Another person new to Diabetes

[jules748]

Hi all,

I've been lurking here for about 5 weeks, now I have the full facts, it's time to share my journey so far. Thanks so much to the other people who have posted and shared their journeys and given advice. I have to say, these forums are about the most friendly, positive and inclusive forums I've ever seen!

I was diagnosed on Tuesday with Diabetes, I'd already diagnosed myself, but on Tuesday got the clinical diagnosis from my GP. As I pretty much already knew, it was not a big shock, in fact as the GP got to this part, she said: you already know don't you, I thought I was going to have to break this news to you. Despite that, it's was still a slight blow to get the 'official' diagnosis.

So a little about me. I'm 60, have led a fairly normal life, I have a desk job, don't take much exercise, just a bit of walking etc, didn't eat particularly healthy food. I don't smoke, I did for about 6 years in my 20s. I have been in good health, normally I'm overweight, I diet when I get fed up with it, but the weight normally creeps back. I'm 173cm (5'8") and currently 85kg (13 1/2 st). I was diagnosed with high BP almost exactly 10 years ago and was put on Candesarten 8mg, which controlled it well. They tried Amlodopine, then Ramapril first, but I didn't get on well with them. They added Atorvastatin 20mg just before COVID hit the UK as my Cholesterol had crept up. I stopped taking it as I was unable to get a blood test 3 months after starting it. I then found it almost impossible to get the Candesarten, due to the COVID restrictions, no blood tests, Chemist kept saying their computers weren't working, come back another day, so stopped taking that about 1.5 years ago. My 60th birthday was not good, a good friend passed away and my mother got seriously ill and within 2 months passed away from bone cancer.

I've had my BG tested by a GP with a finger prick test a few times over the years. I tested it myself about 8 years ago, fasting was 5.5, around 1.5 hours after a meal it was 7.5. I tested it as both my parents became T2s in middle age. Mum's was due to lots of issues with her Pancreas, I don't know about Dad's, I only found out after he died, he never mentioned it. He was never overweight, but only really ate evening meals and drank quite a lot and was a very heavy smoker. He passed about 25 years ago, from nothing related to smoking, alcohol or Diabetes.

So what happened recently, well after Mum passing, I was understandably upset and grieving. When I started to feel better mentally, I still didn't feel right, always tired/fatigued, swollen feet (sometimes quite pink or red), always getting up at night to pee, always thirsty, sometimes feeling much more tired after meals... Oh I also got COVID visiting Mum in Hospital back in late October, the only time I've had it. It was basically like a bad cold, plus loss of taste and smell, which soon came back afterwards, positive LFTs for about 1 week.

I then thought, how's my BG, I dug out the Accu-Chek but everything had expired and the model I have is obsolete, so purchased a new one in late March. Did a test, it was 19 fasting. I took it daily just before lunch for a few weeks, it varied from 12-26. Oh dear, this is not good! I had been meaning to get back on the Candesarten, phoned the doctors surgery, had a phone consultation, explained why I'd stopped the meds, the GP said I needed to book blood tests. I said oh and another thing, my BG... the GP said he'll add that to the tests. The tests came back and the surgery rang me, said I needed to speak to the GP ASAP. I saw the GP who put me back on the Candesarten and Atorvastatin. She discussed the Diabetes, my HbA1c was 79 and said I could make lifestyle changes, or do this and take Metformin. I also needed to see their DSN, I have an appointment to see her next week. She said to hold off on the Metformin for a week or so, while my body gets used to the Candesarten and Atorvastatin.

After seeing the BG results from my Accu-Chek, I started making changes, much of them thanks to the advice on these forums. I didn't go 'big bang', I phased in the changes so far over about 3 weeks. I also saw posts talking about Libre, saw you can get 1 free one, so applied for and got that. I removed it after it expired yesterday, it's been a revelation! I've lost about 3kg (I plan to lose about another 8kg, perhaps more), I've also cut the carbs to less than 130g/day. I'm eating more salads, more healthy food, etc. Those Kind bars made a great replacement for the cakes and sweets I used to eat after a meal, I think I prefer them. Though they are not all low carb, but some are around 10g. So I'm seeing this as a positive thing, a 'wake up call' if you like.

