HbA1c came back as 60

[Seniz]

Hello 🙂

I weigh 47 kg (I lost 15 kg), I eat healthily with almost zero carbs and no sweets at all. My HbA1c was 59–58, and I was diagnosed with type 2 diabetes. The diabetes nurse prescribed Metformin 500 mg twice a day. After 3 months, I had a routine blood test, and my HbA1c came back as 60. I'm quite disappointed and sad. Why didn’t Metformin work? Do I need to take it for a longer period? Maybe I'm not type 2? I’d love to hear your experiences and opinions if any of you have been in the same shoes as me.

Thanks in advance ....

 

[Drummer]

My first thought is that an ordinary type 2 eating low carb would normally see a return to more normal numbers quite quickly.
Have you got any way to check your blood glucose?
Have you been checked for other types of diabetes? Your weight alone should have raised red flags, but combined with no alteration in HbA1c despite your diet, that is not at all typical of type 2

 

[Greatness]

Hello 🙂

I weigh 47 kg (I lost 15 kg), I eat healthily with almost zero carbs and no sweets at all. My HbA1c was 59–58, and I was diagnosed with type 2 diabetes. The diabetes nurse prescribed Metformin 500 mg twice a day. After 3 months, I had a routine blood test, and my HbA1c came back as 60. I'm quite disappointed and sad. Why didn’t Metformin work? Do I need to take it for a longer period? Maybe I'm not type 2? I’d love to hear your experiences and opinions if any of you have been in the same shoes as me.

Thanks in advance ....

Thank you so much for sharing your experience with us , I can imagine how frustrating and discouraging this must feel after the effort you’ve put into managing your health.

It’s important to remember that everyone’s journey with type 2 diabetes is different, and HbA1c levels can be influenced by a range of factors including your body’s unique response to medication, genetics, and other health conditions. While Metformin works well for many people, it may take longer for some, or adjustments might be needed in dose or treatment plan.
I’d encourage you to discuss your concerns with your diabetes nurse or GP. They can explore whether further tests are needed e.g, to rule out other types of diabetes or to adjust your management plan to better suit your needs.

Although I don't have personal experience with diabetes, as a hca/ support worker and someone with a background in public health, I’ve seen how valuable it can be to have supportive conversations with your care team and stay informed about your condition.

You’re not alone in this, and you’re doing the right thing by reaching out. Others in the community may share their own experiences and offer some reassurance as well.

Take care, and we’re here for you.

 

[Inka]

Hello 🙂

I weigh 47 kg (I lost 15 kg), I eat healthily with almost zero carbs and no sweets at all. My HbA1c was 59–58, and I was diagnosed with type 2 diabetes. The diabetes nurse prescribed Metformin 500 mg twice a day. After 3 months, I had a routine blood test, and my HbA1c came back as 60. I'm quite disappointed and sad. Why didn’t Metformin work? Do I need to take it for a longer period? Maybe I'm not type 2? I’d love to hear your experiences and opinions if any of you have been in the same shoes as me.

Thanks in advance ....

When/how did you lose the 15kg @Seniz ? Were you trying to lose weight or did it drop off unexpectedly? Does anyone else in your close family have diabetes? Could you give an example of an average day’s food for you?

 

[Docb]

Hi @Seniz and welcome to the forum. If you read around the forum you will find that there is a group of us who, like you, have HbA1c's above the diagnosis level but are not overweight and for whom the standard advice to lose weight and all will be well simply does not apply. There are many reasons why your natural blood glucose control might be poor. Being overweight is a biggie, but there are other reasons and they all tend to get pushed under the type 2 umbrella. Unless you are obviously T1, the medics will tend to treat you as a generic T2.

A couple of things I might suggest .

First, might I suggest that you do a food diary and write down everything you consume (yes everything including drinks and snacks) just to see how many carbs you are consuming in your normal diet. Will need a bit of looking things up and maybe weighing things but it is worth doing. Those of us who use diet to control blood glucose tend aim for less than 120 g/day of carbohydrate. It would be interesting to see where you stand.

Second, think about getting a blood glucose meter. You can use this to see where your levels are and to see if particular foods give bigger rises than others allowing you to adjust your diet to avoid them.

