Insulin or medication

[ray6]

I try hard with my diet to keep blood sugars in the right area but my HBA1C always registers 54-58 .
Am i right to continue with my efforts or is it time to go to insulin like many of my friends?
Which is best for future health?

 

[murf]

Hi,are you sticking to a low carb 130g a day plan?

 

[Leadinglights]

I try hard with my diet to keep blood sugars in the right area but my HBA1C always registers 54-58 .
Am i right to continue with my efforts or is it time to go to insulin like many of my friends?
Which is best for future health?

You are not too far above what would be acceptable for someone of your age where the risks of being overmedicated to keep an HbA1C at a level that would be appropriate for someone younger.
What medications do you already take and how is your diet.
Making a few changes either to existing med or diet may be sufficient to drop you down a few mmol/mol.
If you are willing to share that information then people will be able to make some suggestions.

 

[Docb]

Hi @ray6 and welcome to the forum. We are in the same age bracket and my HbA1c hovers around 50 using a combination of limited carb diet and medication. I am content with that taking the view that provided I don't have any short term problems of diabetes, the long term problems are something I need not worry about too much - something else will get me first. A year ago my blood glucose levels were beginning to creep up and adding dapaglilozin to the metformin settled things. Should they begin to creep up again, upping the pills would be my way to go.

The idea of insulin never enters my head and I am sure the DN at the surgery would think me a bit bonkers if I suggested it. She would be quite happy with HbA1c's in the middle 50's. Better that than risking low blood glucose levels in a system which is beginning to creek and exacerbating the physical instabilities that are beginning to creep into my daily life.

 

[saffron15]

@ray6 welcome to the forum. How long have you had type 2? My best friends husband is now on insulin. He is in his early 70s and been diabetic for 25 years. I was diagnosed last year and got down to 44 in December. My hba1c rose in June having dropped a metformin. What medication are you taking? In addition to metformin I'm on dapaglifozin an SGLT2 which also helps cardiovascular health as I have high blood pressure. I have lost weight and now am a healthy bmi [ just)
but as we age there is a worry if too much weight is lost we won't have the reserves necessary if we are struck by illness.
I have cut many carbs though still eat some bread and the occasional potato. I also still have an occasional cake or icecream.
Do you think dietary changes may help? I started by usually having full fat Greek style yoghurt with berries, nuts or seeds. I enjoy this. As an alternative I have eggs and sometimes a fry up.
Have a discussion with your Doctor who can judge what route is best for your overall health.

ask anything else that occurs.

 

[Lucyr]

I try hard with my diet to keep blood sugars in the right area but my HBA1C always registers 54-58 .
Am i right to continue with my efforts or is it time to go to insulin like many of my friends?
Which is best for future health?

What does your doctor recommend? Are they advising you to start insulin? It would seem unlikely with your a1c.

 

[ray6]

Hi,are you sticking to a low carb 130g a day plan?

Yes to low carb. I don't measure. Occasional slice of wholemeal and occasional boiled/half jacket potato

 

[ray6]

You are not too far above what would be acceptable for someone of your age where the risks of being overmedicated to keep an HbA1C at a level that would be appropriate for someone younger.
What medications do you already take and how is your diet.
Making a few changes either to existing med or diet may be sufficient to drop you down a few mmol/mol.
If you are willing to share that information then people will be able to make some suggestions.

meds: linoglyptin 5mg,canaglifoxin 100mg.

 

[ray6]

Hi @ray6 and welcome to the forum. We are in the same age bracket and my HbA1c hovers around 50 using a combination of limited carb diet and medication. I am content with that taking the view that provided I don't have any short term problems of diabetes, the long term problems are something I need not worry about too much - something else will get me first. A year ago my blood glucose levels were beginning to creep up and adding dapaglilozin to the metformin settled things. Should they begin to creep up again, upping the pills would be my way to go.

The idea of insulin never enters my head and I am sure the DN at the surgery would think me a bit bonkers if I suggested it. She would be quite happy with HbA1c's in the middle 50's. Better that than risking low blood glucose levels in a system which is beginning to creek and exacerbating the physical instabilities that are beginning to creep into my daily life.

many thanks

 

[Leadinglights]

Yes to low carb. I don't measure. Occasional slice of wholemeal and occasional boiled/half jacket potato

I think some people may find they are actually eating more carbs than they realise and over time portions have crept up.
Many have found it really helpful to keep a food diary for a while with an estimate of the carbs in what they are eating and drinking to see how close they are to being no more 130g per day carbs not just sugar.
It doesn't sound as if you are too far adrift but worth checking. Many foods which people have thought to be healthy options are not always so if your body has a problem with carbohydrates.

 

[Drummer]

Yes to low carb. I don't measure. Occasional slice of wholemeal and occasional boiled/half jacket potato

Hello @ray6 To keep my HbA1c low, out of the diabetes range, I need to stick to quite low carb - under 40gm per day. I don't eat high carb foods as a rule, but it keeps me in normal numbers day by day.
I used a glucose meter to check after meals, and I only eat twice a day at around 12 hourly intervals.
For me I need to eat low carb rather than use medication to lower glucose - my choice and it feels just fine.

 

[Leadinglights]

meds: linoglyptin 5mg,canaglifoxin 100mg.

