for a 3 month period to give you that opportunity. That you are happy to review your treatment plan at the end of that time and if no progress has been made, then reassess the medication situation. It might sweeten it a bit to end by saying that you very much appreciate their help and support with your diabetes management and look forward to showing some good progress when you next see them.

If you don't already have a BG meter, it would be a good idea to get yourself one so that you can self monitor and not just get an idea of how well your lifestyle changes are working but also use it to tailor your diet to your body's individual tolerance for different types of carbs.... and it can vary significantly from one diabetic person to another. The two meters most often recommended by people who self fund on the forum for reliability and economy of use are the Gluco Navii or the Spirit Healthcare Tee2. Both can be purchased online and it is important to buy at least 2 extra pots of test strips and a box of lancets with the meter kit as you will go through quite a few test strips in the first few weeks. A system of testing before and 2 hours after each meal will help to show you which meals are OK and which have too many carbs for your body to cope. It can also help to motivate you to get back on track when you slip by seeing the negative impact that poor food choices have on your levels. If you need more advice and support on this aspect, the forum will help you. We often liken trying to control diabetes through diet without a BG meter as like driving without a speedometer. You don't realise you have got it wrong until a speeding fine comes through the door or your annual HbA1c gives you a rude awakening!

Good luck! You have done it before so no reason why you can't do it again, but this time perhaps armed with a tool to help you and a bit more useful information to sustain it

Reading your replies has helped me a great deal. I have got BG meters just don’t like using them but I have only done it a few times. I think I have been unable to accept the fact that I am diabetic

What a pity you did not get the information every type two ought to be given at diagnosis - you problem is carbohydrate.

I don't need medication and I went from a Hba1c of 91 to 47 in 80 days after diagnosis.
All I did was cut down on carbohydrate and I used a glucose meter - I find the Spirit Healthcare Tee 2+ cheap to use and it seems accurate. I cut out high carb foods, found that beans and peas caused spikes, and got down to 8mmol/l after eating. Without changing anything else I then reduced further, so I suspected I'd got it beaten. I now seem to have a Hba1c stuck at 42 - but my glucose levels are always normal.

What a pity you did not get the information every type two ought to be given at diagnosis - you problem is carbohydrate.

I don't need medication and I went from a Hba1c of 91 to 47 in 80 days after diagnosis.
All I did was cut down on carbohydrate and I used a glucose meter - I find the Spirit Healthcare Tee 2+ cheap to use and it seems accurate. I cut out high carb foods, found that beans and peas caused spikes, and got down to 8mmol/l after eating. Without changing anything else I then reduced further, so I suspected I'd got it beaten. I now seem to have a Hba1c stuck at 42 - but my glucose levels are always normal.

can I ask how old you are?

 

[rebrascora]

Having a proper testing regime is really important if you are going to use a BG meter. Random testing achieves nothing. You have to have a structured approach to it by keeping a food diary along with your readings both before a meal and 2 hours afterwards. The difference between these 2 readings tells you if your body coped well with the food you ate (ie it rose less than 3 mmols) or you ate too many carbs and it rose by 3mmols or more 2 hours after the meal. This way you can see which foods are not worth bothering with and which you can get away with but perhaps need to reduce portion size. Your tastes will also come into play with this as there will be foods that you really love and don't want to give up and sometimes eating those at a different time of day or a smaller portion size or in combination with different foods will help.
For example, if you really love porridge..... Something which is quite finely processed like Ready Brek is not the best choice but jumbo oats which are less processed may work better as they will release their glucose slower. Many of us are more insulin resistant in the morning, so eating a high carb food like porridge can have more impact then than in the evening, when we are often more sensitive to insulin, so porridge for supper might work better than having it for breakfast. Thirdly, combining a smaller portion of it with a high fat food like double cream will make the smaller portion more filling and the fat should also slow down the release of the glucose from the porridge, so our body can cope with it better. Alternatively, you may be not that bothered about eating porridge and decide that it isn't worth the effort of experimenting and there are other things you enjoy more OR your body may cope absolutely fine with porridge but bran flakes send your levels into orbit!
Another example would be potatoes... Mashed they often hit the blood stream like they are pure sugar but a few new potatoes with a nice coating of butter or chips (particularly made with new potatoes with their skins on) or roasties may produce less of a rise in BG, so you might get away with a few potatoes a couple of times a week, whereas without a meter you would probably just avoid potatoes altogether. The meter readings enable you to make educated decisions about your diet and what your body can manage and what isn't worth the BG turmoil.

 

[Shadynook]

Having a proper testing regime is really important if you are going to use a BG meter. Random testing achieves nothing. You have to have a structured approach to it by keeping a food diary along with your readings both before a meal and 2 hours afterwards. The difference between these 2 readings tells you if your body coped well with the food you ate (ie it rose less than 3 mmols) or you ate too many carbs and it rose by 3mmols or more 2 hours after the meal. This way you can see which foods are not worth bothering with and which you can get away with but perhaps need to reduce portion size. Your tastes will also come into play with this as there will be foods that you really love and don't want to give up and sometimes eating those at a different time of day or a smaller portion size or in combination with different foods will help.
For example, if you really love porridge..... Something which is quite finely processed like Ready Brek is not the best choice but jumbo oats which are less processed may work better as they will release their glucose slower. Many of us are more insulin resistant in the morning, so eating a high carb food like porridge can have more impact then than in the evening, when we are often more sensitive to insulin, so porridge for supper might work better than having it for breakfast. Thirdly, combining a smaller portion of it with a high fat food like double cream will make the smaller portion more filling and the fat should also slow down the release of the glucose from the porridge, so our body can cope with it better. Alternatively, you may be not that bothered about eating porridge and decide that it isn't worth the effort of experimenting and there are other things you enjoy more OR your body may cope absolutely fine with porridge but bran flakes send your levels into orbit!
Another example would be potatoes... Mashed they often hit the blood stream like they are pure sugar but a few new potatoes with a nice coating of butter or chips (particularly made with new potatoes with their skins on) or roasties may produce less of a rise in BG, so you might get away with a few potatoes a couple of times a week, whereas without a meter you would probably just avoid potatoes altogether. The meter readings enable you to make educated decisions about your diet and what your body can manage and what isn't worth the BG turmoil.

