Is medication based on fasting BS levels?

[Carina1962]

Just wondering if medication is normally based on fasting BS levels. The reason i ask this is because someone posted that they were diagnosed at a fasting level of 12.1 so were put on medication (i can't remember if it was tablets or insulin). I was diagnosed at fasting of 7.8 and am D/E controlled but i'm getting very nervous about my 2nd diabetic review and HbA1c at the end of July and really hope that i won't need to be put on medication. I don't feel so confident as the first time as i know i have been more 'naughty' than good. When you are first diagnosed you really pull out all the stops to make that lifestyle change as it's all a bit of a shock but i'm sure i'm not alone in getting a little 'complacent' as time goes on - i know i have to get into motivation mode again and stick to it - oh it's so hard!

 

[everydayupsanddowns]

Hi there

Do you have access to a bg meter and strips? Easy for me to say as a T1 I know, but it seems this is the only way for T2s to really know whether they are being naughty or good (by testing 1 hour and 2 hours after eating)

M

 

[Northerner]

Just wondering if medication is normally based on fasting BS levels. The reason i ask this is because someone posted that they were diagnosed at a fasting level of 12.1 so were put on medication (i can't remember if it was tablets or insulin). I was diagnosed at fasting of 7.8 and am D/E controlled but i'm getting very nervous about my 2nd diabetic review and HbA1c at the end of July and really hope that i won't need to be put on medication. I don't feel so confident as the first time as i know i have been more 'naughty' than good. When you are first diagnosed you really pull out all the stops to make that lifestyle change as it's all a bit of a shock but i'm sure i'm not alone in getting a little 'complacent' as time goes on - i know i have to get into motivation mode again and stick to it - oh it's so hard!

Try not to worry about it Carina. I'm sure that, although you may feel as though you have been a little naughty or complacent at times, on the whole you have made little changes that will help you more than you think. A lot will depend on your doctor, and of course your HbA1c, as to whether medication is recommended for you. If the HbA1c is up a little, that doesn't necessarily mean that you need medication, but just need to start fine-tuning things a little. You are perfectly within your rights to request a few more months to try diet and exercise before meds, as long as there hasn't been a significant change, so don't be afraid to do so 🙂

I'm hoping that you are pleasantly surprised!

 

[scootdevon]

Just wondering if medication is normally based on fasting BS levels. The reason i ask this is because someone posted that they were diagnosed at a fasting level of 12.1 so were put on medication (i can't remember if it was tablets or insulin). I was diagnosed at fasting of 7.8 and am D/E controlled but i'm getting very nervous about my 2nd diabetic review and HbA1c at the end of July and really hope that i won't need to be put on medication. I don't feel so confident as the first time as i know i have been more 'naughty' than good. When you are first diagnosed you really pull out all the stops to make that lifestyle change as it's all a bit of a shock but i'm sure i'm not alone in getting a little 'complacent' as time goes on - i know i have to get into motivation mode again and stick to it - oh it's so hard!

Hello carina, I was put on metformin after i was diagnosed type 2 with a fasting reading of 12.1 mmol/l, My dr put me on metformin as im 6 stone overweight according to BMI & the job i do is that of a taxi driver in which im sat on my posteria for long periods of the day on long shifts, 6 days a week, I also broke my neck back in 1984 in which has left me slightly weak (paralysed) down my right hand side, so i cant move around like i use to to shift my weight lol, the Metformin im on is suppose to kick start my pancreas into making more insulin to get my bg levels down as my dr explained, He never mentioned to me about getting a home testing kit to monitor my levels at home so i went and bought a avivo nano kit from boots and started testing 3 weeks ago, hope your 2nd review will be better than my dr's 10 minute diagnosis 🙂

 

[Carina1962]

thanks all of you for your comments and Northerner you have put my mind at rest 🙂 i will go along for my review not knowing what it will be this time but know that if i have to 'improve' then i will knuckle down and do so and deal with it, thanks 🙂

 

[wallycorker]

........... When you are first diagnosed you really pull out all the stops to make that lifestyle change as it's all a bit of a shock but i'm sure i'm not alone in getting a little 'complacent' as time goes on..........

Hi Carina,

It took me a long eight years after diagnosis to learn that I needed to change my diet to eat less starchy carbohydrates.

I'm certainly not 'complacent' these days. In fact, I'm very focussed on keeping my blood glucose down to levels that don't put me at risk of complications.

My GP only put me on metformin after my HbA1c had risen to 9.4% from the 5.7% at diagnosis after six or seven years of gradual progression. These days, I'm very determined to keep as far as I can away from medications and hoping to get off the metformin tablets that I still take before too long.

