This is probably a rehash but this is my first post on this forum, apology’s for the generic “here is my problem” missive.
In summary, my A1c was 11.3 in September of this year. I started Metformin (500 mg 1X per day) and Jardiance (10 mg 1X per day) and as of early December it had dropped to 6.4. Yes, it’s an improvement but I was hoping for a sub 6.
I have used a CGM (both Dexcome and FreeStyle) for the entire 3 months, it showed my EAG to be holding around 115-120 mg/dl for the most part. That does not equate to an A1c 6.4, from what I understand about it. I know I have more work to do, just curious if anybody has any insight. Thx!
Give it a rest. Most diabetics on this board would love to have your A1C, especially after working at it for so little time. Yes, some of us are consistently in the mid-5 range, but it has taken years of fine-tuning our medications, diets, and exercise to get there. If you try to force it, there is an excellent chance that you will end up with other issues as a result of frequent hypoglycemia. Anything under 7 in the first year is certainly a great achievement to be very proud of.
First of all, this is an amazing result. It really is, so congrats on that!
I am not familiar with the rest of your treatment, but a few questions are: how have you adapted your diet and eating habits? And have you followed-up with some exercise - specifically cardio?
These, alongside medication, are the things that can help you lower your BG. Also, sleep can help that too a bit.
I get it. I am happy with the improvement and not downplaying (or up-playing for that matter) the lab results. It clearly indicates the stuff I am doing is having a strong positive effect. I have only seen the labs and have not talked to my GP about them yet, I assume he will have good insight.
I wouldn’t describe myself as a complete noob, possibly a semi-noob as I have been on the glucose roller coaster for a few years now. I will admit I have just recently started figuring out how to eat correctly and what to watch for when I check my numbers.
I lift weights, 4X/week most weeks. I do some walking and bike riding at intervals but at this point no really heavy cardio. I figured out that exercise causes my BG to run up to higher levels and then drop rapidly about 30 minutes after I stop working out. Still trying to figure that part out. I like cardio.
I eat low carb, probably 80-90% keto friendly with all the sugar subs like Stevia, etc.
That’s the general idea, just checking the numbers and trying to get in 80-100 oz. water per day.
Thanks so much! I assumed it to be a good set of labs, I wasn’t sure how good honestly. I realize it is relative, everybody has a unique set of circumstances and set of terms to deal with. Like all the rest, I am just trying to give myself the best opportunity to succeed.
I started in the 11’s and after firing up my control it took almost 2 years to get it to sub 6. Lots of stuff impacts A1C including time. They say it is 3 month measure., but it can be 4 or 5. Just let it go and ease into the next quarter. I predict better outcomes.
Watch out people hate a tall poppy and love to cut them down. I say GO FOR IT. The big misconception for people who have poor control is that the lower a1c attract hypos. In actual fact people who obtain a1cs in the 4s actually have less hypos as their control relates to even straight blood sugar control and less insulin. If as a type 2 (I am a type 1) youve exhausted all options to lower your a1c and it’s still isn’t coming down to where you want it (need it?) then it might be time to consider insulin. Of course this is your and your Drs choice but what I am saying is don’t be frightened of insulin, be frightened of high blood sugars! Don’t be so frightened you become careless or immobilised but absolutely become a perfectionist if it’s already in you. Go for it, you stand to live longer and healthier with all the effort
You really can’t go by the CGM for complete accuracy. Generally they read lower than you are at. You can calibrate the Dexcom which can really help. I aim for my Dexcom to be within 5 points of my BG level. It is invaluable to let you know reactions/trends to food and exercise, but it does need calibration for more accuracy.
