Just joined here. Was diagnosed as T2 in 2014 when I lived in France, it was a big surprise to both me an my GP as I was not overweight, had a good diet and very fit as I was doing heavy physical work. Bumbled along on 500mg of Metformin a day and my levels were between 5.5 and 6.5 on the old scale, last blood test in September last year it was 54 on the new scale but my blood test last week this had risen to 68. Just had a review an it’s been suggested that I go on the attack an increase the Metformin to 1500mg a day!! Oh! And my cholesterol has also gone from good to not good in the last 6 months too. Not much change in diet over the years but have been told to cut down on my cheese consumption and review all my intake of saturated fats, lunch is usually three types of cheese (mainly small pieces of sheep or goats cheese and a sliver of Brie) cucumber and Ryvita type crispbreads and a cup of tea. I do like my butter but I guess that’s got to go too. I think that the sudden increase in diabetes levels is due to an extended visit to France in April/May, it’s nigh on impossible to keep on the straight and narrow when entertaining and being entertained with so much rich food available.
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Sudden increase in HbA1c levels…
- Thread starter Lussac
- Start date
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Hi @Lussac and welcome to the forum.
So far as rich foods are concerned, I suppose you know that France has a lower rate of heart disease than most other countries - especially those who typically eat more carbohydrates and less fats.
Which cholesterol figure(s) do you/your doctor believe actually matter?
Is it Total cholesterol (which includes HDL ? Or just LDL (which isn't measured - just inferred from other lipid readings?
Or is it Triglycerides either alone, or as a ratio with HDL?
I ask this because unless you believe it's total cholesterol (including the 'so called good cholesterol HDL@) then I se no need for you to give up cheese and butter. This is because one of the best ways of beating Type 2 diabetes is through a Low Carb High Protein Moderate (traditional)Fat way of eating. This leans heavily on fatty meat and fatty fish, eggs, cheese, butter and full fat dairy. Counter intuitively, dietary fay doesn't make you fat the way that carbohydrates do because fat (combined with protein) is satiating unlike carbs which make you hungry once the initial sugar rush has worn off. A Low carb way of eating is a good way to reduce weight, normalise Blood Pressure and improve lipid ratios (reducing cardio vascular risk - if you believe that Triglycerides matter as well as LDL and HDL).
Most people on a Low Carb way of eating:
A). lower their Blood Glucose (often putting their Type 2 diabetes into remission without drugs, additional exercise or calorie restrictions.
B). Reduce weight if they are overweight (only about 90% of Type 2 diabetics are above normal weight).
C). Normalise Blood Pressure if its high (come off Blood Pressure medication - otherwise they may start fainting due to low blood pressure).
D). Lower their LDL , lower their Triglycerides and raise their HDL. Even the few whose LFDL doesn't reduce improve their total Lipid profile due to raised HDL and reduced Triglycerides!
So far as rich foods are concerned, I suppose you know that France has a lower rate of heart disease than most other countries - especially those who typically eat more carbohydrates and less fats.
Which cholesterol figure(s) do you/your doctor believe actually matter?
Is it Total cholesterol (which includes HDL ? Or just LDL (which isn't measured - just inferred from other lipid readings?
Or is it Triglycerides either alone, or as a ratio with HDL?
I ask this because unless you believe it's total cholesterol (including the 'so called good cholesterol HDL@) then I se no need for you to give up cheese and butter. This is because one of the best ways of beating Type 2 diabetes is through a Low Carb High Protein Moderate (traditional)Fat way of eating. This leans heavily on fatty meat and fatty fish, eggs, cheese, butter and full fat dairy. Counter intuitively, dietary fay doesn't make you fat the way that carbohydrates do because fat (combined with protein) is satiating unlike carbs which make you hungry once the initial sugar rush has worn off. A Low carb way of eating is a good way to reduce weight, normalise Blood Pressure and improve lipid ratios (reducing cardio vascular risk - if you believe that Triglycerides matter as well as LDL and HDL).