Other thoughts. No need to panic. You don't give your BMI but unless you are uncommonly small losing more weight in an attempt to control blood glucose is not a good idea. Being underweight introduces a whole raft of other problems.

My other thought is to read around the forum, get a perspective on your diabetes and above all ask questions. We will do our best to help you work things out.

 

[saffron15]

I have looked at some of your older posts. You refer to an hba1c of 48 and reducing to 42 in 2023 You seemed to have had a sweet tooth which you have curbed. It looks like the weight loss was when you stopped your sweet treats. You mentioned your father was diabetic was that 2 or 1? A sudden weight loss plus no change in hba1c despite medication can point to possibly type 1. You need to get advice from the surgery. You clearly shouldn't lose more weight. Unless you are eating a lot of sugary food still it is strange your hba1c hasn't dropped. I remember last year you were anxious about testing your blood glucose. Did you manage to do it? Are you managing to move eg short walks gardening housework?
Metformin seems to either disagree with people or works. I see Docb suggests you keep a food diary if it's not going to cause you stress it's a good idea. You can add any testing results. Either testing just when you wake to see if it gradually changes or before you eat something new and two hours after the meal started. I'm sure the surgery will want to discuss if there is any reason for your hba1c not changing. If they don't try a food diary and testing for a fortnight then make an appointment.
Good luck
.

 

[everydayupsanddowns]

Sorry to hear your HbA1c has come back higher than you’d hoped for, despite adding Metformin into your diabetes management toolkit.

Metformin does tend to work fairly steadily in the background once the dose builds up, and seems to have more effect once the dose gets to about 1500mg - 2000mg per day, though people are generally advised to build up to hat level gradually. Metformin works by improving insulin sensitivity, and reducing background glucose released by the liver, so it doesn’t really act directly on a meal-by-meal basis.

I think @Docb ’s suggestion of a food diary might be helpful - once you’ve cut right back on portions of the obvious sources of carbohydrates, the little fractions left from various veggies, dairy, and berries can start to add up, as the body will go looking for them.

If it’s any consolation, I’d not really consider 58-59 to 60 as being any kind of meaningful rise. It’s disappointing that it didn’t go down for sure, but your HbA1c has basically held steady to my mind.

 

[JITR]

The target weight loss of 15kg is largely based.on the original research of Prof Roy Taylor and his team at Newcastle University about fifteen years ago.

This showed that weight loss on a nutritious diet with adequate protein and reduced carbohydrates could restore liver function and reduce blood glucose levels for most people. This was entirely dependent on the capacity of the pancreas to recover and produce more insulin again.

As others have suggested you need to check your diet and review your treatment with your medical team. Members here will be able to advise on diet if you post details of what you have been eating and drinking on a typical day.

 

[Seniz]

My first thought is that an ordinary type 2 eating low carb would normally see a return to more normal numbers quite quickly.
Have you got any way to check your blood glucose?
Have you been checked for other types of diabetes? Your weight alone should have raised red flags, but combined with no alteration in HbA1c despite your diet, that is not at all typical of type 2

Hi ,
I have monitor at home , but my HbA1c started from 48, 59, 58 before metformin , after metformin is 60.
Why do you think my weight is red flags ? I am also very short 🙂
I will be very sad if it is Type 1

 

[Seniz]

Thank you so much for sharing your experience with us , I can imagine how frustrating and discouraging this must feel after the effort you’ve put into managing your health.

It’s important to remember that everyone’s journey with type 2 diabetes is different, and HbA1c levels can be influenced by a range of factors including your body’s unique response to medication, genetics, and other health conditions. While Metformin works well for many people, it may take longer for some, or adjustments might be needed in dose or treatment plan.
I’d encourage you to discuss your concerns with your diabetes nurse or GP. They can explore whether further tests are needed e.g, to rule out other types of diabetes or to adjust your management plan to better suit your needs.

Although I don't have personal experience with diabetes, as a hca/ support worker and someone with a background in public health, I’ve seen how valuable it can be to have supportive conversations with your care team and stay informed about your condition.

You’re not alone in this, and you’re doing the right thing by reaching out. Others in the community may share their own experiences and offer some reassurance as well.

Take care, and we’re here for you.

