I’m type 2, diagnosed 4 years ago. I am now on 3-4 X 500 Metformin a day and occasional Starlix. I can keep my numbers under pretty fair control.(4.4-6.2) I’m only supposed to test twice a week. and I’m pretty much free of complications. I’m never ill, not even a cold. Am I just lucky,or have I hit on the right things to do for myself? I eat low-carb and walk. and do water exercises. Over the 4 years, I’ve learned what I can from Dr. Bernstein, David Mendosa and now Gary Taubes. I’m now coming to think that having a positive mindset and refusing to accept Diabetes as an “illness”.(It’s a condition to be managed. ) is part of my contentment. I refuse to allow my metabolism to spoil my life. I’ve read stuff from some of you other folks that shows that you too are doing well mentally, although textbooks say that depression is common in diabetes. I also refuse to allow my unhelpful metabolism to be a “progressive” condition. I told my doctor as much. Dr. Bernstein says it needn’t progress and I’m believing him.
It isn’t luck.
Post prandial blood sugars are what cause complications and there is every reason to believe that eliminating high post-meal blood sugars will eliminate them.
Sadly, every study of “tight control” including ACCORD and ADVANCE, the most recent, define “tight control” so that it still means having blood sugars rising near or over 200 mg/dl (11 mmol/L) at every meal.
Few of us reading this will probably live long enough to see large ten year studies of people who keep post meal spikes under 140 mg/dl.
I would have a fit if I got up to 11! It could only happen if i made a huge blunder.
Incidentally I’m very proud that I’ve managed to get my point of view on tight control onto the next meeting’s agenda of the Primary Care Trust… I wrote them a very carefully constructed letter saying that setting targets too high,restricting test strips and advising a 60% calorie intake from carbohydrates is a recipe for complications anda short term view that will remain short term if no-one lives long. I included the bit about a newly diagnosed 10 year old that i met, who has been adviwsed to eat a cracker every afternoon, even though his numbers are still in double figures. Now let’s hope someone’s listening. For me low-carb is the only way to go. anything that would allow me to eat more than a few carb grams per meal, boosts my insulin and puts on weight. Having seen a recent photo of David mendosa, I think Byetta is the way to go. do you read david’s stuff?
I do think having a positive outlook helps tremendously, although it can be harder to maintain at some times than at others. Right now, I think the season is wearing on me more than a bit, and I’m having to fight to achieve that good cheer I find easier to maintain at other times.
I do a low carb diet, as well, and my post meal BG levels rarely even get to 130. But I’m actually wondering if I need to start on Metformin, as my fasting levels are getting higher and higher. When I was initially diagnosed last May, I normally would see a FBG of less than 100 if I ate lowcarb. Now, I am always over 100, and often in the teens. (This morning, for example, it was at 117.) I’m due for another A1C next week, but my last one was 5.8, and I had hopes this new one would be even lower, but now with these higher FBG numbers, I’m not so sure… This actually contributes to the difficulty in maintaining that positive outlook. I’m feeling a bit stressed and blue about these stupid numbers.
I’m doiing very well with Metformin. Even 4 years ago, when I started on it, it didn’t upset my digestion much and I adapted quickly. since it works on Insulin resistance, I regard it as a legitimate treatment. I don’t like they things that promote more insulin, because I can’t control my weight on them.
Your numbers don’t look bad to me, even if i have to divide by 18 to understand them, but I can understand your wanting to tihten up even more. 130 after a meal isn’t at all bad with no medication. HbA1c 5.8 is brilliant. If you look it up in the Bernstein book, you can see what your current numbers might give in your next HbA1c. My last was disappointing at 6.2% I was hoping or under 6. Probably I was going higher when I didn’t measure.
Your numbers sound a lot like mine. when I controlled with a very low carb diet for about 6 years, but my fasting started to creep up, probably because I never could get the fasting below 100 mg/dl at the best of times.
When my A1c was 5.7% on the very low carb diet, my doctor first added Metformin. It prevented weight gain, which had started to be a problem, but had little effect on my fasting blood sugar though it helped with after meal values. My next couple A1cs were all 5.7% too and eventually when it rose to 6% (with meals still under 140 mg/dl at one hour) I started in on insulin because my fasting bg was over 115 and I know from reading epidemiological studies that the fasting blood sugar doesn’t rise in a gradual fashion. When it hits a certain level it will skyrocket and then it is very hard to control blood sugars.
I turned out to be insulin sensitive not insulin resistant, but after a long and complicated process I won’t bore you with, my current regimen is one small shot of Lantus at night, Metformin morning and night (I am finding that splitting the dose is much kinder to my stomach) and insulin with any meal over 8 grams of carbs. I eat several low carb meals a day,and am trying to keep my insulin use down because I’d like to lose a couple more pounds. (I put on almost 10 lbs last year thanks to going OFF metformin.).
My fasting bgs are in the low 90s on this regimen. I can’t do better than that because I have an unusual problem with counterregulatory hormones that kicks my blood sugar back up everytime it drops lower than that. I’ve been battling that for 2 years! But 92 is a lot better than 120 which is what I was seeing recently after a month of very low carb (22 g a day) and no insulin, which I tried experimentally to see exactly what was now going on with my body.
Because I’m so insulin sensitive, I’m only using 1.5 units of Lantus. (Yes, that is weird, but it is enough to drop me from 120 to 92!) Normal people would be more likely to need ten or twenty times that.
Thanks for the replies to my reply. Sorry it took me a while to respond – my internet access decreases over the weekend when my husband is home, since I’m currently using his computer after mine bit the dust.
I’ve been waffling a bit on the Metformin, but after doing some more reading, and your helpful comments, I think I’ll give it a try. It may not help with the FBG levels, but if it helps with insulin resistance, and might help with this slight weight gain I’m experiencing, I’m all for it.
I know my BG levels aren’t all that bad, so I shouldn’t be as upset about them as I am. I think it was more the fact that the move upward has been so recent and so inexplicable to me. Nothing in my diet has changed, so I couldn’t see why the numbers were getting worse. However. I just read last night in Taubes’s book that insulin levels do appear to increases in winter, and then drop back down in late spring and summer, so that may be a big part of what is going on.
Anyway, I didn’t mean to take over the thread like this. Thanks for the feedback, though! I appreciate it greatly.
I know exactly how you feel. When I have gained weight because I was eating a ton of food, it was annoying, but I knew it could be corrected. When I have started packing on weight eating exactly what I always eat, it is terrifying.
I’m back on metformin now and I’m much less hungry and my insulin is working very well again. My weight is down to the lowest I got to when I was eating extremely low carb without insulin but I am enjoying my daily piece of peanut butter toast, so I’m happy. I think I should be losing the rest of the weight I need to lose to get back to my normal weight–4 more pounds–very slowly. But the important thing is that I don’t feel deprived or like I’m dieting since I’m not hungry.
I find with the metformin right now that I do much better if I split it and take 750 in the morning and 750 before bed.
My fasting bg is fluctuating a lot, but that is because I am so ridiculously prone to counterregulatory attacks. If I get one, I wake up with pounding pulse and a bg of 108. After several days of that happening I cut my Lantus down by 1/4 of a unit and today I woke up at 79. Wow. One quarter of a unit???