lost 5kg but hba1c the same

[Leadinglights]

I have found reducing carbs to an absolute minimum is still not getting the weight down. Recently, I have been on holiday, and found myself eating a bit of bread every day, given limited choice…. I try not to eat bread, pasta, rice or potatoes , pastry, cakes, biscuits (or couscous or other carbohydrates-high foods,) but every now and then, I am sorely tempted! Since my diagnosis in October 2024, I have lost about 4 kgs, and at my last blood test in March this year, my HbA1c reading was 41. I was told that this is out of the prediabetic range. But I still find it hard to lose another 7-8kg, which I need to do. I’ve stepped up my exercise, but at 71, I find getting fit is a longer and more tiring business than it used to be! I have decided to eat full-fat yogurt, butter (in small quantities), olive oil and a modicum of alcohol, because life is short, and I enjoy it so. Are these indulgences I cannot afford?

Welcome to the forum.
Everybody is different so those things you mention should do no harm to your blood glucose and if doing that makes you less likely to snack on high carb foods that will be a benefit also. How it affects your weight, hard to say.
Having been doing well with losing weight I had an accident which restricts the exercise I was doing and that has made a difference to losing weight, so I have every sympathy, I haven't changed my diet from low carb, luckily HbA1C remains normal.

 

[MarcR]

I have found reducing carbs to an absolute minimum is still not getting the weight down. Recently, I have been on holiday, and found myself eating a bit of bread every day, given limited choice…. I try not to eat bread, pasta, rice or potatoes , pastry, cakes, biscuits (or couscous or other carbohydrates-high foods,) but every now and then, I am sorely tempted! Since my diagnosis in October 2024, I have lost about 4 kgs, and at my last blood test in March this year, my HbA1c reading was 41. I was told that this is out of the prediabetic range. But I still find it hard to lose another 7-8kg, which I need to do. I’ve stepped up my exercise, but at 71, I find getting fit is a longer and more tiring business than it used to be! I have decided to eat full-fat yogurt, butter (in small quantities), olive oil and a modicum of alcohol, because life is short, and I enjoy it so. Are these indulgences I cannot afford?

I think it's possible to enjoy your food and lose weight at the same time.

 

[MarcR]

Its been 13 days since my last Metformin and 14 since my last statin. My fasting blood this morning was 4.4mmol/L and 2 hours after breakfast 7.0mmol/L. I'm thankful my prayers for healing were answered. I'm not planning to change my diet. I told the surgery I stopped my medication. My official hba1c is due in July. I might try and have it early August to make it 3 months after stopping the medication.

 

[everydayupsanddowns]

Its been 13 days since my last Metformin and 14 since my last statin. My fasting blood this morning was 4.4mmol/L and 2 hours after breakfast 7.0mmol/L. I'm thankful my prayers for healing were answered. I'm not planning to change my diet. I told the surgery I stopped my medication. My official hba1c is due in July. I might try and have it early August to make it 3 months after stopping the medication.

Good to hear your levels seem to be holding steady @MarcR

Sounds like an early-Aug HbA1c would be helpful, as it would more fully represent your levels since stopping the metformin.

As people with diabetes are statistically at higher risk of a CVD event, you may consider keeping going with the statin, which stats suggest would reduce your risk of a heart attack or stroke even if your BG levels remain steadily low?

 

[MarcR]

Good to hear your levels seem to be holding steady @MarcR

Sounds like an early-Aug HbA1c would be helpful, as it would more fully represent your levels since stopping the metformin.

As people with diabetes are statistically at higher risk of a CVD event, you may consider keeping going with the statin, which stats suggest would reduce your risk of a heart attack or stroke even if your BG levels remain steadily low?

The consultant and doctor suggested staying on the statin, but from what I've read it only reduces risk absolutely by 1% which seems a high price given the potential side effects. I will see what my tryglicerides are at my next blood test, they say it's the tryglicerides to HDL ratio that is a good indicator of CVD risk. But now my BG is normalised I'm hoping the tryglicerides will have gone down, and that diet and exercise will reduce the risk.

 

[MarcR]

From what I read people at high risk of CVD the benefits outweigh the risks of statins.

 

[MarcR]

A low carb diet helps to reduce triglycerides, statins also reduce it but they also reduce good cholesterol. I guess it depends individually. Apparently a ratio of 2 or under is good, 4 is bad, 6 is dangerous (TRI to HDL).

 

[MarcR]

The doctor did say statins can help to keep plaque in place, and I read they have anti inflammatory properties. But you might also get that from certain foods, like omega 3.

 

[everydayupsanddowns]

but from what I've read it only reduces risk absolutely by 1% which seems a high price given the potential side effects.

There’s a lot of internet hubbub around statins, so depending on your sources you can probably find arguments for statins being compulsorily put in the water supply, or that statins have no effect at all!

The published trial data shows they offer a significantly more substantial risk-reduction than 1% though.