Regards,
Jules.

 

[Leadinglights]

Hi all,

I've been lurking here for about 5 weeks, now I have the full facts, it's time to share my journey so far. Thanks so much to the other people who have posted and shared their journeys and given advice. I have to say, these forums are about the most friendly, positive and inclusive forums I've ever seen!

I was diagnosed on Tuesday with Diabetes, I'd already diagnosed myself, but on Tuesday got the clinical diagnosis from my GP. As I pretty much already knew, it was not a big shock, in fact as the GP got to this part, she said: you already know don't you, I thought I was going to have to break this news to you. Despite that, it's was still a slight blow to get the 'official' diagnosis.

So a little about me. I'm 60, have led a fairly normal life, I have a desk job, don't take much exercise, just a bit of walking etc, didn't eat particularly healthy food. I don't smoke, I did for about 6 years in my 20s. I have been in good health, normally I'm overweight, I diet when I get fed up with it, but the weight normally creeps back. I'm 173cm (5'8") and currently 85kg (13 1/2 st). I was diagnosed with high BP almost exactly 10 years ago and was put on Candesarten 8mg, which controlled it well. They tried Amlodopine, then Ramapril first, but I didn't get on well with them. They added Atorvastatin 20mg just before COVID hit the UK as my Cholesterol had crept up. I stopped taking it as I was unable to get a blood test 3 months after starting it. I then found it almost impossible to get the Candesarten, due to the COVID restrictions, no blood tests, Chemist kept saying their computers weren't working, come back another day, so stopped taking that about 1.5 years ago. My 60th birthday was not good, a good friend passed away and my mother got seriously ill and within 2 months passed away from bone cancer.

I've had my BG tested by a GP with a finger prick test a few times over the years. I tested it myself about 8 years ago, fasting was 5.5, around 1.5 hours after a meal it was 7.5. I tested it as both my parents became T2s in middle age. Mum's was due to lots of issues with her Pancreas, I don't know about Dad's, I only found out after he died, he never mentioned it. He was never overweight, but only really ate evening meals and drank quite a lot and was a very heavy smoker. He passed about 25 years ago, from nothing related to smoking, alcohol or Diabetes.

So what happened recently, well after Mum passing, I was understandably upset and grieving. When I started to feel better mentally, I still didn't feel right, always tired/fatigued, swollen feet (sometimes quite pink or red), always getting up at night to pee, always thirsty, sometimes feeling much more tired after meals... Oh I also got COVID visiting Mum in Hospital back in late October, the only time I've had it. It was basically like a bad cold, plus loss of taste and smell, which soon came back afterwards, positive LFTs for about 1 week.

I then thought, how's my BG, I dug out the Accu-Chek but everything had expired and the model I have is obsolete, so purchased a new one in late March. Did a test, it was 19 fasting. I took it daily just before lunch for a few weeks, it varied from 12-26. Oh dear, this is not good! I had been meaning to get back on the Candesarten, phoned the doctors surgery, had a phone consultation, explained why I'd stopped the meds, the GP said I needed to book blood tests. I said oh and another thing, my BG... the GP said he'll add that to the tests. The tests came back and the surgery rang me, said I needed to speak to the GP ASAP. I saw the GP who put me back on the Candesarten and Atorvastatin. She discussed the Diabetes, my HbA1c was 79 and said I could make lifestyle changes, or do this and take Metformin. I also needed to see their DSN, I have an appointment to see her next week. She said to hold off on the Metformin for a week or so, while my body gets used to the Candesarten and Atorvastatin.

After seeing the BG results from my Accu-Chek, I started making changes, much of them thanks to the advice on these forums. I didn't go 'big bang', I phased in the changes so far over about 3 weeks. I also saw posts talking about Libre, saw you can get 1 free one, so applied for and got that. I removed it after it expired yesterday, it's been a revelation! I've lost about 3kg (I plan to lose about another 8kg, perhaps more), I've also cut the carbs to less than 130g/day. I'm eating more salads, more healthy food, etc. Those Kind bars made a great replacement for the cakes and sweets I used to eat after a meal, I think I prefer them. Though they are not all low carb, but some are around 10g. So I'm seeing this as a positive thing, a 'wake up call' if you like.

