Hello

[Greatgranny1]

I am a 73 year old great grandmother who went to the surgery for an asthma (mild) check back in June. The nurse took bloods as I hadn't had any taken for several years and I was shocked several weeks later when she called back to say my Hba1C level was 48 and the GP was sending out Metformin to take. When I queried this the nurse advised me to return in 3 months for another blood glucose level test. I did this and my level was 45. I refused to take the Metformin until I had the second test result and I still haven't taken any. I have no symptoms, my risk level is moderate due to age and high blood pressure (which is controlled by medication). I have been given no information/help by my surgery but they did arrange for me to have a foot check at a local health centre! I have not been invited to attend any in-person/online advice sessions. My doctor was dismissive when I asked if I could modify my diet (which is healthy anyway) and he just told me to take the tablets. My granddaughter is a junior doctor in our local hospital and she cannot understand my GP's decision. She is of the opinion that my blood results are linked to inherited high cholesterol (I take 2 different meds and my levels are good) and the fact that I am under a great deal of stress as I care for my husband who has dementia, petit mal, heart failure and recently broke his neck of femur, had an op to repair this and has spent a month in hospital.
Help please. Should I take the Metformin and if I don't will I be storing up trouble in the future?

 

[trophywench]

The only thing you shouldn't do, is simply ignore it. It could be, you have developed some intolerance to metabolising carbohydrates OR your body's production of insulin has waned - whatever. Might be an idea for you to test your own blood occasionally, just to keep an eye on your blood glucose.

 

[Burylancs]

I am a 73 year old great grandmother who went to the surgery for an asthma (mild) check back in June. The nurse took bloods as I hadn't had any taken for several years and I was shocked several weeks later when she called back to say my Hba1C level was 48 and the GP was sending out Metformin to take. When I queried this the nurse advised me to return in 3 months for another blood glucose level test. I did this and my level was 45. I refused to take the Metformin until I had the second test result and I still haven't taken any. I have no symptoms, my risk level is moderate due to age and high blood pressure (which is controlled by medication). I have been given no information/help by my surgery but they did arrange for me to have a foot check at a local health centre! I have not been invited to attend any in-person/online advice sessions. My doctor was dismissive when I asked if I could modify my diet (which is healthy anyway) and he just told me to take the tablets. My granddaughter is a junior doctor in our local hospital and she cannot understand my GP's decision. She is of the opinion that my blood results are linked to inherited high cholesterol (I take 2 different meds and my levels are good) and the fact that I am under a great deal of stress as I care for my husband who has dementia, petit mal, heart failure and recently broke his neck of femur, had an op to repair this and has spent a month in hospital.
Help please. Should I take the Metformin and if I don't will I be storing up trouble in the future?

Yes modify your diet first. The usual starting advice is to 'moderate' carbohydrates and increase exercise/ activity. Give it another three months on D&E. On the other hand Metfartin is an excellent drug. It has heart protection properties and a recent study suggests it adds 15% to Life Expectancy ( calculated at an extra 3 years in raw terms). And by the way your lack of support is typical, the NHS is bad at the management and education of newly diagnosed Type 2 Diabetics. The issues you report. Hypertension and hypercholesterol are the usual fellow travellers of diabetes. Controlling them becomes even more important after your dx of Type 2.

 

[Cherrelle DUK]

Hi Greatgranny1, welcome to the forum.

Really sorry to hear about all that you're going through, it sounds like a tough time at the moment.

We can't advise on medical decisions but based on what you've said though improving your diet will be helpful. Given your numbers, it might be worth getting a second opinion or more clarity as there may be other factors that they're considering as to why they've gone down the medical route. Sometimes they do it purely if they feel a dietary change would be too much for the person.

Worth a few phone calls to see whether there's anyone else you can have a chat with. You can also always give our helpline a call for some more direct advice.

