Hello new Type 2 HBa1C of 55....

[Lily123]

I have known of a fair few T2s on this forum who have had stomach problems due to metformin. If this happens to you, you could ask for the slow release version of metformin which shouldn’t cause too bad side effects.( they just don’t give slow release straight away as it’s more expensive)

 

[Mrs Mimoo]

I have known of a fair few T2s on this forum who have had stomach problems due to metformin. If this happens to you, you could ask for the slow release version of metformin which shouldn’t cause too bad side effects.( they just don’t give slow release straight away as it’s more expensive)

yeah i heard you had to suffer and then you might get the syrup version or Sukkarto. I hope I am ok.

 

[Leadinglights]

I have IBS so i'm really concerned about having been given the cheapest nastiest Metformin there is, and not a modified release version. Many drugs upset my digestion i am really concerned about this one!

I would double check with your pharmacist if you intend to actually take the metformin that there are no contra-indications with the bisoprolol you take.
Also mention your IBS, but I wouldn't rush to take it without checking first.

 

[Mrs Mimoo]

I would double check with your pharmacist if you intend to actually take the metformin that there are no contra-indications with the bisoprolol you take.
Also mention your IBS, but I wouldn't rush to take it without checking first.

Good idea I will do that.

 

[everydayupsanddowns]

I have IBS so i'm really concerned about having been given the cheapest nastiest Metformin there is, and not a modified release version. Many drugs upset my digestion i am really concerned about this one!

I have heard it suggested that higher doses of Metformin (1500-2000mg) are generally felt to be more effective.

Quantifying the Effect of Metformin Treatment and Dose on Glycemic Control | Diabetes Care | American Diabetes Association

OBJECTIVE. Metformin is the first-line oral medication recommended for glycemic control in patients with type 2 diabetes. We reviewed the literature to quantify

care.diabetesjournals.org

I’m not sure what dose you have been started on, but it might be that if it is still a lower dose, it may not be having all that much effect?

 

[Mrs Mimoo]

Good idea I will do that.

I will definatley have to delay the metformin. I take topamax for migraine and just noticed this warning not to mix them. The GP should know that i am on Topirimate so I am quite perplexed.

Using Metformin together with topiramate may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis, which is a buildup of lactic acid in the blood that can occasionally occur during treatment with metformin-containing products.

 

[Mrs Mimoo]

I have heard it suggested that higher doses of Metformin (1500-2000mg) are generally felt to be more effective.

Quantifying the Effect of Metformin Treatment and Dose on Glycemic Control | Diabetes Care | American Diabetes Association

OBJECTIVE. Metformin is the first-line oral medication recommended for glycemic control in patients with type 2 diabetes. We reviewed the literature to quantify

care.diabetesjournals.org

I’m not sure what dose you have been started on, but it might be that if it is still a lower dose, it may not be having all that much effect?

he gave me 500mg for one week then up it to 1000.

 

[Leadinglights]

If you are prepared to make dietary changes then maybe you should suggest to your G P that you be given 3 months to reduce your HbA1C without any medication as 55mmol/mol although in the diabetic zone is not desperately high.

 

[Burylancs]

How is he right? he told me type 2 remission is a myth and I'll always be diabetic. But a modest weight loss of 6.2kg has brought my HbA1C down to borderline...I think it will go down more with more weight loss. Plus, I have no intention of ever eating lots of carbs, chips or pasta ever again or putting the weight back on - I'll be on a Med low carb regime for ever. I've learned my lesson the hard way. I can see clear gains from eating a low carb high protein high veg diet from now on. It is filling and healthy.

I have not seen my GP in person for two years. I have had no blood tests for two years prior to this diagnosis which is probably why I am now diabetic....I might have caught it if they'd tested me last year when I was presumably pre diabetic.

I would not describe tachycardia as feeling 'a bit off' but they would not see me face to face for that either. I had to pay to go and see a private cardiologist to obtain a diagnosis and some reassurance, and self prescribe beta blockers after two trips to Casualty. Only then a lame email from the GP to put me on some better beta blockers.... this is not medical care it's a car crash.

Yes , Type 2 remission is a myth, your Doc's right. Its become a buzzword over the last ten years but essentially 'remission of Type 2 Diabetes' is Fake News. Annoyingly it's replacing the more sensible term of 'Good Control.' The return to 'normal' cherished by many newbies is an impossible fantasy at the current level of knowledge. Its proponents cant even agree what it means - a recent consensus statement on 'remission', including Diabetes UK, defines it as hba1c of 48 and no anti-glycemic meds for three months. Prof Taylor defined it as those two things PLUS no anti-hypertensive drugs. That definition looks really dangerous because high blood pressure is a real danger in Type 2 and one of the core components of the Metabolic Syndrome.
And no you haven't 'caught' Type 2, its been in your genes since conception waiting to be triggered. Anyone dxed with Type 2 just made a very poor choice of grandparents.

