Interesting discussion with my GP

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Jenny65

Jenny65

Well-Known Member
Relationship to Diabetes
Type 2
Good Morning

My doctor just called me to discuss my latest test results. He was very positive and pleased about the reduction I have made with my HbA1c level, getting it from 80 to 50 in 3 months. I said I want to get it lower, which he thinks is very possible so going to keep me on 3 monthly tests. He did mention my statins and said on my record it says I have Familial hypercholesterolemia. I explained that I am waiting to see the Lipid clinic to be tested for this as I havent had it confirmed. I said it was an 8 month wait so should see someone in March. He noticed I had reduced it with diet in the 3 month but that as a diabetic it may be worth having statins as I am higher risk for cardiac complications even though I am in remission.

I asked him about this as 50 I believe is still very much in the diabetic range. He then went on to say that 53 is the level that damage from high sugar is considered to put me at risk of damage. I thought it was 48 so a little confused. He went on to say that hopefully I will get it lower at my next test but isn't concerned about it being 50. It's confusing isn't it when there is so much conflicting information.

He went on to say when he saw my liver results that he would arrange a liver scan as my last one was in August 21, I said it was actually 3 months ago and showed a fatty liver and pancreas. Then he looked again and said he was looking at August 2011 and could see my liver was enlarged then! In the last call he said I had elevated liver enzymes in 2011 as well, not sure why I wasn't told at the time. Anyway, on the whole this was a positive call, he is getting me tested in January and I have agreed if my cholesterol remains over 5 I will take statins, He told me to keep on with what I am doing as he was impressed with the massive drop in my HbA1c (as am I)

By the way I mentioned what @travellor said about fasting and he said eating would have impacted my triglycerides but not my cholesterol, but I am going to fast next time anyway to be safe.

Have a good day everyone.
 
grovesy said:
50 is definitely Diabetic. At 53 I was on at least 2 medications.
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I thought this too, but he said my diet is working so not to have diabetes meds but said to consider statins
 
To be fair, his comments about testing every 3 months were in his words. "I think you will see a difference, and this will motivate you to continue"
 
grovesy said:
50 is definitely Diabetic. At 53 I was on at least 2 medications.
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Sure, but as I understand it the law of diminishing returns is true for HbA1c: once you get to low 50s it's still worth trying to lower it further but you don't get as much of a benefit as you do from getting down to low 50s.
 
Bruce Stephens said:
Sure, but as I understand it the law of diminishing returns is true for HbA1c: once you get to low 50s it's still worth trying to lower it further but you don't get as much of a benefit as you do from getting down to low 50s.
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This is exactly what my GP said almost word for word 🙂
 
My niece has FH, it came from her Dad's side of the family, where there had been a lot of heart problems at a young age. Her uncle and aunt had it, but her other uncle and sister don't. She takes statins.
 
Your risk of diabetes complications with an HbA1c of 50 is just about sod all.

53 mmol/mol = 7.0% on the old scale, the cut-off for diabetes in the old days.
 
harbottle said:
My niece has FH, it came from her Dad's side of the family, where there had been a lot of heart problems at a young age. Her uncle and aunt had it, but her other uncle and sister don't. She takes statins.
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The thing is I may have this condition, but I was very obese when it was over 9 and I was told diet alone wouldnt reduce it if I have it, and have reduced it to 7 in 3 months by losing 3 stone, so I am thinking it may not be this condition and just my previous diet, so could possibly get it down to a lower level by continuing my weight loss journey to 8 stone 7. I have no issue with taking statins if I need them and to be honest, I probably will take them in January but watching what happens with diet alone is one way I can see if it is indeed hereditary as if it is I would ask my children to get tested as well. My oldest son lost 5 stone and no longer has a fatty liver, he is 33 and now has the physical age of a 24 year old and normal cholesterol etc, so I do wonder if we just had a bad diet rather than bad genes 🙂
 
harbottle said:
My niece has FH, it came from her Dad's side of the family, where there had been a lot of heart problems at a young age. Her uncle and aunt had it, but her other uncle and sister don't. She takes statins.
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Presumably @Jenny65 's docs know what they're doing, but to me it just seems bizarre that they haven't urged her to start statins if she does have FH. Anyway, it seems way outside guidelines.
 
