Diet or medication?

Status
Not open for further replies.
C

Caroline1967

Well-Known Member
Relationship to Diabetes
Type 2
Hi
I wonder if anyone has any ideas about this!
When I was diagnosed type 2 at the beginning of May I was told to follow a low carb diet....which I did. I am very overweight but have found this way of eating has really helped me lose weight. I have lost about 2 stone since diagnosis. I have been taking metformin for 3 months, initially I took dapaglifozin and gliclozide too but had to stop them because it was suspected I was allergic to one of them as my tongue kept swelling. I stopped the dapa after one month but the swelling still happened so I stopped the gliclazide too. The swelling stopped and I just took the metformin. My HBA1c dropped from 120 to 56 during the 3 months. I spoke to my diabetic nurse on Monday who was obviously pleased with the drop but suggested I take empagliflozin because I am still getting some higher reading such as 9 and 10.

I have been referred to a diabetic weight loss program am am supported by a dietician who was adamant that I should not follow a low carb plan and take empagliflozin as it causes DKA. This isn't going to be an issue as I only took one tablet before my face swelled up and the GP told me to stop taking it! I am speaking to my nurse again this afternoon about replacing the empagliflozin. I think he may offer me canagliflozin as he mentioned it on a previous occasion.

I am wondering which is more important in diabetes control. Significant weight loss which I think I will manage following the low carb diet or taking the canagliflozin? I want to be armed with a response if it is suggested to me. He did say there were other benefits to taking flozins (but I cant remember what they were!) but there are many benefits to weight loss!

Has anyone discussed this with their diabetic team and can help me?
Thanks for reading.

Caroline
 
Caroline1967 said:
Hi
I wonder if anyone has any ideas about this!
When I was diagnosed type 2 at the beginning of May I was told to follow a low carb diet....which I did. I am very overweight but have found this way of eating has really helped me lose weight. I have lost about 2 stone since diagnosis. I have been taking metformin for 3 months, initially I took dapaglifozin and gliclozide too but had to stop them because it was suspected I was allergic to one of them as my tongue kept swelling. I stopped the dapa after one month but the swelling still happened so I stopped the gliclazide too. The swelling stopped and I just took the metformin. My HBA1c dropped from 120 to 56 during the 3 months. I spoke to my diabetic nurse on Monday who was obviously pleased with the drop but suggested I take empagliflozin because I am still getting some higher reading such as 9 and 10.

I have been referred to a diabetic weight loss program am am supported by a dietician who was adamant that I should not follow a low carb plan and take empagliflozin as it causes DKA. This isn't going to be an issue as I only took one tablet before my face swelled up and the GP told me to stop taking it! I am speaking to my nurse again this afternoon about replacing the empagliflozin. I think he may offer me canagliflozin as he mentioned it on a previous occasion.

I am wondering which is more important in diabetes control. Significant weight loss which I think I will manage following the low carb diet or taking the canagliflozin? I want to be armed with a response if it is suggested to me. He did say there were other benefits to taking flozins (but I cant remember what they were!) but there are many benefits to weight loss!

Has anyone discussed this with their diabetic team and can help me?
Thanks for reading.

Caroline
Click to expand...
Hi Caroline,
Sorry I’m no expert as I’ve had my diagnosis less time than you (6 weeks). However, I have read Micheal Mosley’s 8 week Blood Sugar diet book which contains many powerful arguments as to the benefits of a low carb diet the Mediterranean diet. I’ve been following this M idea (but not the actual 800 calorie a day version). I’ve lost weight about a stone so far. Which, along with 1g Metformin a day has managed to control my BG. The stories in the book do suggest that following this diet can reverse diabetes and get you off the meds but I think your medical team need to be on side for this.
 
HI @Brianson I have been reading that too! I have more than 800 calories a day as I can't manage on so little!
Personally I think I would rather rely on the diet rather than the medication so I am hoping my nurse will agree with me. Half of me thinks it is my body and I should do what I want and the other half thinks I should listen to the experts and follow their advice!

Thanks for the reply.
caroline
 
You are very early in the journey to getting your blood glucose under good management and in order to keep it there you have to have a dietary regime (note I do not say A DIET) that is enjoyable and sustainable and will be the new normal way of eating. That might be with the help of some medication but as someone described the meds are like bailing out an overflowing sink which will still overflow unless you turn the tap off i.e. reduce carbs that you are having.
I reduced my carbohydrate intake to 70g per day all at once and yes my HbA1C reduced from 50mmol/mol to 42 in 3 months but I had 6 months of problems with my vision. I only read on here later that reducing carbs too quickly can cause that. But I have stick with the 70g per day and that is what now seems normal to me. I enjoy the foods I have and don't miss all the extra carbs I was having.
 
Caroline1967 said:
HI @Brianson I have been reading that too! I have more than 800 calories a day as I can't manage on so little!
Personally I think I would rather rely on the diet rather than the medication so I am hoping my nurse will agree with me. Half of me thinks it is my body and I should do what I want and the other half thinks I should listen to the experts and follow their advice!

Thanks for the reply.
caroline
Click to expand...

Caroline, you have achieved a seismic shift in your blood glucose numbers in a short time, just using diet aad Metformin. Metformin is a very gentle drug as far as the impact on blood sugars, so YOU did the work, not the tablet, and perhaps a few tweaks could make the required difference.

In your shoes, I would not be keen to take any of the flozins, bearing in mind you had some issues in the past.
However, in terms of Flozins and DKA, yes it can happen, but it seems somewhat usual. If you decided to take it, and continue on your low carb diet, it would be important to understand the signs, so that you would be equipped to take rapid action, if required.

To be clear, I am not telling you what to do, or suggesting I am correct in what I would do, but it's all I can tell you - what I would do.

Whatever you decide, good luck with it. You've done so well so far.
 
Hi. In general the advice is always to try the right diet and exercise before medication and then take medication as well if needed. I don't agree with the dietician which is not unusual as many in my opinion haven't a clue. Yes, be careful to avoid DKA with both low-carb and insulin-triggering meds but that means agreeing with the GP to reduce the meds if necessary.
 
A low carb diet is not reccomended with any of the flozin medications, I’d be surprised if they gave you a different one in the same family after a reaction, after I had a reaction they said not to take any medication in that family.
 
Status
Not open for further replies.
Back
Top