 

[TheClockworkDodo]

Hello @Greatgranny1 and welcome 🙂

As Cherrelle says no-one here can tell you whether or not to take the Metformin - that is entirely up to you. But it does seem a bit odd that your GP has prescribed it in the first instance when your HbA1c is relatively low - 48 is just barely diabetic and 45 is prediabetic. Normally they'd suggest tweaking your diet first with those sorts of levels. What sort of things do you eat, if you don't mind my asking? Sometimes what is a healthy diet for someone without diabetes is not that healthy for someone with diabetes, so there may be a few things you could cut out of your diet which would help to lower your blood sugar.

Sorry to hear your life is so stressful at the moment - that does sound a lot to cope with. Stress can definitely raise blood sugar so that may well have tipped yours over into diabetic levels. Is there anyone who can sit with your husband for half an hour regularly while you potter in the garden or have a bath or whatever calms you down? - because if you can manage to get any time to yourself when you can focus on doing something you find relaxing, that may also help lower your blood sugar (difficult in the circumstances, I know from experience - my Dad had dementia and heart problems and my Mum was his primary carer).

If you do decide to take the Metformin, take it with food - it's less likely to have side effects if taken with food, apparently!

 

[ianf0ster]

Hi @Greatgranny1 and welcome to the forum.#
As the others have said, it's rather unusual for metformin to be prescribed so quickly for somebody who is at worst only barely diabetic. Though the most common side effect of it in loose bowels rather than anything more serious (not that that can't be serious).
As has also been said, while the '5 A Day' focus on fruit and the 'Eatwell Plate' focus on whole grains may be OK for many people, they aren't ideal for Type 2 Diabetics because our condition makes our body intolerant to all forms of (digestible) carbohydrates (both starches and sugars) since they break down into glucose (a sugar) very quickly when we eat them.
This means that we do better if we cut back on the amount of them we consume - particularly tropical fruit, potato, bread, pasta, rice, refined flour. So you need to look at the back of packets (for Total Carbohydrates) rather than just look at the Sugar on the front.
Berries are OK for almost all of us (black, rasp, straw and blue), whole grains are very much the same as refined grains, just a little slower to hit our bloodstream.
We tend to eat more above ground veg especially cauliflower and broccoli which can be made into 'cauliflower rice' or 'green rice' or mashed as a substitute for potato. Celeriac can also be used as a low carb substitute for potato.

 

[Greatgranny1]

Thank you so much for the welcome and for all this help. I have cut back on carbs as in bread, potatoes etc. I have a low fat diet to keep my cholesterol levels down and also use Pro Activ/Benecol spread. I have switched to brown rice and always have wholemeal/granary/seeded bread - one slice of toast for breakfast. I don't have a sweet tooth so avoid cake, sweets etc. I am 5 feet tall and weigh 7.5 stones so I'm not overweight. I am active - running around after my husband and keeping the garden up together along with all the housework. I also aim to eat as many veg as possible each day and watch how much/type of fruit I eat. I'll focus more now on above the soil veg! I have told the nurse that I am not disputing that I could be diabetic but she told me I don't fit the model for diabetes. There is no history of it in my family either. Not sure what more I can do. I shall speak to the helpline for more advice. Thanks again and have a good day!

 

[Burylancs]

Thank you so much for the welcome and for all this help. I have cut back on carbs as in bread, potatoes etc. I have a low fat diet to keep my cholesterol levels down and also use Pro Activ/Benecol spread. I have switched to brown rice and always have wholemeal/granary/seeded bread - one slice of toast for breakfast. I don't have a sweet tooth so avoid cake, sweets etc. I am 5 feet tall and weigh 7.5 stones so I'm not overweight. I am active - running around after my husband and keeping the garden up together along with all the housework. I also aim to eat as many veg as possible each day and watch how much/type of fruit I eat. I'll focus more now on above the soil veg! I have told the nurse that I am not disputing that I could be diabetic but she told me I don't fit the model for diabetes. There is no history of it in my family either. Not sure what more I can do. I shall speak to the helpline for more advice. Thanks again and have a good day!