Regards,
Jules.

Welcome to the forum now you have joined the group, you sound to have a good rapport with your GP and have made a good start in tackling your high HbA1C and losing some weight. It can take a while to find a blood pressure medication that suits you but a few people find that they need to reduce their dose as they lose weight.
You may have seen this link I post, but I certainly found the principals outlined successful. https://lowcarbfreshwell.co.uk/

 

[Callista]

In respect of BP, I am only pre-D (I hope still!)(as in, hope I haven't yet crept into D2 - the next Hb test will tell me), and I am on bp meds (over ten years, in my sixties now). I'm on Ace inhibitors, but the moment I was DX pre-D my GP suggested statins.

I've said I want to get my Hb levels down before I think about bp, cholesterol etc, and that I'm happy with Ace inhibitors.

I'm only saying this because it could be that GP's almost 'automatically' these days 'think statins'. I'm not sayign that's wrong, just to be prepared they might offer them/recommend them.

Unless your bp is critical, personally I'd prefer to get my Hb readings under control before mucking about with bp meds. One thing at a time! (Even if, yes, they are interrelated.) Especially if tackling HB means losing weight and getting fitter, which it does for so many of us. That in itself takes pressure off the heart, and may mean that changing heart meds isn't necessarry (or even, as above, that it could mean reducing bp doses!!!!)

 

[jules748]

Thanks for your responses Leadinglights and Callista.

My plan was to get back on the BP meds when COVID settled down. I tried a number of times to get the blood tests, without blood tests they reduce the amount of medication you can get, from 56 days, to 28 days and so on. Then all the other stuff in my life got in the way. My BP was 158/96 (average of around 10 home readings over a week) before originally being put on meds, it was similar when I came off the meds. Trying to get the meds was probably putting my BP up 🙂

The Statin was new, the Serum Cholesterol was just above 5 when they put me on the Statin at the end of 2019, now it's 5.2. After the 2019 test the surgery contacted me to discuss the result with a GP, the GP basically said I could try them if I wanted to. Now quite a few other Cholesterol numbers are flagged 'abnormal', but not massively out. I think generally the clinicians think there are more benefits to Statins than risks, so prefer to prescribe them if there's any justification.

With the BP meds, the others had side affects and the GP offered other meds for the side affects. I just wanted something to lower the BP, not 2 or 3 drugs to deal with each others side affects. Candesarten give me no noticeable side affects and lowered my BP to 138/86. Were all different, I'm sure some people do not get on with Candesarten.

I did think if my HbA1c was high, as I suspected, they would just put me back on my previous meds and focus on the BG levels. It seems they want to focus on getting me back on the previous meds then take it from there. I've now had an ECG and more blood tests to come. But I have the Metformin which I'm to start later this week, can't wait, given the possible side affects, need to stock up on toilet paper 🙂 I have the appointment with the DSN next week, so I guess they are sort of doing this in parallel. The GP was very good, I've not seen her before, it's a large practice with lots of doctors etc.

I guess with an HbA1c of 79, it's fairly high, but I saw my fasting BG go from 12-26, the average was 18.2. With the Libre 2, I got more insight. It basically goes down to around 11 when I've not eaten anything and was going up to around 24 after a meal. But as my carb reduction regime kicked in the after meal highs went down to around 15 or 16. What confuses me is why the fasting remains stubbornly high. Basically between my evening meal and lunch the next day, I just drink water and have one coffee in the morning. At weekends I normally have beer or red wine in the evenings, but am cutting down on the beer. As I reduce my weight and take the Metformin, it should come down more. Whether it will get to ~5-8 who knows!

I'll check out that link Leadinglights, so far I've been using Carbs & Cals and advice from here and elsewhere on the internet.

