Recent type 2 diagnosis

[Lurcher67]

Good morning All,

I was diagnosed with type 2 around 6 weeks ago with hbA1c of 81. I am on 500mg metformin, 3 times a day. My diet was ok, but lots of poor choice snacks like crisps and biscuits. Any idea what I could realistically expect from the next blood test after 3 months on tablets and improved diet ? I am not overweight, but have lost a few pounds since altering my diet and I still need to increase exercise.
I have been reading some of the posts on this forum as well as plenty of online type 2 information, but it is always great to hear a personal experience as well as the medical advice.

 

[harbottle]

Hello!

I was diagnosed with a hba1c of 83, and started on 1000mg of Metformin a day.
My diet wasn't great, and I was overweight, so I lost 3 stone in 3 months, cut the junk food and 'processed' carbs (Just carbs from fruit and veg and occasionally potato) and it came down to 36. It's been in the 30s for 18 months now. The metformin was cut to 500mg after 3 months and this didn't make a difference to hba1c - I could have stopped it last year but decided to stay on it, although I am starting to come to the conclusion that maybe I don't need it.

Metformin alone won't impact a hba1c of 81 very much - it'll help a little, but lifestyle changes will help far more.

 

[Docb]

Hi @Lurcher67 and welcome to the forum and the wonderful world of the normal weight T2 diabetic! There are a few of us on the forum and in general they come in two types. The first are those who were misdiagnosed and finally turn out to be one of the odder forms of type 1 and the second being those who's pancreas does not work that well for some reason or other which is likely not to be due to excess fat build up.

My own experience is that metformin is of little use. In terms of medication Gliclazide did make a significant difference in blood glucose levels but by far the biggest thing to affect it is carbohydrate intake. After a bit of experimentation I ended up with a moderate carbohydrate diet and this maintains my HbA1c at around 50. If I swapped my diet around and upped the carbohydrate level then I reckon I could easily get my HbA1c up into the 70's or 80's.

To my mind, the important thing is to figure out the more important variables and then work out a plan to get on top of things. The plan needs to be something that will work, will fit into your lifestyle and you can sustain.

For me, finding that reducing carbohydrate intake was a way forward was the key. My trusty meter and a pencil and paper fairly quickly showed me where the bigger hitters were and a bit of elimination and adjustment of portion sizes, soon got things under control. The biggest problem is not to slide back with respect to the things controlled by portion size. The things I eliminated don't matter, they are just gone. Going the full keto low carb was not for me. Fine for those who want to but I don't really do extremes, too much hassle.

Hope that helps you begin to get a perspective.

 

[Leadinglights]

If you don't need to lose weight then you need to make sure you are eating protein and healthy fats whilst cutting down on the carbs as it is the carbs which convert to glucose.
You say your diet was OK but what may be OK for somebody without diabetes it is not so if you have. Reducing intake of the high carb foods, potatoes, bread, cereals, rice, pasta, regardless of colour, tropical fruits and fruit juice as well as the obvious cakes, biscuits, sugary drinks and high carb snacks like crisps.
It is suggested that a good stating point is no more that 130g carbs per day.

 

[Lurcher67]

Hello!

I was diagnosed with a hba1c of 83, and started on 1000mg of Metformin a day.
My diet wasn't great, and I was overweight, so I lost 3 stone in 3 months, cut the junk food and 'processed' carbs (Just carbs from fruit and veg and occasionally potato) and it came down to 36. It's been in the 30s for 18 months now. The metformin was cut to 500mg after 3 months and this didn't make a difference to hba1c - I could have stopped it last year but decided to stay on it, although I am starting to come to the conclusion that maybe I don't need it.

Metformin alone won't impact a hba1c of 81 very much - it'll help a little, but lifestyle changes will help far more.

Hi, it sounds as though diet has made the biggest impact for you. It is encouraging to hear that the levels can be improved quite dramatically. I am cutting out the biscuits etc and reducing the portions of carbs. There is so much information regarding diet that it can be a little confusing. I have lost about 1/2 stone in 6 weeks so hopefully some of my changes to diet are helping.
Stay on track as it sounds as though you have it worked out.

 

[Lurcher67]

If you don't need to lose weight then you need to make sure you are eating protein and healthy fats whilst cutting down on the carbs as it is the carbs which convert to glucose.
You say your diet was OK but what may be OK for somebody without diabetes it is not so if you have. Reducing intake of the high carb foods, potatoes, bread, cereals, rice, pasta, regardless of colour, tropical fruits and fruit juice as well as the obvious cakes, biscuits, sugary drinks and high carb snacks like crisps.
It is suggested that a good stating point is no more that 130g carbs per day.

Hi, yes I agree what I thought was ok as I ate plenty of fruit and veg also included all of the high carb foods especially toast for breakfast. Until being diagnosed, I had assumed that as my bmi was in normal range that I wouldn’t have any issues. My mother has had type 2 for a few years and my younger brother was recently diagnosed. My partner and her family eat a similar diet and none of them have high blood sugar, so I guess faulty genes are at least partly to blame.

 

[Leadinglights]

Hi, it sounds as though diet has made the biggest impact for you. It is encouraging to hear that the levels can be improved quite dramatically. I am cutting out the biscuits etc and reducing the portions of carbs. There is so much information regarding diet that it can be a little confusing. I have lost about 1/2 stone in 6 weeks so hopefully some of my changes to diet are helping.
Stay on track as it sounds as though you have it worked out.

Keeping a food diary of everything you eat and drink with an estimate of the carbs can be really helpful to see where you can make some savings.
The book or app Carbs and Cals is really useful for guiding you on the carbs for various portions of foods, some can be a real surprise.

