Very high H1ac levels practical help

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Slightly defuggled looking for inspiration from anyone who has managed to lower their HB1ac.

Last reading was 107 about 2 months ago have been getting great advice re low carbs on here.

Am getting very mixed support from my GP surgery they just want to brush me under carpet.

So anyone who can impart wisdom.
 
You are still early days since your diagnosis and to quote 'managing diabetes is a marathon not a sprint' so don't be too impatient and stick with your chosen plan of action, it will pay off in the end. Bringing levels down more slowly can be kinder on your body as it has to adapt to a lower level.
If you get a repeat HbA1C 3 months after diagnosis you can see if your measures are being effective, ask for it rather than wait for them to contact you.
 
I have been living with diabetes for 11 years.
 
Berksps said:
I have been living with diabetes for 11 years.
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Sorry I interpreted you saying your HbA1C 2 months ago was a new diagnosis. I should read your other threads before jumping to the wrong conclusion.
It is indeed very high so something must have changed if you had previously been managing to stay at lower level. What medication are you taking and are you checking your blood glucose on a regular basis with finger pricks, testing before and after meals may help you identify what foods are not well tolerated.
I wonder if you are one of those who may be misdiagnosed and are actually Type 1 or LADA.
 
Berksps said:
I have been living with diabetes for 11 years.
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Hello @Berksps, I am an insulin dependent T3c and poorly placed to directly help you with ideas or suggestions - but I can clearly see your "cries for help" in at least 3 different threads you have started or replied to just this month.

Could a moderator please consider drawing together @Berksps recent postings, to help get a better snapshot of his/her predicament

You've told us that:
you currently have a far too high HbA1c, =107 c.2 months ago;
you freely admit that until recently you've not been doing your bit in getting on top of your D - but I'm presuming that was then and not now.
you get in-person foot checks but otherwise feel poorly served by your GP. A recent presumed external referral for a consult only brought about an internal review and extra oral meds; was that a face to face or phone call?
you were overweight, but lost a fair bit in recent months; I didn't glean how you achieved that - deliberate or it just happened?
and you have been T2 for 14 years.
I hope that broadly summarises your situation. I didn't glean if you are male or female (not that this particularly matters) or if you have any other medical problems going on that could confuse the situation.

I also see that various suggestions have been made since you first posted back in 2021. But it's not clear if any of those suggestions have helped you - other than the general perspective that you find this forum helpful. In particular a question was asked about your significant weight loss and a passing observation that perhaps you are not really T2 but possibly a late starting T1 (with an unstated thought that perhaps you have always been misdiagnosed, which can and does sometimes happen).

Hopefully others will see this and provide more focused advice (and hopefully the mods can draw your recent posts into one place).

I'm not clear if you currently test your BG by finger pricking; now you have been prescribed Gliclazide you should have a meter and test strips on prescription. Test, test and test will (in my non- medical opinion) provide you with a proper foundation from which you can plan and build a decent transition back to normal and acceptable BGs.
 
Proud to be erratic said:
Hello @Berksps, I am an insulin dependent T3c and poorly placed to directly help you with ideas or suggestions - but I can clearly see your "cries for help" in at least 3 different threads you have started or replied to just this month.

Could a moderator please consider drawing together @Berksps recent postings, to help get a better snapshot of his/her predicament

You've told us that:
you currently have a far too high HbA1c, =107 c.2 months ago;
you freely admit that until recently you've not been doing your bit in getting on top of your D - but I'm presuming that was then and not now.
you get in-person foot checks but otherwise feel poorly served by your GP. A recent presumed external referral for a consult only brought about an internal review and extra oral meds; was that a face to face or phone call?
you were overweight, but lost a fair bit in recent months; I didn't glean how you achieved that - deliberate or it just happened?
and you have been T2 for 14 years.
I hope that broadly summarises your situation. I didn't glean if you are male or female (not that this particularly matters) or if you have any other medical problems going on that could confuse the situation.

I also see that various suggestions have been made since you first posted back in 2021. But it's not clear if any of those suggestions have helped you - other than the general perspective that you find this forum helpful. In particular a question was asked about your significant weight loss and a passing observation that perhaps you are not really T2 but possibly a late starting T1 (with an unstated thought that perhaps you have always been misdiagnosed, which can and does sometimes happen).

Hopefully others will see this and provide more focused advice (and hopefully the mods can draw your recent posts into one place).

I'm not clear if you currently test your BG by finger pricking; now you have been prescribed Gliclazide you should have a meter and test strips on prescription. Test, test and test will (in my non- medical opinion) provide you with a proper foundation from which you can plan and build a decent transition back to normal and acceptable BGs.
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Thank you, that is most useful, it is hard to put the pieces together when they are all over the place.
 
Leadinglights said:
Thank you, that is most useful, it is hard to put the pieces together when they are all over the place.
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In truth I realistically don't think I can be of much more help - partly because I only have a thin understanding of T2 'niceties' and mainly because I need to deal with what feels like a thousand 'house sale and move' challenges! 5 July was declared yesterday as our possible completion date.
 
