A newbie with a plan...

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loocher

loocher

New Member
Relationship to Diabetes
Type 2
Hi everyone

I'm newly diagnosed T2, aged 52. I was told I was pre-diabetic back in 2017 after hbA1c of 42. Got T2 diagnosis last Monday, hbA1c 62. So no idea how long my BG has been elevated but I think it's probably been a few years - eg have had both shoulders frozen in the meantime, which is much more likely if diabetic.

GP said we should 'hit it hard early' with lifestyle changes and Metformin. I've been taking 1 Metformin for a couple of days, building up over 2 weeks to 3 a day. No side effects yet. I also have low iron, so started on ferrous fumarate, and cholesterol 5.7, don't want meds for that. (I appreciate the double whammy of the iron and Metformin could make for unpleasant gastric side effects but so far so good.)

I know I have tendency to completely overwhelm myself when I have a new thing, and that is exactly what I am doing here. I need to stop reading too much and falling down rabbit holes, make a plan and then take it one step at a time. So I'd really appreciate any feedback on the plan I've formed.

The advice I keep coming across - which really resonates with me - is to learn about my own reaction to carbs through testing. So, the immediate plan is to buy a blood glucose monitor and follow the advice from Maggie Davey and Alan S in the resources section: Test, Review, Adjust.

I had a lot of success losing weight with a low GL diet before my wedding in 2010 and found it pretty easy to stick to. My wife and I are both good cooks, so cooking healthy meals from scratch is mostly fine, esp with planning. I started heading back that way as soon as I had the blood drawn 2 weeks ago because I was pretty sure this diagnosis was coming and finally decided I had to face up to it. I've read some conflicting advice about how useful GI/GL is for diabetics. Obviously, I need to manage carb intake, but it makes sense to me that eating carbs that release glucose more slowly would help to avoid spikes. So I'm planning to start with a GL approach and review based on testing.

The thing I am most unsure of is the Metformin. I can't really see a downside to taking it at least until my next blood test in 3 months (unless gastric side effects). BUT the Metformin will be helping to manage BG spikes, so obviously my home testing is going to reveal my levels supported by Metformin.

So, is it a plausible plan to:
  • Take the Metformin for now, because the most important thing is to get myself within a healthy range to minimise risk of complication.
  • Test, record, review, adjust, knowing the Metformin is helping, but trying to eat as I would if I didn't have it.
  • See where I'm at in 3 months.
  • If/when I come off Metformin, start the test, review, adjust process again to see how I'm reacting to carbs without the Metformin's help.
Also, would appreciate any advice on accurate BG monitors with reasonably priced test strips.
And am I better off going on the slow-release version of Metformin?

Any feedback greatly appreciated.

-Lucy
 
It sounds as if you have started to get your head around making some changes. Metformin is a medication which helps the body use the insulin it produces more effectively and reduces the glucose that the liver releases but sort of works in the background rather than on a meal to meal basis. Slow release metformin is prescribed if people get stomach issues from the standard ones so if you do once you increase the dose then you should ask for those.
Some people find a low GI regime is more beneficial but that does depend on the individual and on their individual gut microflora. Basically carbs are carbs no matter what colour so for many it is the carb load for any particular meal that makes the difference. Some people find that different carbs will affect them differently even if the same amount, so say 20g carb if rice is fine but not bread and for others it is the other way round. This is why the TEST, TEST and Adjust approach is one many people adopt as they can see the effect on THEM not what it may say in the book.
A couple of monitors with the cheaper test strips are the GlucoNavii or TEE2 but worth shopping around as prices change, on line are generally better prices.
Have a look at this link to see how the plans and principals compare to what you are planning. https://lowcarbfreshwell.com/
 
My understanding of taking 'non SR' Metformin is that gastric side effects can frequently be minimised at least somewhat if not completely by taking them during or just after a decent sized meal. So whenever your main daily meal is - eg ours is still our evening meal whereas a lot of friends our age have changed it to their lunch. Metformin isn't time critical, because once your body has got used to it (which takes a couple of weeks - and this can occur again when you go up to 2 tablets, then later 3, etc) you're just topping it up every day after that. Not changing the dose , just more of the same .....
 
Welcome to the forum @loocher

Sounds like you’ve put together a great plan, and have been reading the forum to pick up some tips from the hive mind of lived experience.

Good to hear that you haven’t had any gastric upset so far from the metformin. It’s a fairly common side effect, but not everyone gets in, and any tummy troubles often settle down after a while. Hope your tum stays happy as your dose increases to more effective levels, but as you say, you can always consider the SR versions if you get stomach issues on higher doses. Metformin works by reducing glucose output from the liver and improving insulin sensitivity, so should help gently in the background, but doesn’t work specifically on a meal by meal basis. It also has other beneficial effects on heart health and other things. Your menu changes will have probably a more immediate and more significant effect on your glucose levels.

The most affordable and reliable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £10 for 50

Let us know how you get on 🙂
 
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