Eddy Edson said:
Your risk of diabetes complications with an HbA1c of 50 is just about sod all.

53 mmol/mol = 7.0% on the old scale, the cut-off for diabetes in the old days.
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I think I read something about a change in the cut off, so this makes complete sense now
 
Eddy Edson said:
Your risk of diabetes complications with an HbA1c of 50 is just about sod all.

53 mmol/mol = 7.0% on the old scale, the cut-off for diabetes in the old days.
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My Dad was diagnosed as T2 just because they modified the guidelines and ended up taking drugs for it (I remember my Mum telling me in a phone call, because I asked if he was taking insulin! This was 20+ years ago when I was in my 20s.) He must have been on Metformin because he farted like a thundercloud.
 
Also, there are no relatives with heart conditions at a young age on my side of the family. My grandparents on my dad's side lived to their late 90s, although my grandpa did have angina and that tablet under the tounge medication, he didn't have any surgery and was mobile and healthy right up until he died at 97 despite smoking until he was 60 and he had survived 2 world wars and malaria, my grandma used to have mini strokes when she got over 80 but always recovered fully, and was active until she died at 98. My grandparents on my mums side both lived to 86, my nan died of Alzheimer's and my grandad did have a heart attack but he was 86, he too was a smoker, smoked cigars, only 1 a day and one alcoholic drink before dinner every day too.

My parents lived to 80 and sadly developed cancer. Although no one had heart problems, both my parents did have high cholesterol, despite being healthy active, slim vegetarians, my mum also had Alzheimer's when she died, not sure if it was the ovarian cancer that had spread to her lymph node in her throat or the alzeimers that stopped her being able to swallow, which killed her in the end, the doctor said either condition could have caused it. My dad had bowel cancer which he battled for 7 years before he died. He always said he felt robbed as his parents lived to nearly 100 he thought he had a while left even at 80


My mum had 2 brothers and a sister, her brother sadly took his own life at the age of 72 when he realised he too had alzeimers and in a lucid moment realising he didnt want to end up like his mum decided to take his life. My mums eldest brother is 96 and still well and alive, her sister is now 81 and also well.

Not sure how this matches genetically with this, but I guess what I am saying is that despite having high cholesterol my parents took statins and developed cancer and alzeimers (not connecting the 2 by the way)

On another note my BP is good, normally on the lower side, apart from when I had precampsia

I really believe my cholesterol and diabetes is my poor lifestyle choice of bad diet and not exercising rather than genetic.
 
I do get confused when they tell people who have had a very high HbA1C that 50 mmol/mol is fine yet those who are just diagnosed with a level of 50mmol/mol are told to get their level down.
I feel for comfort I would rather be aiming for normal at below 42 mmol/mol.
 
It will bias the numbers.

total cholesterol
HDL
Triglycerides
Are measured, LDL is calculated


LDL is usually calculated
[LDL] = [Total cholesterol] − [HDL] −
(Triglycerides/5)

The LDL will be calculated lower if trigs are higher, which is why historically a fasting test was the baseline

But your figures looked fine either way, I just always had a fasting test, I guess I'm set in my ways!
 
Leadinglights said:
I do get confused when they tell people who have had a very high HbA1C that 50 mmol/mol is fine yet those who are just diagnosed with a level of 50mmol/mol are told to get their level down.
I feel for comfort I would rather be aiming for normal at below 42 mmol/mol.
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Provided there's not much risk of hypos I don't think anyone's saying that lower isn't better. Just that as far as anyone can tell it's not that much better.
 
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