Did you experience any negative effects while taking statins? I was reluctant for many years (partly because I found it hard to accurately understand my own risk vs the populations in the trials - but also because there is so much noise around the topic). However I’ve been on a low dose for several years now, and have experiences absolutely zero negative effects. The only difference has been an improvement in my cholesterol levels.

In your shoes I’d probably be tempted to stick with the statin, unless you found them difficult to tolerate?

 

[MarcR]

There’s a lot of internet hubbub around statins, so depending on your sources you can probably find arguments for statins being compulsorily put in the water supply, or that statins have no effect at all!

The published trial data shows they offer a significantly more substantial risk-reduction than 1% though.

Did you experience any negative effects while taking statins? I was reluctant for many years (partly because I found it hard to accurately understand my own risk vs the populations in the trials - but also because there is so much noise around the topic). However I’ve been on a low dose for several years now, and have experiences absolutely zero negative effects. The only difference has been an improvement in my cholesterol levels.

In your shoes I’d probably be tempted to stick with the statin, unless you found them difficult to tolerate?

Have you seen this:

I've not experienced much side effects but statins are linked to a number of serious conditions long term.

If you use relative numbers then they would have to say statins increase the risk of diabetes by 25%. They use relative numbers for the benefits and absolute numbers for the side effects.

 

[MarcR]

In one study a group on statins 99.7% didn't die of CVD, in the group without statins 98.7% didn't die if CVD. In absolute terms a 1% reduction in risk.

Using relative numbers
(1-(0.3/1.3)/100)=22% risk reduction!

 

[MarcR]

If someone tries diet, exercise, weight loss, low carb and is able to reduce their triglycerides to a safe level that seems better to me, but if after doing all that it's still high, then a statin may be the best thing to do. However, there is also the question of preexisting plaque and how best to manage that and statins ability to keep it in place. But reducing triglycerides seems to deal with the root cause.

 

[everydayupsanddowns]

Ahhh the old relative vs absolute risk gambit.

I used to find that pretty interesting, perhaps even suspicious?

This by Gil Carvalho does a pretty good job at popping that bubble. It’s one of the pieces of the puzzle that began to change my mind.

 

[Eddy Edson]

It's old misinformation which still lurks like a zombie in the eternal snakepit of the Internet.

https://twitter.com/x/status/1923790148879130770

Simple smell test: if the benefits were actually so minimal do you really think anybody would recommend them?

 

[MarcR]

Ahhh the old relative vs absolute risk gambit.

I used to find that pretty interesting, perhaps even suspicious?

This by Gil Carvalho does a pretty good job at popping that bubble. It’s one of the pieces of the puzzle that began to change my mind.

I see his point about the time factor, but do statins reduce risk by reducing total cholesterol or because they reduce triglycerides? To really determine you would need to track people with low LDL and low triglycerides against people with low LDL and high triglycerides.

 

[MarcR]

It's old misinformation which still lurks like a zombie in the eternal snakepit of the Internet.

https://twitter.com/x/status/1923790148879130770

Simple smell test: if the benefits were actually so minimal do you really think anybody would recommend them?

It interesting that both authors have PhD's but the disagree.

 

[everydayupsanddowns]

I see his point about the time factor, but do statins reduce risk by reducing total cholesterol or because they reduce triglycerides? To really determine you would need to track people with low LDL and low triglycerides against people with low LDL and high triglycerides.

I think trigs are often used as a proxy for vLDL (which opens up the ‘particle size’ ‘fluffy vs dense’ chamber).

Though I think the majority expert view now is that particle size / distribution of fragments doesn’t really track risk very effectively. Because reductions tend to happen across proportionally the board. Reducing LDL seems to be the most consistent measure from what I can tell.

 

[MarcR]

I think trigs are often used as a proxy for vLDL (which opens up the ‘particle size’ ‘fluffy vs dense’ chamber).

Though I think the majority expert view now is that particle size / distribution of fragments doesn’t really track risk very effectively. Because reductions tend to happen across proportionally the board. Reducing LDL seems to be the most consistent measure from what I can tell.

When my blood results come back in July or August, if my cholesterol level have shot up, I may need to consider that and perhaps speak to a cardiologist.

 

[MarcR]

I asked Google Gemini about absolute risk reduction and got this answer:

"For primary prevention (in people who have not previously had a cardiovascular event), studies show a range of absolute risk reductions. For example, over a period of about 5 years, the ARR for major cardiovascular events in primary prevention can range from less than 1% in lower-risk individuals to a few percentage points in those at higher risk. Some sources indicate that for a 10-year period, the ARR can be around 1.9% for those with a 10-year baseline risk of 5%, increasing to 7% for those with a 20% baseline risk."

 

[MarcR]

When I first got diabetes my doctor said my qrisk wasn't high enough for a statin but when he added in diabetes it was. But now my BG is back to normal, surely the risk is reduced?