Hi
This week, I’m planning to see my diabetic nurse. I also wrote an email to my professor, who is an endocronolojist. I hope they can both help me because I’m very symptomatic — I feel every small change in my body, and it makes me so uncomfortable and unsocial.

 

[Seniz]

When/how did you lose the 15kg @Seniz ? Were you trying to lose weight or did it drop off unexpectedly? Does anyone else in your close family have diabetes? Could you give an example of an average day’s food for you?

Hi,
To be honest, I lost weight slowly — it took me 1.5 years. I just cut out all carbs and everything I loved.
I was hoping to reverse my prediabetes, but unfortunately, it didn’t work and now I’m diabetic.

Sadly, my dad, my brothers, and my cousins on my dad’s side all have diabetes.
I’m not sure if it’s genetic or caused by their eating habits.

My own eating habits are actually quite healthy — more of a Mediterranean style, since I’m Turkish.

In the morning – I have 1 boiled egg, a small cucumber, tomatoes, olives, white cheese, walnuts, a bit of olive oil and oregano on top of some parsley.
For lunch – I eat some salad and grilled chicken.
In the evening – I have a vegetable dish, just soup, or grilled fish

 

[Seniz]

Hi @Seniz and welcome to the forum. If you read around the forum you will find that there is a group of us who, like you, have HbA1c's above the diagnosis level but are not overweight and for whom the standard advice to lose weight and all will be well simply does not apply. There are many reasons why your natural blood glucose control might be poor. Being overweight is a biggie, but there are other reasons and they all tend to get pushed under the type 2 umbrella. Unless you are obviously T1, the medics will tend to treat you as a generic T2.

A couple of things I might suggest .

First, might I suggest that you do a food diary and write down everything you consume (yes everything including drinks and snacks) just to see how many carbs you are consuming in your normal diet. Will need a bit of looking things up and maybe weighing things but it is worth doing. Those of us who use diet to control blood glucose tend aim for less than 120 g/day of carbohydrate. It would be interesting to see where you stand.

Second, think about getting a blood glucose meter. You can use this to see where your levels are and to see if particular foods give bigger rises than others allowing you to adjust your diet to avoid them.

Other thoughts. No need to panic. You don't give your BMI but unless you are uncommonly small losing more weight in an attempt to control blood glucose is not a good idea. Being underweight introduces a whole raft of other problems.

My other thought is to read around the forum, get a perspective on your diabetes and above all ask questions. We will do our best to help you work things out.

Thank you so much for all your advice — I will follow it.
The nurse gave me a blood test monitor but told me not to check too often, as it might cause stress. I’m using it once a week.


I’ve cut most carbs, but I still really love lentil soup, bulgur pilaf, and bean dishes.
I was hoping those are good carbs.

 

[Seniz]

I have looked at some of your older posts. You refer to an hba1c of 48 and reducing to 42 in 2023 You seemed to have had a sweet tooth which you have curbed. It looks like the weight loss was when you stopped your sweet treats. You mentioned your father was diabetic was that 2 or 1? A sudden weight loss plus no change in hba1c despite medication can point to possibly type 1. You need to get advice from the surgery. You clearly shouldn't lose more weight. Unless you are eating a lot of sugary food still it is strange your hba1c hasn't dropped. I remember last year you were anxious about testing your blood glucose. Did you manage to do it? Are you managing to move eg short walks gardening housework?
Metformin seems to either disagree with people or works. I see Docb suggests you keep a food diary if it's not going to cause you stress it's a good idea. You can add any testing results. Either testing just when you wake to see if it gradually changes or before you eat something new and two hours after the meal started. I'm sure the surgery will want to discuss if there is any reason for your hba1c not changing. If they don't try a food diary and testing for a fortnight then make an appointment.
Good luck
.

Hi
To be honest, after everything I’ve done and all the advice I’ve followed from health professionals, I’m really scared to say this — but I’m starting to think I might be Type 1.

My dad was on insulin.
I haven’t eaten any sweets or “bad” foods for more than 1.5 years. No bread, nothing unhealthy.

I go for a walk after work at 5 PM, and I try to do 4 km. I also do some gardening and of course, house cleaning.
But some days, I have no energy at all — not even for the smallest things.

