Talk with nurse at surgery, am confused...

S

Sharron1

Well-Known Member
Relationship to Diabetes
Type 2
As the subject title indicates I spoke with the nurse yesterday and (silly me) I took my food diary. She was able to see my BG numbers are usually at 5.6 , 5.7, 5.9 rarely occasionally they hit 7 or 8 ( BH or birthdays etc) .I have been quite ok with those numbers, however, she told me I should aim for 5 or a little under. I really thought my nunbers and low carb diet were good. She told me the lower BG the better management of D. I didn't say much but just think D is (alas) a fickle mistress and I keep an eye on. it is a life long activity. So I will continue with my current food choices. I just wondered a) what people think of this advice and b) is she just numbers focused and a little on the over zealous side?

Hope you all have a lovely day.
 
Oh wow. That’s quite disconcerting for you. I have similar numbers and am very happy with them. My nurse’s advice was to try and keep between 5&7. I’m low carb too between 50-75 daily but I need a tiny bit of insulin to keep me ticking over.
I think many of us can attest to widely differing advice from health professionals which is why I find this forum so helpful.
As ever keep doing what works for you and your A1c results are proof that it’s working. Best wishes.
 
I did the same once and showed my DN similar numbers. She told me that as I was getting those numbers consistently I could stop taking my Metformin to see how I got on without it. I haven't taken it since.

@Taighnamona is right about how advice differs across the NHS.
 
Inka said:
Those numbers sound great to me @Sharron1 🙂 What’s your HbA1C?
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Last one was mid 37 I think can't remember but no real.worries I just think each time I meet with a different HCP they have a different opinion to management of D. Sigh
 
Martin.A said:
I did the same once and showed my DN similar numbers. She told me that as I was getting those numbers consistently I could stop taking my Metformin to see how I got on without it. I haven't taken it since.

@Taighnamona is right about how advice differs across the NHS.
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Ah ha, stop taking Metformin, not in my surgery, as I repeatedly post on the forum the attitude I get when I ask for a reduction is '...if it ain't broke don't fix it' Can't now be bothered with a conversation let's see what happens with a gradual reduction.
 
I am very new to this journey. Have met diabetes nurse once and didn't have foot check or weigh in. Today increased metaformin to 3 tablets a day and am due another blood test next month. My first test was 69 and second 64 so am encouraged yours are so low. Why do you test? I'm tempted because I haven't a clue how individual foods affect me. However when I used to donate blood it was the finger prick I loathed. If you haven't been taken off metaformin asa trial I suspect I will be pill popping for ever plus I expect further drugs next month as someone talked taking statins
 
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Your HbA1c numbers since 2020 are in the normal range. Testing a reduction in Metformin makes sense. Keep yourself in good shape!
 
saffron15 said:
. However when I used to donate blood it was the finger prick I loathed
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In my previous experience (I can’t donate now I’m Type 1) they always have the finger pricker on the deepest setting, and go for the middle of the pad, which is the most sensitive spot. Pricking my own finger with the lightest setting that I know will produce a drop, and doing it on the side of the pad, plus other techniques (there’s a thread somewhere about it on here, I’m sure) is nothing like as bad as the experience of the blood donor clinic.
 
@saffron15. I got my HbA1c down from three figures to the mid 30s in a few months on a diet of protein and vegetables. I tested only once to make sure I was on the right track.

If you need to reassess your diet you might find these helpful:
- https://www.lowcarbfreshwell.com/documents/8/Freshwell_Red_Amber_Green.pdf
- https://phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf
- What should we eat? https://www.zoeharcombe.com/2021/08/what-should-we-eat/
Different ways of looking at the same thing!
 
Your fingerstick numbers and your HbA1c look great to me @Sharron1

I’m not sure what benefit there would be for you in trying to push them into the 4s, and you may lose some flexibility in your menu, or need to add an additional med that might risk hypoglycaemia?

In your shoes I’d be tempted to keep doing what I was doing!
 
