HbA1C update

[Northerner]

Fantastic @ColinUK ! Well done!

 

[ColinUK]

The UK guidelines currently focus on the total chol/HDL ratio. For context, US guidelines focus on LDL levels. Either way, you're a bit high on both.

Total chol = LDL + HDL + 0.5 * trigs. Your HDL levels are just fine and in any case, changing HDL can be tough. Your trigs are fine. So from either the US or UK points of view, the evident thing to focus on is reducing LDL.

Dietary changes can have an impact on LDL (eg eating less saturated fat). Statins have a bigger impact. So yr doc will probably want to have a statin conversation.

This is the rough little tool recommended in the UK guidelines for working out your CV, stroke etc risk: https://qrisk.org/three/index.php It's probably worth playing around with it a bit as prep for the doc conversation. You'll quickly see that "diabetes" is just a yes/no switch - no provision for exploring risk for different HbA1c levels etc - and the rough doubling in risk you might see from turning it on is surely far too crude.

But in any case, depending on whether you have any contributing factors, you'll probably find that yr risk levels aren't way high, in which case there's probably no need to make snap decisions on statins etc.

I come out with this...

 

[eggyg]

Well done Colin. Amazeballs daaarhling!

 

[Bloden]

Er, did you mean to put this on the '7 day waking average' thread?

Again?! I seem to do this far too often! Thanks @Robin.

 

[Eddy Edson]

I come out with this...

View attachment 15232

If you want to see roughly what impact taking a statin might have, see what it looks like with yr LDL reduced by 50% (keeping HDL and trigs constant).

 

[PhoebeC]

Great result on the HB1ac

 

[ColinUK]

Interestingly the GP made my Qrisk come out to 16% but we couldn’t figure out why the discrepancy.

Anyway he’s thrilled at the HbA1C figures and the weight loss. He’s a tad concerned at the serum cholesterol/HDL ratio but agreed that we’ll wait another three months and repeat the bloods. I’ve agreed that if the ratio is still a concern I’ll take statins.

Oh and he’s said just one metformin per day and reassess again in three months. That’s officially down from 4 a day and I’m hopeful that in three months it’ll be down to zero.

 

[travellor]

Interestingly the GP made my Qrisk come out to 16% but we couldn’t figure out why the discrepancy.

Anyway he’s thrilled at the HbA1C figures and the weight loss. He’s a tad concerned at the serum cholesterol/HDL ratio but agreed that we’ll wait another three months and repeat the bloods. I’ve agreed that if the ratio is still a concern I’ll take statins.

Oh and he’s said just one metformin per day and reassess again in three months. That’s officially down from 4 a day and I’m hopeful that in three months it’ll be down to zero.

I resisted being taken off Metformin for as long as possible.
It does seem to have a lot of other protective qualities.
Eventually they did refuse to prescribe it though.

 

[Perfect10]

My GP said if your Qrisk is above 20 then you should be on statins, if it’s between 10 - 20 then it’s that grey area, government guidelines say statins but not all GP’s agree. Ideally it should be below 10?
Really good results on the HbA1c though

 

[ColinUK]

I resisted being taken off Metformin for as long as possible.
It does seem to have a lot of other protective qualities.
Eventually they did refuse to prescribe it though.

That’s interesting as the DN was clearly in favour of me continuing to take it twice a day but I resisted. Discussing it with the GP we settled on the once a day.
Nobody’s mentioned the systemic benefits of taking it if BG is stable at these levels though.

 

[Eddy Edson]

That’s interesting as the DN was clearly in favour of me continuing to take it twice a day but I resisted. Discussing it with the GP we settled on the once a day.
Nobody’s mentioned the systemic benefits of taking it if BG is stable at these levels though.

Over the years there have been lots & lots of studies of highly variable quality suggesting that Met has lots & lots of different benefits - ranging from making laboratory rats happier to perhaps making humans live longer.

There are also pretty credible studies showing that in some (not all) people, in can actually intefere with exercise benefits for insulin sensitivity improvements & maybe increase post-exercise fatigue. After experimenting, that's the reason I stopped taking it.

The main BG benefit of Met is to improve waking/fasting levels, by improving liver insulin sensitivity. Once you've lost enough weight to get yr liver insulin sensitivity sorted, Met usually isn't going to do much for yr BG - maybe a bit of post-prandial improvement, but modulo the effect noted above, for some people.

 

[grovesy]

That’s interesting as the DN was clearly in favour of me continuing to take it twice a day but I resisted. Discussing it with the GP we settled on the once a day.
Nobody’s mentioned the systemic benefits of taking it if BG is stable at these levels though.

At one point there were study after study claiming the other benefits, it was almost as if it was the holy grail.

 

[Docb]

Must admit that I have never thought metformin did anything for me. Cannot show it from my data because other things were changing when I was changing metformin doses. The DN wants me to keep taking the minimum dose so I do.

Gliclazide on the other hand was different. Blood glucose levels went up sharply and distinctly when I stopped taking it but returned back to where they were when I restarted.

 

[grovesy]

Must admit that I have never thought metformin did anything for me. Cannot show it from my data because other things were changing when I was changing metformin doses. The DN wants me to keep taking the minimum dose so I do.

Gliclazide on the other hand was different. Blood glucose levels went up sharply and distinctly when I stopped taking it but returned back to where they were when I restarted.

When I came off Gliclazide I was suprised after a week or so how much better I felt. I was having quite a few hypos and despite being on the slow release, I suspect it was making my blood levels swing.

 

[Sharron1]

That’s interesting as the DN was clearly in favour of me continuing to take it twice a day but I resisted. Discussing it with the GP we settled on the once a day.
Nobody’s mentioned the systemic benefits of taking it if BG is stable at these levels though.

There was a time a few months ago when Metformin was in the news about all sorts of good stuff it could do.

 

[Docb]

When I came off Gliclazide I was suprised after a week or so how much better I felt. I was having quite a few hypos and despite being on the slow release, I suspect it was making my blood levels swing.

The way I see it is that there is a lot more to the T2 label than meets the eye and it is no surprise that different people get different outcomes from "standard" treatments.

 

[zuludog]

Well done Colin!

 

[Ljc]

Thought I’d share.... my HbA1C is now 38!

Wonderful

 

[HenryBennett]

Thought I’d share.... my HbA1C is now 38!

Absolutely amazing Colin. Congratulations. You’ll be feeling elated I reckon.

 

[ColinUK]

Absolutely amazing Colin. Congratulations. You’ll be feeling elated I reckon.

Momentarily yes. But I can’t become complacent or I’ll be back to square one. I’ve still got more weight to shift and I want to move more, especially as I’m now WFH so sit at my desk for hours on end instead of getting out for a walk as far as I fancy.

I’m thinking of going full on keto too. Maybe.