I walk because it calms me down.
I feel like diabetes is making me angry for no reason.

 

[Seniz]

Sorry to hear your HbA1c has come back higher than you’d hoped for, despite adding Metformin into your diabetes management toolkit.

Metformin does tend to work fairly steadily in the background once the dose builds up, and seems to have more effect once the dose gets to about 1500mg - 2000mg per day, though people are generally advised to build up to hat level gradually. Metformin works by improving insulin sensitivity, and reducing background glucose released by the liver, so it doesn’t really act directly on a meal-by-meal basis.

I think @Docb ’s suggestion of a food diary might be helpful - once you’ve cut right back on portions of the obvious sources of carbohydrates, the little fractions left from various veggies, dairy, and berries can start to add up, as the body will go looking for them.

If it’s any consolation, I’d not really consider 58-59 to 60 as being any kind of meaningful rise. It’s disappointing that it didn’t go down for sure, but your HbA1c has basically held steady to my mind.

Thank you so much for your time and advice — I keep all of it in mind.
Listening to and following the advice and experiences of other people with diabetes is very important to me

 

[Seniz]

The target weight loss of 15kg is largely based.on the original research of Prof Roy Taylor and his team at Newcastle University about fifteen years ago.

This showed that weight loss on a nutritious diet with adequate protein and reduced carbohydrates could restore liver function and reduce blood glucose levels for most people. This was entirely dependent on the capacity of the pancreas to recover and produce more insulin again.

As others have suggested you need to check your diet and review your treatment with your medical team. Members here will be able to advise on diet if you post details of what you have been eating and drinking on a typical day.

Hi,
I’m 1.5 meters tall and 47 kg — I look like a 12-year-old girl, but with a 50-year-old face
I used to be 63 kg, and all my life I was overweight for my height.

When my doctor told me I needed to lose weight or I’d move into diabetes, I listened very carefully.
I lost 15 kg in 1.5 years — but it didn’t work.

Maybe it’s just bad luck… or genetics.

 

[Leadinglights]

Hi,
I’m 1.5 meters tall and 47 kg — I look like a 12-year-old girl, but with a 50-year-old face
I used to be 63 kg, and all my life I was overweight for my height.

When my doctor told me I needed to lose weight or I’d move into diabetes, I listened very carefully.
I lost 15 kg in 1.5 years — but it didn’t work.

Maybe it’s just bad luck… or genetics.

As you have a monitor it would be worth testing some of your meals especially those with the higher carb foods by testing before you eat and after 2 hours, a increase of less than 2-3mmol/l or less than 8-8.5 mmol/l would indicate the meal is OK.
It is usually sudden weight loss that may point to Type 1 together with symptoms of excessive thirst, frequent loo visits, tiredness, fussy vision and sometimes UTIs.
Some blood glucose readings together with a food diary of everything you eat and drink with an estimate of the carbs would provide some evidence to inform your doctor as to the next step to help reduce your HbA1C which although not desperately high could do with being lower to reduce your risk of complications.
It is disappointing when you seem to have been doing the right thing and taken it seriously but you can undo the past and the focus now is to find a way forward.

 

[Seniz]

As you have a monitor it would be worth testing some of your meals especially those with the higher carb foods by testing before you eat and after 2 hours, a increase of less than 2-3mmol/l or less than 8-8.5 mmol/l would indicate the meal is OK.
It is usually sudden weight loss that may point to Type 1 together with symptoms of excessive thirst, frequent loo visits, tiredness, fussy vision and sometimes UTIs.
Some blood glucose readings together with a food diary of everything you eat and drink with an estimate of the carbs would provide some evidence to inform your doctor as to the next step to help reduce your HbA1C which although not desperately high could do with being lower to reduce your risk of complications.
It is disappointing when you seem to have been doing the right thing and taken it seriously but you can undo the past and the focus now is to find a way forward.

thank you , i am planning to have food diary and show it to my nurse.
I was thinking of beans , lentils, bulgur are okey but maybe they are bad for me as well.
Also maybe some vitamins sprays and gaviscon i am using daily maybe has sugar in them ( pharmacy told me no but)

frequent loo visits, tiredness, fussy vision are my symptoms as well