Ok then you will need to be having some carbs because of that medication.
It might help you if you did some meal testing to see if there are any particular foods or meals which could be causing higher post meal levels than desirable. Do you have a home blood glucose monitor if not then ask your GP to prescribe one.

 

[ray6]

@ray6 welcome to the forum. How long have you had type 2? My best friends husband is now on insulin. He is in his early 70s and been diabetic for 25 years. I was diagnosed last year and got down to 44 in December. My hba1c rose in June having dropped a metformin. What medication are you taking? In addition to metformin I'm on dapaglifozin an SGLT2 which also helps cardiovascular health as I have high blood pressure. I have lost weight and now am a healthy bmi [ just)
but as we age there is a worry if too much weight is lost we won't have the reserves necessary if we are struck by illness.
I have cut many carbs though still eat some bread and the occasional potato. I also still have an occasional cake or icecream.
Do you think dietary changes may help? I started by usually having full fat Greek style yoghurt with berries, nuts or seeds. I enjoy this. As an alternative I have eggs and sometimes a fry up.
Have a discussion with your Doctor who can judge what route is best for your overall health.

ask anything else that occurs.

diabetic 21years. similar BMI just a fraction over recommended. Breakfast similar but sometimes with a very little mini shreddies.

 

[ray6]

Ok then you will need to be having some carbs because of that medication.
It might help you if you did some meal testing to see if there are any particular foods or meals which could be causing higher post meal levels than desirable. Do you have a home blood glucose monitor if not then ask your GP to prescribe one.

Have bought sensor to try to get better idea. So far 90% in range. also have monitor

 

[ray6]

Hi @ray6 and welcome to the forum. We are in the same age bracket and my HbA1c hovers around 50 using a combination of limited carb diet and medication. I am content with that taking the view that provided I don't have any short term problems of diabetes, the long term problems are something I need not worry about too much - something else will get me first. A year ago my blood glucose levels were beginning to creep up and adding dapaglilozin to the metformin settled things. Should they begin to creep up again, upping the pills would be my way to go.

The idea of insulin never enters my head and I am sure the DN at the surgery would think me a bit bonkers if I suggested it. She would be quite happy with HbA1c's in the middle 50's. Better that than risking low blood glucose levels in a system which is beginning to creek and exacerbating the physical instabilities that are beginning to creep into my daily life.

Thanks. I walk 3-4k regularly and play golf twice a week.

 

[ray6]

Hi @ray6 and welcome to the forum. We are in the same age bracket and my HbA1c hovers around 50 using a combination of limited carb diet and medication. I am content with that taking the view that provided I don't have any short term problems of diabetes, the long term problems are something I need not worry about too much - something else will get me first. A year ago my blood glucose levels were beginning to creep up and adding dapaglilozin to the metformin settled things. Should they begin to creep up again, upping the pills would be my way to go.

The idea of insulin never enters my head and I am sure the DN at the surgery would think me a bit bonkers if I suggested it. She would be quite happy with HbA1c's in the middle 50's. Better that than risking low blood glucose levels in a system which is beginning to creek and exacerbating the physical instabilities that are beginning to creep into my daily life.

Thanks for answer. Right to persevere with diet and meds rather than insulin.A few friends are telling to give up the efforts and go to insulin like they have and eat what they like!!

 

[Leadinglights]

Thanks for answer. Right to persevere with diet and meds rather than insulin.A few friends are telling to give up the efforts and go to insulin like they have and eat what they like!!

I don't think it quite as simple as that, takes a lot of work to get it right.

 

[Lucyr]

Hello @ray6 To keep my HbA1c low, out of the diabetes range, I need to stick to quite low carb - under 40gm per day. I don't eat high carb foods as a rule, but it keeps me in normal numbers day by day.

The OP can’t cut carbs that low, it would be dangerous as they are on a flozin

 

[Docb]

Thanks for answer. Right to persevere with diet and meds rather than insulin.A few friends are telling to give up the efforts and go to insulin like they have and eat what they like!!

One way of looking at it but I would say I eat what I like. It helps that I don't like stodge, or prepared stuff where more thought has been put into the packaging than the foodstuff or stuff that is heavily advertised or stuff where the extravagant claims on the front of the packet are not supported by the nutritional label on the back, and above all, I prefer quality to quantity.

I took my normal diet and made a few swaps and adjustments to keep the carb levels down. Add to that a couple of well tested medications and a recognition that I was trying to achieve a reasonable HbA1c and not to break records, and I finish up where I am. I have diabetes but it is well enough controlled without a lot of faff. These days I can well do without extra faff where it is not absolutely necessary.

The idea that you use insulin solely so that you can "eat what you like" might give somebody bragging rights down the pub but it shows a bit of a lack of appreciation of what diabetes is all about and makes you wonder what the prescriber of the insulin was thinking about.

OOPs......that looks like a bit of a rant so better add caveat that my moderator hat has been hanging on the coat rack for the last half hour! Putting it back on whilst I check out the rest of the forum.

 

[saffron15]

@ray6 I see you are by now an expert! I lost weight on carbs between 100 to120. However when I went on dapaglifozin I was told I needed to eat a reasonable number of carbs. No one gave me a figure but at least 130 seemed needed. Im assuming the 'flozin' is similar to the one I take.
Obviously you need to make sure you are getting enough fat and protein as you are a healthy weight but you may be able to reduce your portion size of carbs or add more veg or use suitable alternatives to pasta or rice.
You are obviously living life well.