 

[ColinUK]

Sounds like you have quite a good grapes of what’s what and what’s needed.
You’re off to a great start so carry on!

 

[ColinUK]

*grasp not grapes! Grapes are not ideal as they’re little sugar bombs!

 

[jules748]

Thanks ColinUK, yes I'll avoid the grapes 🙂. When I looked at this originally I thought more fruit, fine, I love grapes, bananas, apples, cherries, etc. Little did I know... Looks like berries are the thing, which I also like.

As my old boss used to say so often: 'it is what it is', so like most of us here, I have to deal with what life has thrown at me. I think I'll feel a lot better, not that I feel too bad, when I see the DSN, I'm a bit impatient, so having to wait 2 1/2 weeks from booking the appointment is a little frustrating. But I appreciate the NHS can't drop everything to deal with me.

 

[Leadinglights]

Morning readings can remain stubbornly high because something referred to as Foot on the Floor or Dawn Phenomenon can kick into action whereby the liver releases glucose to give you energy for the morning hunt for breakfast and for your organs to function when you haven't eaten.
Your high levels after eating perhaps suggest your meal was too carb heavy.

 

[ColinUK]

Thanks ColinUK, yes I'll avoid the grapes 🙂. When I looked at this originally I thought more fruit, fine, I love grapes, bananas, apples, cherries, etc. Little did I know... Looks like berries are the thing, which I also like.

As my old boss used to say so often: 'it is what it is', so like most of us here, I have to deal with what life has thrown at me. I think I'll feel a lot better, not that I feel too bad, when I see the DSN, I'm a bit impatient, so having to wait 2 1/2 weeks from booking the appointment is a little frustrating. But I appreciate the NHS can't drop everything to deal with me.

It’s also not automatic that all berries are ok for you. I’m great with blueberries and also strawberries but blackberries send my glucose sky high. Of course you can guess which one is my favourite.

 

[jules748]

My BG seems to flat line at around 10-12 anytime I've not eaten for a while. But I do sometimes see a rise, in the morning before even eating or drinking anything but water or coffee (no sugar). Sometimes I saw the rise with the Libre before I wake up, so yes this would support the Dawn Phenomenon idea.

I'm trying to keep my carbs down to about 50g per meal, I normally only have lunch and dinner. I don't normally snack much. I think I'm getting my head around carbs, but as you both point out, there are carbs and carbs. I will need to see which ones affect me more and which ones less out of the main things I now eat.

I assume you prefer the blackberries ColinUK, if so sorry about that. I guess they are then an extra special treat?

I suppose I expected the whole graph/numbers to come down, so far all I really see is a drop in the peaks. I've only been doing the much lower carbs for about 1 1/2 weeks, I phased it in over the preceding 3 weeks. Perhaps it needs more time and more weight loss. When I look at the Libre graphs, it looks like it needs to be compressed peak to trough by about 50% and then shifted down by about 50%. Then it would be 5 or 6 to peaks of 7 or 8. We shall see, of course I've got the Metformin to add into the mix too. Maybe I'm just expecting too much too soon.

I'd be interested if this echoes anyone else's experience, I'm probably over thinking it to be honest, but this is all new to me?

 

[Leadinglights]

My BG seems to flat line at around 10-12 anytime I've not eaten for a while. But I do sometimes see a rise, in the morning before even eating or drinking anything but water or coffee (no sugar). Sometimes I saw the rise with the Libre before I wake up, so yes this would support the Dawn Phenomenon idea.

I'm trying to keep my carbs down to about 50g per meal, I normally only have lunch and dinner. I don't normally snack much. I think I'm getting my head around carbs, but as you both point out, there are carbs and carbs. I will need to see which ones affect me more and which ones less out of the main things I now eat.

I assume you prefer the blackberries ColinUK, if so sorry about that. I guess they are then an extra special treat?