You are doing great! It didn’t take only 3 months to get to your high numbers, so doing so well to lower them in 3 months is doing a really good job. .You probably need some more time to refine what you are doing right. But one thing I can highly recommend is using exercise as a valuable tool. Exercise forces the cells to uptake insulin better. My husband is/was a type 2 and usually has an A1C in the low 6’s. He does take Metformin and probably always will because he still likes his snacks of some junk food off and on. He really controls his portions when he eats it now. But one thing he has learned is to use exercise to control his numbers. He loves spaghetti, so when he has spaghetti he swims pretty intensely for about 45 minutes before or after he eats it and his numbers don’t spike. But exercise really helps.
Another small item not to overlook is whether your labs come from a lab using certified equipment or a DR’s office desktop unit. The non-certified units can be off +/- .5%, so an A1C of 6.4 in a doctor’s office could be anywhere between 5.9% to 6.9% for the same sample sent to a lab using certified equipment. This is, of course, a non-issue when a diabetic is at an 11% A1C but when approaching 6% is a possible factor.
I think we started off on the wrong foot talking about hypo, this is not a T1 but a T2 using only metformin and jardiance - there is no possibility of going hypo. So yeah, keep doing what you’re doing and it should keep getting better.
Thanks @Rphil2. Per your suggestion and others, I am trying to temper my expectations. It is such a unique set of circumstances, I feel like I am earning my Associate’s degree in T2 control, seeking a Master’s.
Thanks @rocksta. After going over this particular set of labs with my GP, I think the plan going forward is “Keep Calm and Carry On.” He seemed very pleased, he even said I could “loosen” up the diet some. I am looking forward to eating a few things I have been avoiding, not getting out of hand of course and checking the numbers accordingly. As far as meds/insulin, I am a believer in doing exactly as he tells me, when he tells me. I trust him implicitly, if I didn’t I would find somebody else. He has gotten me this far and per your advice, we will cross that bridge should the need arise.
Thanks @Marie20. I have used both the Dexcom and the Freestyle (1 & 2) models, I have mixed emotions about both. The Dexcom (G6) worked fine, I didn’t care for having it on my abdomen and of the two it is the more expensive, considerably so. Especially without insurance. The FreeStyle(s) are probably more my speed and obviously more cost effective.
My intent is not to use a CGM all the time unless for some reason my condition warrants it. Right now it is by far my best learning tool. I figured out it is providing a delayed number, I still use finger sticks often to get both sets of metrics. Finally, I agree about the exercise piece 100%. I have been an avid weight lifter, runner, bike-rider and heavy bag guy for many years. I am not drastically overweight by any standards which is one reason I was very puzzled with the diagnosis in the first place. I guess we all go through that. Extreme weight loss is not a good option, I can’t afford it. I guess I have a lot more work/education to do because some spaghetti sound awesome at this point!
I think you highlighted the wrong part of that quote:
“Jardiance works by helping the body get rid of glucose through the kidneys. When used alongside other medications that lower glucose levels, it’s possible that your blood sugar can get too low. Too low of blood sugar (glucose) levels is called hypoglycemia .”
What other medications is he taking that can lower glucose? Since there are none then that sentence does not apply.
To be clear, here is a more explicit explanation: “If you use certain diabetes drugs, including insulin or sulfonylureas such as glyburide, talk with your doctor before using Jardiance. Taking Jardiance with these drugs could raise your risk for hypoglycemia” https://www.healthline.com/health/drugs/jardiance-side-effects#warnings
That’s been my mantra so far and it seems to work pretty well. Case in point, I had no idea a whole ripe banana would spike me off the chart like it did until I saw it firsthand. Doing that trial and error provided me with a starting set of foods that I could feel pretty good about eating while culling out some stuff that obviously wasn’t working.
I have tried to use the glycemic index data as well, still working that part out really.
This was a separate lab and not a Dr’s office unit/setup. As far as certification goes, not sure about that. I am having to mostly rely on his judgement as I am assuming he has my best interests in mind. I think he does because he has helped me tremendously in the past. That doesn’t mean I wouldn’t ask the question however, it hadn’t occurred to me to ask. Thanks for that!
