Just had my three month catch up and need a little rant

[Deb_l]

Unless of course this is normal and I’m making a mountain out of a molehill!!

I was all happy and full of myself and practically bounced into my catch up with the nurse only to be told, despite my best efforts of reducing my HbA1c from 96 to 49, they still want to start me on metformin as well as continuing to take the Sitagliptin.

They are also still advising statins, which I understand to some degree but Metformin? Really? Even when my numbers are heading in the right direction? I could understand it if my HbA1c had remained at 96.

Anyway, I’ve said no to the metformin and no to the statins at the moment. The metformin will be a permanent ‘no’ if my results stay good and the statins will also be the same if my cholesterol is less than 4.

The reason for my rant is, why keep throwing more and more tablets at people who are actively trying to help themselves and winning? What purpose does it serve?

In the past I’ve raved about my GP and the care I’ve received since being diagnosed T2 but this has really annoyed me and they just seem to be going through the motions and not treating each person as an individual.

Rant over, I just needed to vent a little 🙂

 

[Robin]

I see your previous HbA1c was in January, which means that unless it dropped miraculously to the 40s in a couple of weeks (very unlikely, it has probably come down steadily) your current HbA1c, being a 3 month average, will partly date back to when it was still much higher. So you're probably currently better than 49, so I would agree with you that adding Metformin at this stage is unnecessary.

 

[Toddyken]

I see your previous HbA1c was in January, which means that unless it dropped miraculously to the 40s in a couple of weeks (very unlikely, it has probably come down steadily) your current HbA1c, being a 3 month average, will partly date back to when it was still much higher. So you're probably currently better than 49, so I would agree with you that adding Metformin at this stage is unnecessary.

Well done , totally agree , you’ve done so well getting your numbers where they are, I’m sure if you continue on the same path you will get it even lower. I would be the same as you .

 

[Vonny]

I believe @Sharron1 has a similar hba1c to me, ie below 40, and she is still on more metformin than me, and has questioned her DN with no joy! Hopefully she will see this tag and confirm. Think it's a post code thing!
I strenuously resisted statins for a couple of years but am now comfortable on simverstatin after a bad experience with atorvastatin.
Well done on getting your BG down! Keep up the fab work x

 

[harbottle]

That's a good reduction.

I believe current guidelines are to try to get hba1c to 48 if not on a drug that causes hypos or just trying to control it through lifestyle.
It looks like this is what they are aiming for.

 

[IrvineHimself]

Emphasizing I totally sympathise with your desire to come off the Metformin: In my case, when two 4 month reviews in a row came back at 39 and then 38 mmols/mol, I asked the Doc about reducing my diabetic meds, she kinda wrinkled her nose and shook her head. While I would welcome a reduction in Metformin or Empagliflozin, I can still remember how bad my symptoms were prior to starting treatment. As a result, I personally am quite content to go along with my Doctors advice. However, I do sympathise with your plight, and totally support the principle that "I" [the patient] have ultimate control of my treatment.

 

[Sharron1]

I believe @Sharron1 has a similar hba1c to me, ie below 40, and she is still on more metformin than me, and has questioned her DN with no joy! Hopefully she will see this tag and confirm. Think it's a post code thing!
I strenuously resisted statins for a couple of years but am now comfortable on simverstatin after a bad experience with atorvastatin.
Well done on getting your BG down! Keep up the fab work x

Oh yes, Vonny is correct. Check out my hba1c results and I am still taking metformin x 4 tabs. Each time i suggest seeing what might happen if these are reduced the response is 'if it ain't broke...' so I decided to pick my battles and just leave this one alone. However I am convinced the low carb diet and my busy life helps way more than Metformin. Adding to the mix the very first rogue blood test which the nurses believe means I was never diabetic in the first place. Sigh. Good luck.

 

[Leadinglights]

Good on you for saying NO and well done on the reduction in HbA1C, I would have thought the discussion would have been about reducing the meds not adding more.

 

[harbottle]

Oh yes, Vonny is correct. Check out my hba1c results and I am still taking metformin x 4 tabs. Each time i suggest seeing what might happen if these are reduced the response is 'if it ain't broke...' so I decided to pick my battles and just leave this one alone. However I am convinced the low carb diet and my busy life helps way more than Metformin. Adding to the mix the very first rogue blood test which the nurses believe means I was never diabetic in the first place. Sigh. Good luck.

My GP couldn't wait to stop it - as soon as my hba1c was in the 30s they wanted me to cut it, and a six months later said I could stop it if I wanted.