Best wishes - John

 

[Carina1962]

hello john, i have heard of people coming off medication and good luck to you but what i wonder is if you do come off medication, will your levels be as good as they are at the moment? i hope so. I know that you have said that it's more the fact that you don't each starchy carbs which has kept your BS levels so good. Although i haven't given up starchy carbs completely, i have very little of them, my pre-meal readings are better than my post-meal readings but i find that with D/E controlled it's very hard to keep them low, especially if you have a day where you have eaten little and healthy but the levels are not as low as you would like. With testing though i have found out what foods push my levels high and it is chips, white bread, naan bread the most but i am OK with wholewheat pasta, small portion of basmati rice and low GI bread. The testing has been a huge eye opener for me.

 

[wallycorker]

................i have heard of people coming off medication and good luck to you but what i wonder is if you do come off medication, will your levels be as good as they are at the moment? i hope so.......................

People that I have met on these forums who control their situations through managing their diet and have come off metformin haven't seen rises in their levels. So, I hope that will be the case for me too.

........The testing has been a huge eye opener for me.........

Yes it was for me too - and the thing that showed me quite clearly the way I needed to go to sort out my condition.

From what you say, I think that you will do OK.

Good luck - John

 

[thedame]

Hi Carina

I think that a good doctor should use both fasting and HBA1C levels to fully assess and prescribe. A very high pin prick test by your GP might prompt them to start you on something like Metformin right away but they will need the HBA1C to see an overall average. However, as was only recently pointed out to me after 8 years of ignorance, why it is very important for a patient to be able to test at random intervals during the day. My nurse likes me to test 2 hours after eating for example. She tells me that 2 hours after eating should show your highest level in the day, apart from possibly a high fasting level, and that after 2 hours the level should start to come down, reach it's lowest point before your next meal and then the process repeats itself. This is just as important as the HBA1C in her opinion as very high and very low levels could average out at what seems to be a reasonable HBA1C but it is the spikes which can cause the most damage to a diabetic. She doesn't advocate over testing but feels it is important to be aware of how food affects you and take some control. The aim is to bring the highs and lows closer.

 

[wallycorker]

Hi thedame,

It sounds as though you have a very good nurse because in my opinion that all makes very good sense.

The only thing that I would slightly differ with is that most people seem to find their highest level in the day around one hour to one-and-a-half hours after finishing eating rather than two hours. It is my experience that I am well on the way down two hours after finishing eating in almost every case.

You sound to be doing just fine.

Best wishes - John

 

[am64]

hi carina ....i think you will be surprised when your results come in ...your commitment to your diet and exercise has been commendable ..i always check your threads to see how you are getting on ...so please dont worry about the next appointment ...we all do it!... get a little wound upbefore the appointments ...hands up who does ...whole forum waves !!

to manage diabetes on diet and excercise with no support for cost of strips is one of my pet rants ... i can get them no problem by explaining ...very clearly ...why i was using them they are happy to give me 1 pot a month ...as that is all i need now

i doubt your levels will have risen ..i really expect them to be down and
as i said before i am sure you will be pleasently surprised .

 

[thedame]

Hi thedame,

It sounds as though you have a very good nurse because in my opinion that all makes very good sense.

The only thing that I would slightly differ with is that most people seem to find their highest level in the day around one hour to one-and-a-half hours after finishing eating rather than two hours. It is my experience that I am well on the way down two hours after finishing eating in almost every case.

You sound to be doing just fine.

Best wishes - John

Hi John

Yes, I have to agree that my own levels do seem highest a little before 2 hours - I didn't realise that until I tested earlier than planned by accident - thing is is the NHS are asking for 2 hour tests then people won't be any the wiser...unless they read your post of course😉

I have am very lucky to have a very good nurse- she has looked after me from diagnosis and understands all of my problems - she sees the whole person not just the diabetes. She takes all my comments and charts and uses them to discuss the care of her patients with the doctors- she is constrained by regulations but tries to move things forward. I am so blessed to have her and feel for the majoiryt who do not get such excellent care I now go to her as my first port of call for almost everything medical - I will be gutted when she or I part company

 

[MargB]

Thedame, can you send your practice nurse up to Manchester please? Mine is a tick list type and other factors do not compute with her. She has decided that if you have diabetes then you go on Metformin straightaway. End of. I was diagnosed at 7.3, brought it down to 5.8 but still have to take the Metformin even though it is having its effects.

Good luck with yours - sounds as they know what they are doing and actually want to help you.