I suppose I expected the whole graph/numbers to come down, so far all I really see is a drop in the peaks. I've only been doing the much lower carbs for about 1 1/2 weeks, I phased it in over the preceding 3 weeks. Perhaps it needs more time and more weight loss. When I look at the Libre graphs, it looks like it needs to be compressed peak to trough by about 50% and then shifted down by about 50%. Then it would be 5 or 6 to peaks of 7 or 8. We shall see, of course I've got the Metformin to add into the mix too. Maybe I'm just expecting too much too soon.

I'd be interested if this echoes anyone else's experience, I'm probably over thinking it to be honest, but this is all new to me?

It maybe that by only having 2 meals but quite a high number of carbs at each is where the problem is as you may not be able to cope with that much per meal.
It may take a bit longer to show lower levels.
Looking at the before and 2 hours post meal can be very helpful in telling you if your meal have been too carb heavy, no more than 2-3mmol/l increase is where you want to aim.
I went cold turkey having 70g per day but that is spread between 3 meals and drinks so 50g per meal seems pretty high. I'm not suggesting you go as low as that but be guided by your testing.

 

[Jessica DUK]

Hi @jules748 and welcome (officially) to the forum! Thank you for taking the time to share your journey with us. It does sound like you've been through a lot recently, so we're glad to hear you've found this space friendly and inclusive so far! As you've seen, you'll always have so many people you can talk to and gain knowledge from. I know I learn so much on here every day 🙂

 

[harbottle]

What confuses me is why the fasting remains stubbornly high.

Even when you are fasting your body is still producing a 'background' level of glucose via releases from stores and/or generating it from fatty acids and amino acids. If you are diabetic you can't handle this due to insulin resistance and/or lack of insulin so levels will rise. (Insulin resistance in the liver also means it produces glucose even if it doesn't need to.)

Hopefully the weight loss will improve this and fix the broken mechanism.

 

[jules748]

I thought it was time for an update. Also thanks for the advice and support. Yes I had been wondering about having no breakfast. I got into the habit of doing this years ago, I actually found it helped me maintain my weight, or stop it going even higher! More on the breakfast below. Also the so called Dawn Phenomenon might be contributing too. I'm typically having 40g of carbs for lunch and 30g for dinner, unless I go out, which is rare these days, 2 or 3 evenings a month typically. I get a bigger spike after lunch, as I've effectively fasted for around 16 hours, perhaps my body is going 'mad for the carbs' after the fasting?

I had my appointment with the DSN on Friday. She was extremely helpful and supportive. I got offered so many things in terms of training and services: Diabetic training, Diabetic eye check, getting my toenails cut, weight loss programme plus a few more. I accepted the first two. I have no problem losing weight, keeping it off has been the challenge, but my new regime should help there. I had my BG, BP, height, weight, waist and feet measured/checked. BP is now 140/80, BMI 27 and the feet currently 'not at high risk'. I was given lots of advice and told the lifestyle changes and Metformain are the way to go. I already had 28 tablets of Metformain from seeing the GP, who said not to start taking it immediately to give my body a chance to get back used to the BP meds and Statin. Then it was almost time to see the DSN anyway, so thought I'd wait till then. I now have the Metformain on repeat too. It was a shock to get the big bag handed to me at the pharmacy, 8 boxes of it! I was instructed to take 1 500mg tab a day for a week, then increase it by 1 more tab every week until I get to 4 tabs/day (2g). These should be spread between breakfast and dinner. Back to the breakfast, yes she said I should have it, she suggested porridge. I mentioned the yoghurt and berries which seem a popular suggestion on these forums, she said watch for the sugar, i.e. sweetened yoghurt. I had already bought some natural Greek style FF yoghurt, which should be fine, plus some berries.

I started the Metformain after the evening meal on Friday, Saturday morning was not good, glad I had plenty of toilet paper. Things are much more settled today. I still get a bit of gurgling in the tummy area, very slight nauseousness and quite a lot of wind, plus a slightly metallic taste. But if that's as bad as it gets, I'll take that. I suspect it will settle more in the coming days and weeks. I tested my BG yesterday before lunch, it was 7.8, the lowest I've seen it since this all came to my attention in late March.

