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Hba1c up.

D

Debbie Thomsett

New Member
Relationship to Diabetes
Type 2
Hi, I’m looking for a bit of advice really. I’ve been type 2, diet controlled for about 12 years. My Hba1c recently went up to 58 and I was told to start Metformin. No discussion, just “you need to take it”. I’m a retired nurse so have a little medical knowledge and I’m aware that it is contraindicated if you have kidney disease or liver problems, I have both. The practice nurse seemed clueless about this so I declined the tablets and asked to be retested in June.
My question is, has anyone else had this sort of experience? I’m reluctant to start medication that might have adverse effects and I know the side effects can be bad. What would you do?

Debbie
 
Hi and welcome.

First off, well done for 12 years of dietary management, but sorry to hear that your HbA1c has crept up. Can I ask what dietary changes you made and is there any wriggle room for additional carb reduction and adding in a bit more protein and healthy fats so that you don't feel hungry?
Do you have much/any weight to lose?
Are you able to increase exercise?
Do you test your response to foods with a BG meter? It may be that there are just certain foods which are elevating your BG levels which you could reduce the portion of or find a lower carb alternative. Bread, pasta and porridge are the ones that cause my body problems, even wholemeal versions, so I mostly avoid those but I have a small portion of potatoes occasionally but mostly base my meals on meat/fish/cheese/eggs and veg/salad.
 
Hi @Debbie Thomsett and welcome to the forum! You'll see from my (rather verbose) signature, that my experience was somewhat similar. I had several years of managing Type 2 via diet and exercise. However, as my GP explained, this can be a progressive condition, and the time came when I needed medication to help, much to my annoyance. I had pushed back against going on Metformin for some time, and my GP certainly wasn't forcing it on me. Unfortunately, it gradually stopped my guts from working, and I lost weight, which I could ill afford, and we agreed I come off it, pending something else - the GP admitting it was developed originally as a slimming drug! The pandemic intervened, I managed to recover control by diet and exercise for some time longer. I did this by really focussing on what I ate, and serious carb counting, so ensuring I didn't eat too much in any single meal, ensuring my calorie needs were met by the reduced cards, plus proteins and fats.

I was then put on Sitagliptin, which works for me. This seems to keep down my baseline blood sugar (fasting) levels. However it may not be suitable for someone who has had kidney problems.

You should feel able to consult your GP about not taking Metformin if you have concerns over its side effects and suitability. There are alternatives out there. Metformin is the NHS default go-to treatment and I suspect the alternatives are dearer - so I don't blame them for prescribing it first...but obviously not if it's dangerous to you. If they insist you must take it, ensure they monitor your other conditions closely!

@rebrascora has asked you a number of pertinent, important questions and made points that I would otherwise made - please consider her reply also.

Hope this helps, Nick.
 
Debbie Thomsett said:
My question is, has anyone else had this sort of experience? I’m reluctant to start medication that might have adverse effects and I know the side effects can be bad. What would you do?
Click to expand...

Yes. I had not been tested for over 10 years when my HbA1c came out 104. GP ordered me to start on Metformin at once and also diagnosed hemochromatosis (too much iron for the liver).

After looking up the side effects, I read Prof Roy Taylor's Life without Diabetes,Type 2. That convinced me to see if my HbA1c would come down to normal (<42) by losing 15kg on a real food version of the Newcastle Diet without medication. It did.

He covered the same ground in this excellent talk Roy Taylor, Achieving T2D remission (May 2023) and emphasised his message to lose weight by any sensible means.

Two 'sensible means' are described in:
- Dr David Unwin's Norwood diet sheet and
- Dr Kim Andrew's Freshwell simple meal planner and red, amber, green food lists.
 
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