Wow I understand now!! If I’m going to go down the ‘diet’ route and not meds I really need to get used to testing. What you’ve explained shows how easily BG can shoot up or down. So if I continue on the dapagliflozin I won’t have to test all the time? Just eat sensibly cutting out all sugars and reducing carbs?

 

[Drummer]

Reading your replies has helped me a great deal. I have got BG meters just don’t like using them but I have only done it a few times. I think I have been unable to accept the fact that I am diabetic

If you don't want to be testing, then the fastest way not to need to is to eat only the carbs you can cope with. I only needed to test my first meal of the day a few times to see have I was eating right and not seeing numbers over 8 - so I just kept on eating the same thing. Without breakfast my levels kept on rising - in case I had to trek 10 miles to find something to eat, which is logical when you think about it - so breakfast is good for me.
Once I sorted out a few dinners and could see how many carbs the good ones were, that was the target for every night, and I was soon seeing lower numbers all the time and in a couple of months my Hba1c was no longer in the diabetic range.

 

[rebrascora]

BG is constantly fluctuating. The food we eat has the biggest impact in altering it but there are believed to be about 42 factors which affect it either increasing or lowering it. Exercise is probably the second most influential factor but some exercise increased your levels in the short term but decreases them in the longer term whilst other exercise lowers them at the time. This is why testing right before a meal and then 2 hours afterwards is necessary to narrow down the impact the food has over other things which might be going on. Testing is just a huge eye opener but it is important to understand that non diabetic people have fluctuating BG levels too, it's just that their body is more efficient at balancing things and bringing it back into the normal range more quickly.

It may interest you to know that food starts being absorbed into the blood stream in the mouth. So for those of us insulin dependent diabetics who need to eat something sugary when our levels drop too low, chewing our hypo treatment(glucose tablets or jelly babies) really well can actually be more effective than just a couple of chews and swallowing them and that sugar will hit out blood stream in about 10 mins which still blows my mind as to how quickly glucose goes from our digestive system to our blood stream to the tip of my finger!
More complex carbs like bread may take half an hour or more. Porridge, which is supposed to be slow release, starts hitting my blood stream within 20 mins, so it's not a good choice for me but it can be much slower for other people.

I think even taking the Dapagliflozin, testing would be beneficial. I believe that medication works by encouraging the kidneys to remove excess glucose from the blood stream. Obviously it is better if the kidneys don't have to work extra hard, so not putting foods into your system which will spike your BG to the point that the kidneys are triggered into action is helpful as well as the increased risk of thrush and UTIs but if you find the idea of testing regularly a challenge or financially prohibitive then just cutting the sugar and reducing carb portions is fine. I think if you are going to disregard your health care professionals' advice regarding taking medication then it is best to be able to monitor what you are doing by testing because you have essentially taken over the responsibility of treatment.

Hopefully that makes sense, but it is just my take on the situation and other people will have different opinions.
Most members here who are successful in managing their diabetes will agree though that using a BG meter is hugely beneficial.

 

[Shadynook]

BG is constantly fluctuating. The food we eat has the biggest impact in altering it but there are believed to be about 42 factors which affect it either increasing or lowering it. Exercise is probably the second most influential factor but some exercise increased your levels in the short term but decreases them in the longer term whilst other exercise lowers them at the time. This is why testing right before a meal and then 2 hours afterwards is necessary to narrow down the impact the food has over other things which might be going on. Testing is just a huge eye opener but it is important to understand that non diabetic people have fluctuating BG levels too, it's just that their body is more efficient at balancing things and bringing it back into the normal range more quickly.

It may interest you to know that food starts being absorbed into the blood stream in the mouth. So for those of us insulin dependent diabetics who need to eat something sugary when our levels drop too low, chewing our hypo treatment(glucose tablets or jelly babies) really well can actually be more effective than just a couple of chews and swallowing them and that sugar will hit out blood stream in about 10 mins which still blows my mind as to how quickly glucose goes from our digestive system to our blood stream to the tip of my finger!
More complex carbs like bread may take half an hour or more. Porridge, which is supposed to be slow release, starts hitting my blood stream within 20 mins, so it's not a good choice for me but it can be much slower for other people.

I think even taking the Dapagliflozin, testing would be beneficial. I believe that medication works by encouraging the kidneys to remove excess glucose from the blood stream. Obviously it is better if the kidneys don't have to work extra hard, so not putting foods into your system which will spike your BG to the point that the kidneys are triggered into action is helpful as well as the increased risk of thrush and UTIs but if you find the idea of testing regularly a challenge or financially prohibitive then just cutting the sugar and reducing carb portions is fine. I think if you are going to disregard your health care professionals' advice regarding taking medication then it is best to be able to monitor what you are doing by testing because you have essentially taken over the responsibility of treatment.

Hopefully that makes sense, but it is just my take on the situation and other people will have different opinions.
Most members here who are successful in managing their diabetes will agree though that using a BG meter is hugely beneficial.

Yes I totally agree. I will start tomorrow I have everything I need. Thank you for explaining it so clearly and thoroughly