 

[Deb_l]

Good on you for saying NO and well done on the reduction in HbA1C, I would have thought the discussion would have been about reducing the meds not adding more.

Well, I half heartedly thought we might be able to start the conversation about stopping all medication, never mind adding to the current tally!!

I’m happy to stay on the Sitagliptin. I have no side affects, it’s one tablet a day and there are no risks of hypos but I’m not adding more unnecessarily.

The nurse just kept saying, well it’s our protocol to prescribe metformin to all type 2’s regardless of blood test results. Well, that seems a bonkers protocol to me if I can control this myself.

 

[Dragonheart]

Absolutely bonkers.

 

[bulkbiker]

why keep throwing more and more tablets at people who are actively trying to help themselves and winning? What purpose does it serve?

Great question and one that your HCP's won't be able to answer except for "it's the guidelines"

 

[Dave_Z1a]

Indeed, guidelines are just that, guidelines. Often used as a security blanket by a medical professional to make a decision which covers their backside should anything go wrong.

 

[Lucyr]

Anyway, I’ve said no to the metformin and no to the statins at the moment. The metformin will be a permanent ‘no’ if my results stay good

If your a1c is 49 then whilst it’s vastly better than before it is still in the diabetic range and could be improved a bit more. Are there more changes you plan to make to diet and exercise if you’re saying no to metformin?

 

[Drummer]

My Hba1c was 91 at diagnosis, put onto Metformin and Atorvastatin at once, but after 5 weeks I was in such dire state that I stopped.
At the first retest I was at 47 and at 6 months 41 and have been close to normal numbers ever since, 5 years now.
I was eating no more than 50gm of carbs a day, now I eat no more than 40 gm. I can't see any reason to make myself feel so ill and become so debilitated by taking tablets I don't need.

 

[Gwynn]

It's your body. You make the decisions. They advise (sometimes well. Sometimes badly). Congratulations for sticking up for yoyrself. It can be quite daunting to do so.

So, for doing so well here's a gold star

 

[Burylancs]

Unless of course this is normal and I’m making a mountain out of a molehill!!

I was all happy and full of myself and practically bounced into my catch up with the nurse only to be told, despite my best efforts of reducing my HbA1c from 96 to 49, they still want to start me on metformin as well as continuing to take the Sitagliptin.

They are also still advising statins, which I understand to some degree but Metformin? Really? Even when my numbers are heading in the right direction? I could understand it if my HbA1c had remained at 96.

Anyway, I’ve said no to the metformin and no to the statins at the moment. The metformin will be a permanent ‘no’ if my results stay good and the statins will also be the same if my cholesterol is less than 4.

The reason for my rant is, why keep throwing more and more tablets at people who are actively trying to help themselves and winning? What purpose does it serve?

In the past I’ve raved about my GP and the care I’ve received since being diagnosed T2 but this has really annoyed me and they just seem to be going through the motions and not treating each person as an individual.

Rant over, I just needed to vent a little 🙂

Hi, congrats on your progress.
Metformin has excellent heart protection properties ( a cascade of unintended consequences which add up to a significant degree of heart protection ). So it makes sense for T2s to be on it in general since cardio and heart problems are the main complication we're locked in battle with.

 

[harbottle]

Hi, congrats on your progress.
Metformin has excellent heart protection properties ( a cascade of unintended consequences which add up to a significant degree of heart protection ). So it makes sense for T2s to be on it in general since cardio and heart problems are the main complication we're locked in battle with.

Which is why I said I might as well keep taking the daily 500mg tablet when told I could stop if I wanted to.
Although I do forget it half the time!

 

[everydayupsanddowns]

I’m happy to stay on the Sitagliptin. I have no side affects, it’s one tablet a day and there are no risks of hypos

Congrats on your progress so far!

Sorry you were a bit frustrated with the appointment

Hope you can continue to make positive progress - and try not to fret about meds. They can help and support you for a period.

 

[DiabloT2]

Unless of course this is normal and I’m making a mountain out of a molehill!!

I don't think you are making a mountain out of a molehill. I think you are a making a mountain of a mountain. After all it is long term medication so needs to be considered fully.

As to whether it is normal - well I had a very similar experience to you with a huge improvement at the three month stage, but still just in the diabetic range so was wanted a little more time to see. I was aware that the HBA1C was a lagging indicator and it was very likely that I'd already entered the pre-diabetic stage. Come my next test, it was in the non-diabetic range (actually under 40) by which time I'd stopped metformin. Though it was discussed, I never started statins.