Proud to be erratic said:
Could a moderator please consider drawing together @Berksps recent postings, to help get a better snapshot of his/her predicament
Click to expand...

I’ve merged three threads that seemed to overlap slightly into one. Hopefully it will give a fuller context with earlier replies?
 
everydayupsanddowns said:
I’ve merged three threads that seemed to overlap slightly into one. Hopefully it will give a fuller context with earlier replies?
Click to expand...
@everydayupsanddowns thank you. It certainly helps me!.

@Berksps - sincere apologies if this has hi-jacked your strategy with your postings under different topics. I just couldn't see the wood while amongst the trees. I suspect your macular degeneration must be very worrying.

Getting your BG down seems the most obvious start point, not just for your eyesight but being so high will almost certainly leave you feeling "poorly" in so many ways, physically and mentally - being out of sorts for even a short period can be very debilitating which can drain our mental resilience. Hopefully all you've been trying over the last couple of months, including the latest increase in oral meds is now helping. But as said earlier better this is done steadily and not too rapidly.

An updating HbA1c in about a months time (this test looks at your blood going back up to 3 months) would be good. In my GP Surgery there is no forward thinking for me. I have to book the blood (or any other) test and if I want it locally (I can walk to my Surgery) they seem to need 3 weeks minimum notice. So perhaps it would be worth you booking your next HbA1c now.

If that next HbA1c is still markedly high then you need to persuade someone to properly review your situation - which is clear that you have recently tried.

Meanwhile, despite my interfering with your posting stragy, do keep asking other questions - ideally initially from this thread so the bigger picture can be seen. My experience from this forum is that there are many members happy to offer thoughts or opinions from their experiences. Good luck.
 
So i tried my first dose of gliclazide and it left me feeling very odd indeed. My head was spinning and it really sent me spinning. I am feeling better 24 hrs later but i am really worried about taking it again. I have a call booked with the diabetic nurse on monday but i really think i should have been referred properly to actually see a human being.
 
How long after taking it did you feel unwell and did you test your BG levels at that time? Testing when you feel unwell is important to help understand what is going on and particularly when using a medication like Gliclazide. If you haven't been prescribed a BG meter and test strips then you should have been so that you can test in these situations, so do ask the nurse about it when you speak to him/her.
 
Quite quick within the hour or so. No my surgery did not give me a BG monitor. Have said before how non involved they are. I got referred and the diabetic clinic recmmended i take this gliclazide. With no explanation at all
 
Then you need to be proactive and insist that they give you testing kit to keep yourself safe. Do you drive? If so, then you should be testing whilst on Gliclazide.
Many people here have to self fund their testing gear, but those on Gliclazide should be provided on prescription.
 
Berksps said:
Hello all,

I have had type 2 for quite some time and i will be honest have tried to ignore it. I have made little or no change to diet and about the only thing i have done is loose weight probably about 3 stome. My level has always been high around 100 and shows no sign of change. I have recently been referred to a diabetic clinic and await my first appointment. I am interested in practical tips to help from anyone. One thing that has happened is i have been having treatment for macular degeneration i wondered if anyone had similiar.

Male
55
Diagnosed 2012

Thanks
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Practical Tips

1. Binge-watch the following people on YouTube and type in 'Diabetes' by their name in the search bar:
Dr. Fung, Dr. Berry, Dr. Dhand, Dr. Boz, Dr. Berg, Dr. Eckberg, Denis Pollock (Beat Diabetes guy),
Glucose goddess, and Blood Sugar King, to see some common themes
2. Consider drinking only H20 from now on -eliminate every other drink save occasionally hot coffee or hot tea, and if you must drink alcohol, stick with the distilled stuff
3. Consider significant carbohydrate restrictions to be as low as possible until your numbers start to improve. This means limiting or eliminating, breads, pasta, noodles, french fries, baked goods, rice, grains, and non-starchy vegetables like potatoes. Eat as many green vegetables as you like and don't worry about slabs of grass-fed meat like steak or chicken. Eat nuts instead of potato chips.
4. Consider intermittent fasting beyond 24 hours to enter into Ketosis. 48 hour fasting is hard, but doing it once a week will eventually feel good and really deep cleanse your body of sugars and other bad stuff.
5. Try and get 150 min of vigorous exercise a week. Something like hard running, lap swimming, wrestling, etc. Anything that gets your heart feeling like it is going to explode, and like you can't breathe for a few seconds, can help. Might feel painful at first, but you'll get to like the rush it gives you.
6. Measure yourself constantly on BP, waist, weight, and 'Mike the meter" blood glucose monitor if you have one, and get into optimal ranges. Get your BMI to the low end of normal but not underweight.
7. Find a low carb, low sugar diet that works for you.
8. Do all the above, be serious about it, and get tested in 3 months later or about 180 days later (when your red blood cells begin to replace themselves being less glycated) with an A1C or fasting blood glucose test, and tell us how your numbers have improved, to motivate us all to continue to aspire to live and eat healthy.
 