 

[Windy]

@Burylancs it's not unknown for scientists disagree on a particular definition. So for diabetes remission, I found a paper published this year:
Kalra, S., Singal, A. and Lathia, T., 2021. What’s in a name? Redefining type 2 diabetes remission. Diabetes Therapy, pp.1-8.
which states: "However, the definition of diabetes remission has not been agreed upon at a global level." but also goes on to say:
"Type 2 diabetes remission is defined as a healthy clinical state characterized by achievement of HBA1c below the targeted level, maintained for at least 6 months, with or without continued use of lifestyle modification and/or metformin, provided that this is not due to complications, comorbid conditions or concomitant therapy".

which conflicts with:
Buse, J.B., Caprio, S., Cefalu, W.T., Ceriello, A., Del Prato, S., Inzucchi, S.E., McLaughlin, S., Phillips, G.L., Robertson, R.P., Rubino, F. and Kahn, R., 2009. How do we define cure of diabetes?. Diabetes care, 32(11), pp.2133-2135.
who state:
"Complete remission is a return to “normal” measures of glucose metabolism (A1C in the normal range, fasting glucose <100 mg/dl [5.6 mmol/l]) of at least 1 year's duration in the absence of active pharmacologic therapy or ongoing procedures."

and also conflicts with: Lean, M.E., Leslie, W.S., Barnes, A.C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K.G. and Rodrigues, A.M., 2018. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet, 391(10120), pp.541-551.
"remission of diabetes, defined as glycated haemoglobin (HbA1c) of less than 6·5% (<48 mmol/mol) after at least 2 months off all antidiabetic medications, from baseline to 12 months."

Taylor's paper Taylor, R., Ramachandran, A., Yancy, W.S. and Forouhi, N.G., 2021. Nutritional basis of type 2 diabetes remission. bmj, 374.
says "Remission is durable provided weight regain is avoided" and "Type 2 diabetes can be reversed by substantial weight loss in the early years after diagnosis"

I disagree that it's fake news, though I appreciate it may just be rebadging of "good control" that you mention. The last study in particular, linked remission to weight loss, and the participants who didn't get remission got better control of their diabetes, which is a win as far as I'm concerned.
I conceed that it might just be wishful thinking by newbie diabetics such as myself, but the BMJ and The Lancet are well respected medical journals, so I doubt they'd have published two of the papers if they didn't think they were scientifically robust.
Anyhow, you look after yourself and have a good Christmas, Sarah

 

[Mrs Mimoo]

Yes , Type 2 remission is a myth, your Doc's right. Its become a buzzword over the last ten years but essentially 'remission of Type 2 Diabetes' is Fake News. Annoyingly it's replacing the more sensible term of 'Good Control.' The return to 'normal' cherished by many newbies is an impossible fantasy at the current level of knowledge. Its proponents cant even agree what it means - a recent consensus statement on 'remission', including Diabetes UK, defines it as hba1c of 48 and no anti-glycemic meds for three months. Prof Taylor defined it as those two things PLUS no anti-hypertensive drugs. That definition looks really dangerous because high blood pressure is a real danger in Type 2 and one of the core components of the Metabolic Syndrome.
And no you haven't 'caught' Type 2, its been in your genes since conception waiting to be triggered. Anyone dxed with Type 2 just made a very poor choice of grandparents.

1. None of my grandparents had diabetes of any kind and as they are dead i'd rather you didn't disrespect them.
2. I disagree that you can't be in remission as I've read as many papers on it as I can since diagnosis. It seems to depend on keeping your weight under your personal fat threshold. It does not work for everyone. If it does, If you lose lots of weight fast, within 5 years of diagnosis this can work. I'm not saying it will work for ever, but it seems like a good thing to do anyway.
3. I'm new to this - it's been a month since diagnosis so perhaps you could be a bit more reasonable?

 

[Mrs Mimoo]

If you are prepared to make dietary changes then maybe you should suggest to your G P that you be given 3 months to reduce your HbA1C without any medication as 55mmol/mol although in the diabetic zone is not desperately high.

I did suggest this but got a curt text message and a script for metformin.

 

[Lily123]

@Burylancs T2 diabetics can go into remission and saying that genes are the only cause waiting to be triggered is wrong and could really upset someone.