Most people on a Low Carb way of eating:
A). lower their Blood Glucose (often putting their Type 2 diabetes into remission without drugs, additional exercise or calorie restrictions.
B). Reduce weight if they are overweight (only about 90% of Type 2 diabetics are above normal weight).
C). Normalise Blood Pressure if its high (come off Blood Pressure medication - otherwise they may start fainting due to low blood pressure).
D). Lower their LDL , lower their Triglycerides and raise their HDL. Even the few whose LFDL doesn't reduce improve their total Lipid profile due to raised HDL and reduced Triglycerides!
Yes, it was Triglycerides that were above the limits (was 2.3 and should be below 1.7, LDL was 3.14 and HDL 1.31 the LDL and HDL are OK I think). I am not overweight and probably slightly underweight (6'1" and under 12st), do between 6 and 7 hours at the gym (mon/wed/fri) doing weights, floor and a 10k bike ride so I thought all was good. I am on Amlodipine 5mg for blood pressure but that's a whole other issue as I don't think I need them, it came about when I had my blood pressure taken at the surgery when I returned from living in France, that day had been particularly stressful and my BP was up I think due to that (a month before I had my blood pressure taken at my GP in France as part of a three monthly check on my diabetes and it was normal). I was slightly terrified that I had high blood pressure and that gave me white coat syndrome, so couldn't get a reliable reading at the surgery. Also, went into hospital for a hernia op about 18months ago and they take your meds off you and when I was going to be discharged I asked for my Amlodipine and they said no as my blood pressure was too low!!
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
You could see if your surgery will loan you a blood pressure monitor so you can do some readings at home, or buy yourself one, they are not expensive, the OMRON ones are pretty good. 5mg is a pretty low dose or amlodipine anyway.
You may be able to improve your cholesterol numbers by reducing your carbs as there is a fair bit of evidence that it is carbs that can affect cholesterol and dietary fats do not convert to convert to serum cholesterol though saturated fats may affect some people.
I eat plenty of cheese, butter, cream and although I do take a low dose statin, cholesterol is 3.7 at last count. I do go low carb approx 70g per day.
Looking at your carb intake and keeping it to no more than 130g per day as the suggested starting point if following a low carb approach and you may not need to increase the metformin dose.
You may be able to improve your cholesterol numbers by reducing your carbs as there is a fair bit of evidence that it is carbs that can affect cholesterol and dietary fats do not convert to convert to serum cholesterol though saturated fats may affect some people.
I eat plenty of cheese, butter, cream and although I do take a low dose statin, cholesterol is 3.7 at last count. I do go low carb approx 70g per day.
Looking at your carb intake and keeping it to no more than 130g per day as the suggested starting point if following a low carb approach and you may not need to increase the metformin dose.
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
I also follow a low carb, higher natural fat (cream, cheese, fatty meat etc) way of eating and my cholesterol levels are now lower than they were at diagnosis 4 years ago when I ate much less fat but lots of carbs. I have refused statins because my levels are only just above 4 which is what the NHS would like them to be under for someone with diabetes. I am fitter and healthier than most women my age so I don't see why I should take tablets that wouldn't be warranted if I didn't have diabetes.
nonethewiser
Well-Known Member
- Relationship to Diabetes
- Type 1
Check first but sure figure of 1.7 for trigs is if its fasting test, as in no food previous 10 hours.
Ldl should be below 2 for people with certain health conditions, been told this by consultant as I'm type 1.
You could reduce your cheese consumption & see how you get on, no harm in trying anyway. Like my cheese & butter yet my cholesterol levels are consistently good so I'm told, don't follow any diet in particular so must just be one of those fortunate few.
There are lots of different ideas (amongst medical profession) as to what ideal levels should be.
I had a triple Cardio bypass while eating the NHS advised high carb low fat diet which also gave me T2Diabetes.
I'm not on statins since A). They raise my BG and B). I got side effects.
From my reading I don't believe that LDL numbers don't matter in the context of a Low Carb/Keto way of eating.
I have read that the ideal figures for HDL and Triglycerides are HDL over 2.0 and Trigs less than 1.0 which according to some calculators put you into the lowest 5% at risk.