The DSN did say there's no need to keep checking my BG, then added the NHS won't fund it (which I knew), but if my medication changes to something that had a risk of causing a Hypo, they would fund a meter and strips. I said I want to monitor it and I have no problem funding it at this point. I like to keep an eye on it, mainly to check on progress. I'm fortunate that I can stretch to a tub of strips every month or so. I must say I find this 'no need to test' ideology odd. To me having no testing is a bit like driving without a speedometer. But yes I guess people could just go on the 3 monthly HbA1c tests, but it's a long time to wait and how would you know which foods/patterns are the problem ones? I'm only testing about 4 or 5 times a week currently.

I've lost a little more weight and plan to introduce breakfast from tomorrow.

 

[Leadinglights]

I thought it was time for an update. Also thanks for the advice and support. Yes I had been wondering about having no breakfast. I got into the habit of doing this years ago, I actually found it helped me maintain my weight, or stop it going even higher! More on the breakfast below. Also the so called Dawn Phenomenon might be contributing too. I'm typically having 40g of carbs for lunch and 30g for dinner, unless I go out, which is rare these days, 2 or 3 evenings a month typically. I get a bigger spike after lunch, as I've effectively fasted for around 16 hours, perhaps my body is going 'mad for the carbs' after the fasting?

I had my appointment with the DSN on Friday. She was extremely helpful and supportive. I got offered so many things in terms of training and services: Diabetic training, Diabetic eye check, getting my toenails cut, weight loss programme plus a few more. I accepted the first two. I have no problem losing weight, keeping it off has been the challenge, but my new regime should help there. I had my BG, BP, height, weight, waist and feet measured/checked. BP is now 140/80, BMI 27 and the feet currently 'not at high risk'. I was given lots of advice and told the lifestyle changes and Metformain are the way to go. I already had 28 tablets of Metformain from seeing the GP, who said not to start taking it immediately to give my body a chance to get back used to the BP meds and Statin. Then it was almost time to see the DSN anyway, so thought I'd wait till then. I now have the Metformain on repeat too. It was a shock to get the big bag handed to me at the pharmacy, 8 boxes of it! I was instructed to take 1 500mg tab a day for a week, then increase it by 1 more tab every week until I get to 4 tabs/day (2g). These should be spread between breakfast and dinner. Back to the breakfast, yes she said I should have it, she suggested porridge. I mentioned the yoghurt and berries which seem a popular suggestion on these forums, she said watch for the sugar, i.e. sweetened yoghurt. I had already bought some natural Greek style FF yoghurt, which should be fine, plus some berries.

I started the Metformain after the evening meal on Friday, Saturday morning was not good, glad I had plenty of toilet paper. Things are much more settled today. I still get a bit of gurgling in the tummy area, very slight nauseousness and quite a lot of wind, plus a slightly metallic taste. But if that's as bad as it gets, I'll take that. I suspect it will settle more in the coming days and weeks. I tested my BG yesterday before lunch, it was 7.8, the lowest I've seen it since this all came to my attention in late March.

The DSN did say there's no need to keep checking my BG, then added the NHS won't fund it (which I knew), but if my medication changes to something that had a risk of causing a Hypo, they would fund a meter and strips. I said I want to monitor it and I have no problem funding it at this point. I like to keep an eye on it, mainly to check on progress. I'm fortunate that I can stretch to a tub of strips every month or so. I must say I find this 'no need to test' ideology odd. To me having no testing is a bit like driving without a speedometer. But yes I guess people could just go on the 3 monthly HbA1c tests, but it's a long time to wait and how would you know which foods/patterns are the problem ones? I'm only testing about 4 or 5 times a week currently.

I've lost a little more weight and plan to introduce breakfast from tomorrow.

That sounds like good support you have got and hopefully your stomach will settle, many find taking the metformin mid meal helps with that.
If it doesn't then ask for the slow release version if they are not already as they are supposed to be gentler.