.....and keep a weather eye on the grandchildren and great grand children now

 

[ianf0ster]

................................................ I am 5 feet tall and weigh 7.5 stones so I'm not overweight. I am active - running around after my husband and keeping the garden up together along with all the housework. I also aim to eat as many veg as possible each day and watch how much/type of fruit I eat. I'll focus more now on above the soil veg! I have told the nurse that I am not disputing that I could be diabetic but she told me I don't fit the model for diabetes. There is no history of it in my family either. Not sure what more I can do. I shall speak to the helpline for more advice. Thanks again and have a good day!

About 10% of Type 2 diabetics aren't overweight. I gained weight very slowly from my mid 50's to my Type 2 diagnosis at age 68 but even then I was still only 2lbs overweight according to the BMI charts. So I wasn't typical either. I was eating what my doctor told me was a heart healthy diet mediterranean style. It was high in both fruit and starches (bananas, apples, porridge, whole grain bread , brown rice etc) and low fat versions of everything (which are almost always higher in carbohydrates) I was gaining around 2lbs per year.
My HbA1C was further into the diabetic range than yours. I cut out all those those things, started eating more eggs, fish . cheese and full fat/lower carb versions of things again and both my Blood Sugars and my weight dropped off in weeks, so I'm now at the same weight I was in my 30's.

 

[Greatgranny1]

Thanks for your message, Ian. Lots more for me to think about as regards the diet I was advised to follow back when I was diagnosed with high cholesterol. I can't really afford to lose any more weight. I'm lighter now than when I married at 22!

 

[Greatgranny1]

The only thing you shouldn't do, is simply ignore it. It could be, you have developed some intolerance to metabolising carbohydrates OR your body's production of insulin has waned - whatever. Might be an idea for you to test your own blood occasionally, just to keep an eye on your blood glucose.

Thanks for your message, trophywench. I'm even more aware now of what I'm eating and kept a food diary for a month to show the nurse but, of course, I didn't actually see her at the surgery. I'm so new to this health problem I don't even know if I took Metformin, would I have to check my blood regularly and if so how? I've not had any information at all about doing my own blood tests. I just feel out of my depth at the moment.

 

[Leadinglights]

As you are only in the at risk category then a few tweaks to your diet should be sufficient. There may be a few things you are eating that you are particularly sensitive to which could be contributing to the slightly elevated levels. By testing before and 2 hours after eating you could identify anything specific. Blood testing is very easy and monitors and strips can be obtained relatively cheaply on line, the GlucoNavil or Spirit TEE2 are both reliable.
I am sure that stress does affect glucose levels but now you are aware you can try with some modifications to give the dietary route a shot and if that is not successful after say 3 months then the metformin could be your option.

 

[TheClockworkDodo]

You wouldn't have to check your blood sugar if you were on Metformin, as it doesn't cause dangerously low blood sugar. You could choose to check it if you want to, as @Leadinglights describes, just to see which foods send it spiking up and which are fine for you to eat, as this does vary quite a bit from person to person. You won't get a test kit or any advice about using one on the NHS but this is one people on here have recommended in the past - https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/ and there are links to others in this page - https://forum.diabetes.org.uk/board...for-people-new-to-diabetes.10406/#post-938458 which I think are the ones LeadingLights mentioned.

If you are getting one, make sure you choose mmol/L as this is the measurement used in the UK - and make sure you get the test strips which go with the meter you get, as they're not all compatible. It's possible to re-use lancets (you're not supposed to, but most people do) but you will need a new test strip every time you test. It's just a finger-prick test so very easy to do - just make sure you use the sides of your fingers (near - but not too near! - the nail) as there are nerve-endings in the pads.

You may feel it's not worth getting a kit at the moment as your HbA1c is relatively low, but if it goes up in the future it would definitely be a good investment.

 

[Drummer]

My cholesterol went down eating low carb, after it going up and up on a high carb low fat diet which was supposed to lower it - I felt so unwell and I was practically spherical at diagnosis.
I don't do high fat, just don't avoid the fats which come with the foods.
Only downside to the way I eat is finding that my clothes are too big - I have just brought out my winter things and nothing fits.