Sharron1 said:
As the subject title indicates I spoke with the nurse yesterday and (silly me) I took my food diary. She was able to see my BG numbers are usually at 5.6 , 5.7, 5.9 rarely occasionally they hit 7 or 8 ( BH or birthdays etc) .I have been quite ok with those numbers, however, she told me I should aim for 5 or a little under. I really thought my nunbers and low carb diet were good. She told me the lower BG the better management of D. I didn't say much but just think D is (alas) a fickle mistress and I keep an eye on. it is a life long activity. So I will continue with my current food choices. I just wondered a) what people think of this advice and b) is she just numbers focused and a little on the over zealous side?

Hope you all have a lovely day.
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She probably has a range of skills & talents unrelated to diabetes management.
 
everydayupsanddowns said:
Your fingerstick numbers and your HbA1c look great to me @Sharron1

I’m not sure what benefit there would be for you in trying to push them into the 4s, and you may lose some flexibility in your menu, or need to add an additional med that might risk hypoglycaemia?

In your shoes I’d be tempted to keep doing what I was doing!
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That is my plan. I find the advice given at my surgery fascinating. I usually smile, say thank you and then ignore it. Although I did feel like asking would it help if gave up eating... but decided against that in case she thought I meant it.
 
As I was originally asked to go to surgery because cholesterol had crept up ( I have an annual blood test for high blood pressure) I cut out meat pastry sweet things etc. Lots of fish and veg. I discovered they were not testing me for diabetes and ask for a test. Two weeks later I was 69. Because of concentrating on the cholesterol some of the appealing meals with red meat don't seem appropriate. I have started also eating chicken and turkey plus occasional bread - I like an open sandwich with cream cheese and smoked salmon. I have been using m and s robust rye.
Disappointingly having lost 8 kilos in 9 weeks it seems to have stopped. Hopefully temporarily.
Thanks for the links @JITR and thank you @Robin for the reassurance about finger pricking.
 
Eddy Edson said:
She probably has a range of skills & talents unrelated to diabetes management.
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You joke, but it is probably true. Sigh. My aunt used to say it was amazing how some people have so much confidence in their limited abilities.
 
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saffron15 said:
I am very new to this journey. Have met diabetes nurse once and didn't have foot check or weigh in. Today increased metaformin to 3 tablets a day and am due another blood test next month. My first test was 69 and second 64 so am encouraged yours are so low. Why do you test? I'm tempted because I haven't a clue how individual foods affect me. However when I used to donate blood it was the finger prick I loathed. If you haven't been taken off metaformin asa trial I suspect I will be pill popping for ever plus I expect further drugs next month as someone talked taking statins
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Testing is a good strategy to see both what foods you do not tolerate well and those which you might reject when they would be fine.
Testing before you eat and after 2 hours, aiming at no more than a 2-3mmol/l increase will help bring your overall levels down. You don't need to do it all the time as you will soon establish what you can tolerate. People also check first thing in the morning to check progress rather than wait for months between HbA1C tests as that will show you are on the right track with dietary changes or not as the case may be and you can then take action.
To be honest doing the finger prick yourself hurts far less than when the nurses do it or at the blood donation place, a paper cut hurts far more.
If you want some low carb ideas then have a look at this link https://lowcarbfreshwell.com/
I got my HbA1C down from 50mmol/mol to 42 in 3 months following those principals.
 
saffron15 said:
I am very new to this journey. Have met diabetes nurse once and didn't have foot check or weigh in. Today increased metaformin to 3 tablets a day and am due another blood test next month. My first test was 69 and second 64 so am encouraged yours are so low. Why do you test? I'm tempted because I haven't a clue how individual foods affect me. However when I used to donate blood it was the finger prick I loathed. If you haven't been taken off metaformin asa trial I suspect I will be pill popping for ever plus I expect further drugs next month as someone talked taking statins
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I test to see if everything is still ok. D is fickle. I don't test that often anymore but good to keep an eye on BG and food.

As for Metformin, I will keep on asking like a broken record and wait for their usual response. I now await the Statins chat. Tried them at the beginning of year but was taken off them immediately once it was seen they elevated my liver enzymes. No other side effects and they did work wonders to my cholestrol
 
Ignore her, clearly she hasn't had the right training!!!! You are doing just fine. I hardly test anymore as it eat affecting my mental health. I know what I can eat and stick to it. Can't eat a meal without some carbs ( not veg carbs ) as an hour later I am starving!!!
 
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