Admiral Benbow said:
Practical Tips

1. Binge-watch the following people on YouTube and type in 'Diabetes' by their name in the search bar:
Dr. Fung, Dr. Berry, Dr. Dhand, Dr. Boz, Dr. Berg, Dr. Eckberg, Denis Pollock (Beat Diabetes guy),
Glucose goddess, and Blood Sugar King, to see some common themes
2. Consider drinking only H20 from now on -eliminate every other drink save occasionally hot coffee or hot tea, and if you must drink alcohol, stick with the distilled stuff
3. Consider significant carbohydrate restrictions to be as low as possible until your numbers start to improve. This means limiting or eliminating, breads, pasta, noodles, french fries, baked goods, rice, grains, and non-starchy vegetables like potatoes. Eat as many green vegetables as you like and don't worry about slabs of grass-fed meat like steak or chicken. Eat nuts instead of potato chips.
4. Consider intermittent fasting beyond 24 hours to enter into Ketosis. 48 hour fasting is hard, but doing it once a week will eventually feel good and really deep cleanse your body of sugars and other bad stuff.
5. Try and get 150 min of vigorous exercise a week. Something like hard running, lap swimming, wrestling, etc. Anything that gets your heart feeling like it is going to explode, and like you can't breathe for a few seconds, can help. Might feel painful at first, but you'll get to like the rush it gives you.
6. Measure yourself constantly on BP, waist, weight, and 'Mike the meter" blood glucose monitor if you have one, and get into optimal ranges. Get your BMI to the low end of normal but not underweight.
7. Find a low carb, low sugar diet that works for you.
8. Do all the above, be serious about it, and get tested in 3 months later or about 180 days later (when your red blood cells begin to replace themselves being less glycated) with an A1C or fasting blood glucose test, and tell us how your numbers have improved, to motivate us all to continue to aspire to live and eat healthy.
Click to expand...
This really is far more extreme than it needs to be and not sustainable long term for most people and could make it appear so daunting that people give up before they even start to make lifestyle changes.

@Berksps Please do not feel that the above list is the norm or necessary for most people to achieve remission, even with a really high HbA1c. It is one extreme of a very broad spectrum. I would suggest you look for some middle ground.
 
rebrascora said:
Do you drive? If so, then you should be testing whilst on Gliclazide.
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There’s no requirement to test blood sugar or carry a blood sugar meter if only on gliclazide from the DVLA. You only have to inform the dvla on gliclazide if you drive larger vehicles or if you’ve had a severe hypo or hypounawareness or certain eye complications. It is good to have a meter so you can test when feeling unwell, just isn’t a requirement to test before driving.

 
Lucyr said:
There’s no requirement to test blood sugar or carry a blood sugar meter if only on gliclazide from the DVLA. You only have to inform the dvla on gliclazide if you drive larger vehicles or if you’ve had a severe hypo or hypounawareness or certain eye complications. It is good to have a meter so you can test when feeling unwell, just isn’t a requirement to test before driving.

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Sorry but there is a requirement to test on glicliazide - although not to inform dvla automatically which is what your link talks about rather than the testing requirements.

If you are on gliclazide or other meds that carry a risk of hypos you should have testing equipment provided as it’s necessary for driving within the law as well as the direct risks of the hypo. Look at NICE NG28 and in there is https://assets.publishing.service.g...84397/assessing-fitness-to-drive-may-2022.pdf
which says

Managed by tablets carrying hypoglycaemia risk- Including sulphonylureas and glinides (for example Repaglinide, Nateglinide)
May drive and need not notify DVLA, provided:
■ no more than 1 episode of severe hypoglycaemia while awake in the last 12 months and the most recent episode occurred more than 3 months ago
■ should practise appropriate glucose monitoring at times relevant to driving
■ under regular review
It is appropriate to offer self monitoring of blood glucose at times relevant to driving to enable the detection of hypoglycaemia.
If the above requirements and those set out in Appendix D (page 127) are met, DVLA need not be informed.
DVLA must be notified if clinical information indicates the agency may need to undertake medical enquiries.
Click to expand...
 
HSSS said:
Sorry but there is a requirement to test on glicliazide
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Not according to latest DVLA guidelines for patients there isn’t a requirement to test before driving, it doesn’t mention it at all in the patient leaflet, the one you linked is for medical professionals not the advice to individual drivers. It also says should not must which means it isn’t a requirement.

It’s only if your Dr advises you that you should test before driving that you need to, your licence isn’t automatically conditional on you testing before driving just because you’re taking gliclazide.
 
Whatever the law says, if you are on meds that can cause hypos you are morally obliged to keep others safe by ensuring you don't have hypos when in control of any vehicle.
 
Tdm said:
Whatever the law says, if you are on meds that can cause hypos you are morally obliged to keep others safe by ensuring you don't have hypos when in control of any vehicle.
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Agreed, but with a hba1c of 107 and a1c always around 100 it’s more likely false hypos than actual hypos, so it’s more important that OP takes into account how they feel when deciding whether to drive rather than just test and assume if it’s not hypo I’ll drive.
 
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