 

[Windy]

I guess it comes down to if you're willing to believe a professor who studies diabetes at a diabetes research centre at a university and has run multiple clinical trials on remission and the NHS who are running trials of the diet in England about which the web page says "in some cases, put their Type 2 diabetes into remission (no longer have diabetes)" or not. I did wonder if he was a snake oil salesman, but he's not selling the shakes, and he's donated the proceeds from his books to Diabetes UK, so he's not gaining financially there either.

I'd rather give it a go and try for remission than not. At worst, it doesn't work and I've lost a bit of weight and have better control of my blood sugar levels, at best it does work and I have to continue to lose weight and keep it off, but have normal blood sugar levels.

 

[Leadinglights]

I did suggest this but got a curt text message and a script for metformin.

Yes but it is your decision whether you take it, and hopefully you will be able to prove him wrong.

 

[ianf0ster]

It isn't just Prof Taylor saying about lasting T2 Diabetes remission, it's also the Low Carb exponents in the UK (Dr David Unwin etc. ) , in Australia (Dr Paul Mason. Dr Gary Fettke etc) , in South Africa (Prof Tim Noakes ), in the USA (the Virta doctors including Volek and Sarah Hallberg) and from Canada a proponent of fasting which is a more extreme version of vlcd or Low Carb for the morbidly obese ( Dr Jason Fung). All of the above mentioned including Prof Taylor have agreed a definition of the term Type 2 Diabetes remission, in the last couple of months.
And there are people who have met that definition for over 10yrs - so don't let anybody try to persuade you that it's a myth!

 

[Drummer]

I am classed as in remission, and I got to the state where I don't spike when I eat carbs - BUT - and it is a big BUT - if I eat carbs over my self imposed 40 gm of carbs a day I put on weight - it has always been the same, and I have battled with those who tell me that I am wrong about it - I just need to keep on eating the carbs in small amounts and it will all come right - though one or two have been alarmed by my chalk white appearance and inability to understand what is going on when in starvation mode after following orders for a few weeks.
One did order me to exercise and only relented when I went grey and passed out.

 

[janw]

@Mrs Mimoo Hello. I am still fairly new to T2 but as you will see from my signature, our result at diagnosis was pretty much the same. I said I did not want the meds but to try diet and exercise, there is nothing to stop you from trying that way, they cannot make you take the metformin. My DN is well aware that I do not like meds (nor do most like me!), so they are a "last resort" for me, and she is happy to let me continue without until I see her next April - by which time I hope that I have returned to prediabetic. I appreciate that this new eating and exercise regime, plus carb counting, will be for life, but that is no bad thing when we can see how much healthier it is for us and the benefits that come with it.
You have been given some good advice on the whole. Once you get your meter you will start to feel even more in control of what you can eat, adjustments of or alternatives to try.
We are all individuals and things affect all of us differently, that is why we test a lot to start with, perhaps also when we don't feel "right" or unwell, or when we try something new - because there is no rule for all, we have to find our own paths.
I hope you find, and take, the path that is right for you - we will be here to support you in any way we can. I would be lost without this site, it has been a blessing in providing so much understanding and knowledge, friendship and empowerment.

 

[Mrs Mimoo]

@Mrs Mimoo Hello. I am still fairly new to T2 but as you will see from my signature, our result at diagnosis was pretty much the same. I said I did not want the meds but to try diet and exercise, there is nothing to stop you from trying that way, they cannot make you take the metformin. My DN is well aware that I do not like meds (nor do most like me!), so they are a "last resort" for me, and she is happy to let me continue without until I see her next April - by which time I hope that I have returned to prediabetic. I appreciate that this new eating and exercise regime, plus carb counting, will be for life, but that is no bad thing when we can see how much healthier it is for us and the benefits that come with it.
You have been given some good advice on the whole. Once you get your meter you will start to feel even more in control of what you can eat, adjustments of or alternatives to try.
We are all individuals and things affect all of us differently, that is why we test a lot to start with, perhaps also when we don't feel "right" or unwell, or when we try something new - because there is no rule for all, we have to find our own paths.
I hope you find, and take, the path that is right for you - we will be here to support you in any way we can. I would be lost without this site, it has been a blessing in providing so much understanding and knowledge, friendship and empowerment.

Hi there! thank you and yes, our profiles look similar! I have just had a mail from the actual Professor Taylor (I am amazed and so pleased he mailed me) saying I am on the right track.... I emailed him and he mailed back. He says my lowered HbA1C in one month of weight loss shows I will probably hit my target as long as I keep losing weight on the Newcastle Diet and see where it takes me. He has told me to lose 15kg so I will. Feeling a bit better today.

 

[Mrs Mimoo]

weight loss now 8kg....down to 93... that target of 15kg is achievable. Merry Christmas to all.