 

[Greatgranny1]

As you are only in the at risk category then a few tweaks to your diet should be sufficient. There may be a few things you are eating that you are particularly sensitive to which could be contributing to the slightly elevated levels. By testing before and 2 hours after eating you could identify anything specific. Blood testing is very easy and monitors and strips can be obtained relatively cheaply on line, the GlucoNavil or Spirit TEE2 are both reliable.
I am sure that stress does affect glucose levels but now you are aware you can try with some modifications to give the dietary route a shot and if that is not successful after say 3 months then the metformin could be your option.

Thanks Leadinglights. Very helpful information and recommendations for testing kits. This is the sort of help I should have been directed to by my surgery but obviously I'm not unique in that I've had no help at all. Sad state of affairs. The NHS system is well and truly broken. When my husband (83 yrs old) fell and broke his hip a month ago I had to leave him lying on the floor in agony for 11 hours until the ambulance arrived to take him into hospital. Even then he was kept in the ambulance for hours before being assessed in A&E and transferred to a ward.

 

[Greatgranny1]

My cholesterol went down eating low carb, after it going up and up on a high carb low fat diet which was supposed to lower it - I felt so unwell and I was practically spherical at diagnosis.
I don't do high fat, just don't avoid the fats which come with the foods.
Only downside to the way I eat is finding that my clothes are too big - I have just brought out my winter things and nothing fits.

Thanks for your tips, Drummer. Much appreciated.

 

[Greatgranny1]

You wouldn't have to check your blood sugar if you were on Metformin, as it doesn't cause dangerously low blood sugar. You could choose to check it if you want to, as @Leadinglights describes, just to see which foods send it spiking up and which are fine for you to eat, as this does vary quite a bit from person to person. You won't get a test kit or any advice about using one on the NHS but this is one people on here have recommended in the past - https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/ and there are links to others in this page - https://forum.diabetes.org.uk/board...for-people-new-to-diabetes.10406/#post-938458 which I think are the ones LeadingLights mentioned.

If you are getting one, make sure you choose mmol/L as this is the measurement used in the UK - and make sure you get the test strips which go with the meter you get, as they're not all compatible. It's possible to re-use lancets (you're not supposed to, but most people do) but you will need a new test strip every time you test. It's just a finger-prick test so very easy to do - just make sure you use the sides of your fingers (near - but not too near! - the nail) as there are nerve-endings in the pads.

You may feel it's not worth getting a kit at the moment as your HbA1c is relatively low, but if it goes up in the future it would definitely be a good investment.

Thanks TheClockWorkDodo. Very useful links and tips.

 

[Leadinglights]

Thanks Leadinglights. Very helpful information and recommendations for testing kits. This is the sort of help I should have been directed to by my surgery but obviously I'm not unique in that I've had no help at all. Sad state of affairs. The NHS system is well and truly broken. When my husband (83 yrs old) fell and broke his hip a month ago I had to leave him lying on the floor in agony for 11 hours until the ambulance arrived to take him into hospital. Even then he was kept in the ambulance for hours before being assessed in A&E and transferred to a ward.

I have every sympathy for you with your long wait, I fell off a laddder on Sunday and damaged my knee and was told there was a 3-4 hour wait for the ambulance, so with help from a couple of people who managed to get me into the car, I was able to get to A &E, but you obviously had no choice but to wait. No wonder you are stressed.
I now await surgery(hopefully next Tues) for a ruptured tendon and fracture in my knee. I must admit I did receive good attention once there.

 

[Greatgranny1]

Hello again. Today I've managed to speak to another GP at our surgery. He can't understand why his colleague sent out Metformin for me. He agreed that it is up to me whether I take the tablets and thought that my suggestion to buy a monitor was a good idea. He's advised me to check my levels in 3 and 6 months and make a judgement then. Thanks again for all your shared knowledge and tips.