 

[Drummer]

. I was given lots of advice and told the lifestyle changes and Metformain are the way to go. I already had 28 tablets of Metformain from seeing the GP, who said not to start taking it immediately to give my body a chance to get back used to the BP meds and Statin. Then it was almost time to see the DSN anyway, so thought I'd wait till then. I now have the Metformain on repeat too. It was a shock to get the big bag handed to me at the pharmacy, 8 boxes of it! I was instructed to take 1 500mg tab a day for a week, then increase it by 1 more tab every week until I get to 4 tabs/day (2g). These should be spread between breakfast and dinner. Back to the breakfast, yes she said I should have it, she suggested porridge. I mentioned the yoghurt and berries which seem a popular suggestion on these forums, she said watch for the sugar, i.e. sweetened yoghurt. I had already bought some natural Greek style FF yoghurt, which should be fine, plus some berries.

I started the Metformain after the evening meal on Friday, Saturday morning was not good, glad I had plenty of toilet paper. Things are much more settled today. I still get a bit of gurgling in the tummy area, very slight nauseousness and quite a lot of wind, plus a slightly metallic taste. But if that's as bad as it gets, I'll take that. I suspect it will settle more in the coming days and weeks. I tested my BG yesterday before lunch, it was 7.8, the lowest I've seen it since this all came to my attention in late March.

The DSN did say there's no need to keep checking my BG, then added the NHS won't fund it (which I knew), but if my medication changes to something that had a risk of causing a Hypo, they would fund a meter and strips. I said I want to monitor it and I have no problem funding it at this point. I like to keep an eye on it, mainly to check on progress. I'm fortunate that I can stretch to a tub of strips every month or so. I must say I find this 'no need to test' ideology odd. To me having no testing is a bit like driving without a speedometer. But yes I guess people could just go on the 3 monthly HbA1c tests, but it's a long time to wait and how would you know which foods/patterns are the problem ones? I'm only testing about 4 or 5 times a week currently.

I've lost a little more weight and plan to introduce breakfast from tomorrow.

A little learning is a dangerous thing - it is carbohydrate, both starch and sugar which raises the blood glucose, so porridge is often not a wise choice unless, by testing you know that it is something you can cope with.
I'm afraid that if the Metformin had such an immediate effect, it might not be at all good in the long term. I'd far rather be able to go out and live my life than be confined to the house - or even just the bathroom, for fear of the effects. Some people do find that things improve, but it got very bad for me and I gave up on the tablets - only to find I never needed them in the first place.
I used a meter t find out what I could eat, stuck to those meals and saw further improvement, and then did not really ned to test any more, so it is not an ongoing expense - something the NHS powers that be seem not to realise. I checked before and after eating at first, then after eating and then only after my evening meals but once I was seeing under 8 almost every time I tested I cut back quite a bit on the testing until I ran out of strips.

 

[bulkbiker]

used to the BP meds and Statin.

You'll find that as your weight drops you probably won't need the BP meds and as for statins unless you've had a heart attack their benefits are dubious and they are known to increase blood sugar levels in some people so....

 

[Admiral Benbow]

You'll find that as your weight drops you probably won't need the BP meds and as for statins unless you've had a heart attack their benefits are dubious and they are known to increase blood sugar levels in some people so....

Yeah about a week or two ago a cardiologist was on the Joe Rogan podcast saying statins are overprescribed and only have effects for four days.

 

[everydayupsanddowns]

I thought it was time for an update. Also thanks for the advice and support. Yes I had been wondering about having no breakfast. I got into the habit of doing this years ago, I actually found it helped me maintain my weight, or stop it going even higher! More on the breakfast below. Also the so called Dawn Phenomenon might be contributing too. I'm typically having 40g of carbs for lunch and 30g for dinner, unless I go out, which is rare these days, 2 or 3 evenings a month typically. I get a bigger spike after lunch, as I've effectively fasted for around 16 hours, perhaps my body is going 'mad for the carbs' after the fasting?