In my case I'm in a minority that my LDL is higher than before Low carb. But my Trigs basically halved and my HDL basically doubled - so very happy with my current ratios!
I had a triple Cardio bypass while eating the NHS advised high carb low fat diet which also gave me T2Diabetes.
I'm not on statins since A). They raise my BG and B). I got side effects.
From my reading I don't believe that LDL numbers don't matter in the context of a Low Carb/Keto way of eating.
I have read that the ideal figures for HDL and Triglycerides are HDL over 2.0 and Trigs less than 1.0 which according to some calculators put you into the lowest 5% at risk.
In my case I'm in a minority that my LDL is higher than before Low carb. But my Trigs basically halved and my HDL basically doubled - so very happy with my current ratios!
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
Just reposting this thread referencing the current official NHS England guidance about cholesterol management for reference.
These guidelines will have been carefully put together balancing all available evidence, from all trials and meta analyses weighting them according to their scope and quality.
The PDF is here: https://www.england.nhs.uk/aac/wp-c...-for-Lipid-Management-Prevention-Dec-2022.pdf
These guidelines will have been carefully put together balancing all available evidence, from all trials and meta analyses weighting them according to their scope and quality.
The PDF is here: https://www.england.nhs.uk/aac/wp-c...-for-Lipid-Management-Prevention-Dec-2022.pdf
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TheClockworkDodo
Well-Known Member
- Relationship to Diabetes
- Type 1
I'm just wondering whether you were tested for type 1 when you were diagnosed, @Lussac ? - given that you say that at the time you had a good diet and were very fit, and that you are slightly underweight, which should have suggested to your doctor at least the possibility of type 1 (but probably didn't because most GPs don't know much about type 1 and often incorrectly believe it only occurs in children - actually about half the people diagnosed with it are adults at the time).
I'm not saying it's likely - but given your circumstances it's possible - and if I were you I'd want to be sure, so it's worth asking for the tests (and if they refuse asking why - if the reason is you're too old, that's not a valid reason at all, and if the reason is the onset wasn't sudden enough, that's not a valid reason either - there is such a thing as slow-onset type 1, and some people can be misdiagnosed as type 2 for years before finding they are really type 1). If you are type 1, just throwing more Metformin at it won't help - even if it's very slow-onset you will need insulin, and the sooner you get it the better. The tests to ask for are GAD antibody and C-Peptide.
Re the blood pressure checks, I agree with @Leadinglights that Omron meters are good - but Omron also make the ones sold by Boots as Boots own brand, which are cheaper! Do get an upper-arm one if you're getting one yourself, the wrist ones are not as accurate - and do check the size of the armband bit before buying as they come in different sizes and people are often caught out by getting one which is too small for their arms.
My blood pressure is borderline low when I do it at home, much higher when they do it in stressful hospital environment! I always do a few checks before appointments now and tell the nurse an average of what it is at home.
I'm not saying it's likely - but given your circumstances it's possible - and if I were you I'd want to be sure, so it's worth asking for the tests (and if they refuse asking why - if the reason is you're too old, that's not a valid reason at all, and if the reason is the onset wasn't sudden enough, that's not a valid reason either - there is such a thing as slow-onset type 1, and some people can be misdiagnosed as type 2 for years before finding they are really type 1). If you are type 1, just throwing more Metformin at it won't help - even if it's very slow-onset you will need insulin, and the sooner you get it the better. The tests to ask for are GAD antibody and C-Peptide.
Re the blood pressure checks, I agree with @Leadinglights that Omron meters are good - but Omron also make the ones sold by Boots as Boots own brand, which are cheaper! Do get an upper-arm one if you're getting one yourself, the wrist ones are not as accurate - and do check the size of the armband bit before buying as they come in different sizes and people are often caught out by getting one which is too small for their arms.
My blood pressure is borderline low when I do it at home, much higher when they do it in stressful hospital environment! I always do a few checks before appointments now and tell the nurse an average of what it is at home.
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