 

[Lurcher67]

Hi

Hi @Lurcher67 and welcome to the forum and the wonderful world of the normal weight T2 diabetic! There are a few of us on the forum and in general they come in two types. The first are those who were misdiagnosed and finally turn out to be one of the odder forms of type 1 and the second being those who's pancreas does not work that well for some reason or other which is likely not to be due to excess fat build up.

My own experience is that metformin is of little use. In terms of medication Gliclazide did make a significant difference in blood glucose levels but by far the biggest thing to affect it is carbohydrate intake. After a bit of experimentation I ended up with a moderate carbohydrate diet and this maintains my HbA1c at around 50. If I swapped my diet around and upped the carbohydrate level then I reckon I could easily get my HbA1c up into the 70's or 80's.

To my mind, the important thing is to figure out the more important variables and then work out a plan to get on top of things. The plan needs to be something that will work, will fit into your lifestyle and you can sustain.

For me, finding that reducing carbohydrate intake was a way forward was the key. My trusty meter and a pencil and paper fairly quickly showed me where the bigger hitters were and a bit of elimination and adjustment of portion sizes, soon got things under control. The biggest problem is not to slide back with respect to the things controlled by portion size. The things I eliminated don't matter, they are just gone. Going the full keto low carb was not for me. Fine for those who want to but I don't really do extremes, too much hassle.

Hope that helps you begin to get a perspective.

Hi DocB,
Thanks for the advice, this is definitely the route for me, I don’t think I could go to an extreme diet and maintain it for any length of time. think portion control and moderation is the way to go as a long term lifestyle change. Good to hear that you have worked out what works for you.

 

[Lurcher67]

Keeping a food diary of everything you eat and drink with an estimate of the carbs can be really helpful to see where you can make some savings.
The book or app Carbs and Cals is really useful for guiding you on the carbs for various portions of foods, some can be a real surprise.

I have started a diary of what I am eating, but haven’t checked the carbs, though I have now started to look at food labelling which I would never have previously done as I thought I knew which foods were fatty, sugary or salty.

 

[Leadinglights]

I have started a diary of what I am eating, but haven’t checked the carbs, though I have now started to look at food labelling which I would never have previously done as I thought I knew which foods were fatty, sugary or salty.

Yes it is the total carbohydrate information you need to look at, ignore the sugar which is usually on the back of the packet.
tin or whatever. The traffic light system is as much use as a chocolate teapot if diabetic.
Having some scales on your worktop is a good idea as it is easy to underestimate the portion, then a bit of arithmetic is needed to work out the carbs which is usually in g carb per 100g product for the portion you are going to have.
Healthy fats are no problem from a diabetes point of view and many find that full fat Greek yoghurt with berries is a good breakfast option or eggs in any form.

 

[everydayupsanddowns]

Hi

Hi DocB,
Thanks for the advice, this is definitely the route for me, I don’t think I could go to an extreme diet and maintain it for any length of time. think portion control and moderation is the way to go as a long term lifestyle change. Good to hear that you have worked out what works for you.

Sounds like you are beginning to develop a plan of action @Lurcher67 - welcome to the forum!

If you’d like to use a BG meter to investigate your reaction to various moderate portions of carbs you may need to self fund. Several GP surgeries are reluctant to prescribe meters to T2s, unless they are on medication that carries a risk of hypoglycaemia.

If you need to self fund your BG meter, the most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £10 for 50 (some other brands can be 3x that much!)
The blog post test-review-adjust by Alan S has been a helpful framework for many forum members seeking to use a BG meter to tweak their menu. 🙂

 

[Lurcher67]

Sounds like you are beginning to develop a plan of action @Lurcher67 - welcome to the forum!

If you’d like to use a BG meter to investigate your reaction to various moderate portions of carbs you may need to self fund. Several GP surgeries are reluctant to prescribe meters to T2s, unless they are on medication that carries a risk of hypoglycaemia.

If you need to self fund your BG meter, the most affordable meters members here have found are the SD Gluco Navii or the Spirit Tee2 - which both have test strips at around £10 for 50 (some other brands can be 3x that much!)
The blog post test-review-adjust by Alan S has been a helpful framework for many forum members seeking to use a BG meter to tweak their menu. 🙂

Hi, I was given an Accu-Chek instant meter, so I am already seeing a reduction in the levels, though still not sure my fasting levels higher than previous evening ie last night 2 hours after food 5.4, then up to 8.1 this morning. My level at first visit to nurse was 12.5, so I am fairly happy with progress, but morning level always seem to be 7.5 - 8.5. I shall be reading some of the post’s on this site to improve my understanding of where I am and where I need to aim for. Thanks again for the advice on meter’s, although I have been given one it seems as though it maybe a postcode lottery type situation.

 

[everydayupsanddowns]

Hi, I was given an Accu-Chek instant meter, so I am already seeing a reduction in the levels, though still not sure my fasting levels higher than previous evening ie last night 2 hours after food 5.4, then up to 8.1 this morning. My level at first visit to nurse was 12.5, so I am fairly happy with progress, but morning level always seem to be 7.5 - 8.5. I shall be reading some of the post’s on this site to improve my understanding of where I am and where I need to aim for. Thanks again for the advice on meter’s, although I have been given one it seems as though it maybe a postcode lottery type situation.

Sounds like you may have a little ‘dawn phenomenon’ going on. The ancient circadian rhythms of hormones where the body ‘fires up the burners’ with a glucose boost in the early hours so that our cave dwelling forbears could get up and about and be equipped to snaffle a breakfast mammoth, or something.

Of course, these days our access to food is somewhat easier, so we don’t really need it, but the body is still following the ancient patterns. Not especially helpful if you have a slightly wonky metabolism that struggles with the burst of glucose released from the liver 🙄😉