I had my appointment with the DSN on Friday. She was extremely helpful and supportive. I got offered so many things in terms of training and services: Diabetic training, Diabetic eye check, getting my toenails cut, weight loss programme plus a few more. I accepted the first two. I have no problem losing weight, keeping it off has been the challenge, but my new regime should help there. I had my BG, BP, height, weight, waist and feet measured/checked. BP is now 140/80, BMI 27 and the feet currently 'not at high risk'. I was given lots of advice and told the lifestyle changes and Metformain are the way to go. I already had 28 tablets of Metformain from seeing the GP, who said not to start taking it immediately to give my body a chance to get back used to the BP meds and Statin. Then it was almost time to see the DSN anyway, so thought I'd wait till then. I now have the Metformain on repeat too. It was a shock to get the big bag handed to me at the pharmacy, 8 boxes of it! I was instructed to take 1 500mg tab a day for a week, then increase it by 1 more tab every week until I get to 4 tabs/day (2g). These should be spread between breakfast and dinner. Back to the breakfast, yes she said I should have it, she suggested porridge. I mentioned the yoghurt and berries which seem a popular suggestion on these forums, she said watch for the sugar, i.e. sweetened yoghurt. I had already bought some natural Greek style FF yoghurt, which should be fine, plus some berries.

Great to hear you had such a positive appointment @jules748, and thanks for the update 🙂

Hopefully adding in a little something to 'break your fast' will help to switch off the Dawn Phenomenon liver dump - it does seem to for many here. As you have a meter you are in a great place to try a few options. Many members here find porridge is a good reliable slow-release start to the day, but others find their body doesn't seem to have read the memo, and that greek yoghurt and berries or something else fairly low-carb is a better option. I find a single slice of seedy toast is pretty reliable and approx 15-20g carbs.

Some gastric upset is not uncommon when starting Metformin, but lots of people find it settles in a short while as it seem to be doing for you.

I started the Metformain after the evening meal on Friday, Saturday morning was not good, glad I had plenty of toilet paper. Things are much more settled today. I still get a bit of gurgling in the tummy area, very slight nauseousness and quite a lot of wind, plus a slightly metallic taste. But if that's as bad as it gets, I'll take that. I suspect it will settle more in the coming days and weeks. I tested my BG yesterday before lunch, it was 7.8, the lowest I've seen it since this all came to my attention in late March.

The DSN did say there's no need to keep checking my BG, then added the NHS won't fund it (which I knew), but if my medication changes to something that had a risk of causing a Hypo, they would fund a meter and strips. I said I want to monitor it and I have no problem funding it at this point. I like to keep an eye on it, mainly to check on progress. I'm fortunate that I can stretch to a tub of strips every month or so. I must say I find this 'no need to test' ideology odd. To me having no testing is a bit like driving without a speedometer. But yes I guess people could just go on the 3 monthly HbA1c tests, but it's a long time to wait and how would you know which foods/patterns are the problem ones? I'm only testing about 4 or 5 times a week currently.

I think practice nurses are used to seeing lots of different sorts of people with diabetes, and many of their patients find the idea (or reality) of self monitoring painful, inconvenient, and in some cases even anxiety-inducing, demotivating and depressing.

Conversely many on the forum find it an immensely practical way to make better food choices based on the specific reactions of their own bodies. And that seeing the numbers helps them fine tune their menu and motivates them to make further improvements by 'eating to their meter' while being confident they aren't unnecessarily limiting intake of foods just because of their reputation.

I've lost a little more weight and plan to introduce breakfast from tomorrow.

Congratulations on the weight loss. Hope the introduction of breakfast goes well. 🙂

 

[everydayupsanddowns]

Yeah about a week or two ago a cardiologist was on the Joe Rogan podcast saying statins are overprescribed and only have effects for four days.

Couldn't be further from the truth for me.

Low dose statin has put all parts of my cholesterol panel (total cholesterol, LDL, HDL and trigs) within their recommended ranges. And that has certainly lasted for more than four days, because it was several months before I had an updated lipid panel. What an odd thing to say.

This is a summary of the current evidence-based guidelines for cholesterol as a flow-chart

https://www.england.nhs.uk/aac/wp-content/uploads/sites/50/2020/04/National-Guidance-for-Lipid-Management-Prevention-Dec-2022.pdf