HbA1C of 40 - do I still need Metformin?

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Helen1966

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Type 2
Hi Everyone, I was diagnosed mid June 2021 with Type 2 Diabetes. I've just had follow-up HbA1C results.
In June - 57
Now - 40

Diabetes nurse said I could stop taking the Metformin if I liked and have another HbA1C test in 6 months.

I've elected to stay on the meds and review in 6 months. I've lost 2 stone in weight, my cholesterol is now only 3.5 as well.

What would you do, have I made the right choice? 40 is a bit close to the pre diabetes 42-47 for my liking you see?
 
Hi @Helen1966 . How did you lose your weight, if was was a deliberate low carb regime it would have been that much more than the metformin that helped you lose the weight which was probably the main contributory factor in dropping your BG. I couldn't wait to get off Metformin, hated the things - but if you are not having any side effects then there is no harm in staying on them...IMHO.
 
Helen1966 said:
Hi Everyone, I was diagnosed mid June 2021 with Type 2 Diabetes. I've just had follow-up HbA1C results.
In June - 57
Now - 40

Diabetes nurse said I could stop taking the Metformin if I liked and have another HbA1C test in 6 months.

I've elected to stay on the meds and review in 6 months. I've lost 2 stone in weight, my cholesterol is now only 3.5 as well.

What would you do, have I made the right choice? 40 is a bit close to the pre diabetes 42-47 for my liking you see?
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Well done!

IMO, generally there should be no harm in staying on the Met if you like, but the benefits may be quite small.

HCP's never seem to explain what Met actually does, but it can be helpful to look at in a bit of detail.

Generally one of the big things for a T2D is insulin resistance in the liver, which screws up the mechanism by which the liver decides whether or not it should chug out more glucose to keep your brain alive etc etc ("gluconeogenesis"). Met reduces this insulin resistance => reduced unwanted glucose production by the liver.

And generally a major reaon why the T2D liver has high insulin resistance is because there's too much fat hanging around it. Lose a bunch of weight => reduce liver fat => reduce liver insulin resistance => reduce gluconeogenesis => less for Met to do.

A reasonable sign that yr liver is sorted after weight loss is probably if your waking/fasting BG levels are back into "normal" ranges, so say less than 5.4 mmol/L (because your liver hasn't been chugging out glucose all night, unnesessarily). At that point, probably the benefit of continuing with Met is improvement of insulin resistance in your muscles, which could lead to lower BG levels after eating. But this effect might be pretty small.
 
I didn't do anything special to lose the weight. I went through a phase where I lost my appetite, then another month where I was hungry all the time. I haven't been low carbon, I'm just more mindful of what I eat and have stopped eating pastry and cake. I love chocolate but have switched to 85% dark and only 20g on any given day.
I didn't set out to lose 2 stone, it just kind of happened.
 
I haven't been low carbing, I eat wholemeal bread, about 2 slices a day. If I have risotto it's from a recipe on here and I've switched to wholemeal pasta. I don't buy anything that's all red on the traffic light system on the packaging and have switched to sugar free biscuits.
 
I prefer brown rice anyway and weigh it, I weigh my porridge oats in the morning as well. I've just made some lifestyle changes. I exercise every day which I think helps as well. Even if it's just a 15 min walking and low impact workout on youtube till I can build up to 30 min a day ones, I'm moving more than I was before the diagnosis. Now the evenings are dark I prefer to exercise at home
 
Helen1966 said:
I didn't do anything special to lose the weight. I went through a phase where I lost my appetite, then another month where I was hungry all the time. I haven't been low carbon, I'm just more mindful of what I eat and have stopped eating pastry and cake. I love chocolate but have switched to 85% dark and only 20g on any given day.
I didn't set out to lose 2 stone, it just kind of happened.
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Well it is still fantastic.
 
Thanks everyone. I'll do some 1st thing tests and see what the figures are. I didn't want to just come off the Metformin, I'm staying on it another 6 months and see what the next blood test looks like. I didn't want to assume I was fine and end up falling off the wagon.
 
Helen1966 said:
Thanks everyone. I'll do some 1st thing tests and see what the figures are. I didn't want to just come off the Metformin, I'm staying on it another 6 months and see what the next blood test looks like. I didn't want to assume I was fine and end up falling off the wagon.
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Tbh I would do the same. 6 months gives you some thinking time abd Eddy's info re Metformin was super helpful. Happy testing.
 
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