Hi, what was your A1C when diagnosed if you don’t mind me asking? Were you immediately started on insulin and if so are you still on it or were you able to discontinue it? Thanks
The person who you directed your question to has not been active here for the last several years. Some people with T2D are able to discontinue insulin by following a low carb way of eating and some need to stay on insulin long-term. Each case is unique.
Perhaps you could share a little more about your situation so that we understand better what your concerns are.
Welcome to TuD!
I use to practice in Endocrinology. Currently in GI. However for an A1c of 11% I would typically do 2000 mg of Metformin, a SLGT2 like Jardiance and a GLP1 like Trulicity. It is important you learn how to eat well. The key is VEGETABLES! I have literally seen a patient come down from a A1c of 11% to 6.5% (still mild diabetes) by eating 5-6 cups of veggies per day. Balanced meals are important! Half you plate should be veggies (potatoes and corn are starches and count as carbs) 1/4 should be carb (fruit, beans, pasta, bread etc) and 1/4 should be a lean meat. Also you should find something to do for physical activity 30 min 4 times a week (swimming, biking, zumba etc). You should check your sugars twice a day and take your logs back to your doctor. Seeing an Endocrinologist is best for specialized care as they are the only ones who can prescribe the CGM (continuous glucose monitors). Do not drink your sugars (stop ALL soda and fruit juice). Waiting 90 days to see what will happen will not be detrimental but you should have close supervision. Your A1c is a reflection of your blood sugars over 90 days and not what your blood sugar is the moment they poke you. This is because a red blood cell lives about 90 days, so the A1c is a percentile of what your sugars were running. You can always eat the day of your labs unless they are checking your cholesterol, then you should be fasting. I recommend you get your eyes checked yearly.
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I use to practice in Endocrinology. Currently in GI. However for an A1c of 11% I would typically do 2000 mg of Metformin, a SLGT2 like Jardiance and a GLP1 like Trulicity. It is important you learn how to eat well. The key is VEGETABLES! I have literally seen a patient come down from a A1c of 11% to 6.5% (still mild diabetes) by eating 5-6 cups of veggies per day. Balanced meals are important! Half you plate should be veggies (potatoes and corn are starches and count as carbs) 1/4 should be carb (fruit, beans, pasta, bread etc) and 1/4 should be a lean meat. Also you should find something to do for physical activity 30 min 4 times a week (swimming, biking, zumba etc). You should check your sugars twice a day and take your logs back to your doctor. Seeing an Endocrinologist is best for specialized care as they are the only ones who can prescribe the CGM (continuous glucose monitors). Do not drink your sugars (stop ALL soda and fruit juice). Waiting 90 days to see what will happen will not be detrimental but you should have close supervision. Your A1c is a reflection of your blood sugars over 90 days and not what your blood sugar is the moment they poke you. This is because a red blood cell lives about 90 days, so the A1c is a percentile of what your sugars were running. You can always eat the day of your labs unless they are checking your cholesterol, then you should be fasting. I recommend you get your eyes checked yearly. Hope this helps
A1C is useless for managing diabetes. It’s fine for an 1950’s initial diagnosis of “diabetes”, but not which type or stage. It doesn’t tell you when or why you are high.
You need an endocrinologist and should have a fasting blood glucose test with a c-peptide test to start, A PCP trained years ago didn’t learn to do the differential diagnosis. Metformin is not a golden bullet.
Ask an endo to “install” a professional CGM for 10 days and start keeping a detailed log of what you eat, when you sleep and what you do hour by hour along with fingerstick tests before each meal and 2 hours after .
In 10 days you’ll have enough information to see when you are highest and decide to change what you can to get your BG peaks down and keep your lows at night at a safe level. .
If you drop those peaks and everything else will drop. Then the endo can see which and if more meds are needed.