Off Meformin!

Since my hospital appointment a few weeks ago, where I was told to come off my low carb diet in no uncertain terms (the doc called me “crazy”), I have taken things into my own hands. I was afraid that after the hospital sort of refused to treat me, my GP would do likewise (I haven’t talked to her about my diet yet) so I looked up a private GP, paid a good amount of money and was treated very well for it :-). Although he doesn’t seem convinced that what I’m doing is healthy, he will let me do it (and support me when there is trouble) until we get blood tests in three months’ time which will prove which way I’m going with the 75% fat, 10% carb, 15% protein diet that makes everybody here in Italy freak out when I tell them about it.

When I asked the private doc if I could come off Metformin since I was still having hypos (low 50s) in the afternoon, he said yes and that’s what I did. Wow, I could hear my liver take a deep deep breath over the next few days, as it was finally allowed to store glucose again (I’m sure I put on water weight, too) and give it off in small doses as it’s supposed to do. It took five full days for the afternoon hypos to stop and I couldn’t believe how much energy I suddenly had when they did. Everything seems to normalise in my body: the fasting glucose has been in the 80s and not 70s, post-prandial figures have been higher than before (110s) after breakfast, as they are supposed to be when you add a few carbs. Maybe insulin resistance has increased a little bit (since Metformin is supposed to lower that), meaning that I should finally start doing some exercise - I had just been too afraid of hypos to do it so far.

Of course it won’t last… or maybe it will? According to Dr Bernstein, theoretically a honeymoon period of a Type 1 diabetic can go on forever. But let’s not hope for it, let’s work at it - I think I’ll aim for bloodsugars between 85 and 95 mg/dl and see if I can achieve that consistently on a low carb diet. I have just bought Jenny Ruhl’s book, after reading the whole website - the book IS much better structured and easier to read indeed. I am reading Dr Bernstein’s book for the third time, always discovering completely new things on pages that I have supposedly already read two times. And last but not least, sort of for fun, I have bought “Atkins for Life”, so that I get some background information about what I’m doing with this low carbing - and also get some vocabulary to explain it better to the people around me.

There are still a lot of issues to face - for example, I will have to talk to my normal GP about my diet. A friend has given me a helpful metaphor: if someone with lung cancer keeps smoking, the doc will still have to treat him. So even if my GP thinks I am killing myself with the low carb diet (which I am pretty sure she will, like they did at the hospital), she would still have to help me when I’m sick. That’s a relief.

Another thing is that I am considering how to keep the balance of being off metformin and not having hypos, and at the same time having higher glucose levels, leading to higher insulin needs. That in turn may mean that more of my beta-cells are being killed through the auto-immune attack than necessary, since every time one of the cells “rears its head” (that’s how I imagine it) to secrete insulin granules, it faces an attack from the angry (misguided) immune system… I don’t think I’m anywhere near levels where glucose toxicity will kill beta-cells but the need for more insulin from overworked cells that are under attack worries me.

Let me go back to my books, I’m sure I can find some answers there.

Why do you have to talk to you GP about your diet? Why do you have to convince him? Why don’t you just go your visit, don’t bring up diet. If the GP asks about your diet, just be non-specific. You are watching what you eat, trying to limit quantities, but you have trouble counting everything and can’t really report any specifics. Listen to his mouth move as he tells you to eat low fat high carb. Move your head up and down. Say “ok” and “I’ll try to do better.”

Then just leave and follow your diet anyway.

Hey Uta, Glad you are getting some good numbers. I wish mine were better after my 2 hours. Even low carb gets me going up at times.

I go to a dietician because she is connected with my clinic and hospital She is always yelling at me about the low carb and hates it. She wants me to eat the ADA diet. I told her that I would burn up my beta cells for sure doing that. I dont listen to her and ignore her. My doctor just says he is happy with my lipid profiles and blood pressure and couldn’t be happier. I think he is reading Dr B’s book now too.

I am slowly drifting over to Atkins diet and like some of the things in that diet. Metformin leaves me with little appetite at times and that is a problem for me at times.

Your doing great, thanks for the post!

I’m with bsc. I don’t know why you need to discuss your diet with your GP. A doctor may have to treat a smoker with lung cancer, but it still means the patient will get lectured about smoking. I refused to receive ill-informed low carb lectures from people who are pushing potatoes.

I grew so weary of the head-shaking & arguing with my first doctors about low carb, that I stopped discussing it. Dieticians–forget it completely. I’m not withholding info about meds, doses, readings that they need to know to help me. I’m doing far better low carb & let them argue with success. I feel better, too!

Great Job Uta! You are taking the responsibility upon yourself for the treatment of your disease, as we all should strive to do. No one can possibly care more about your health than you. Taking your life into your own hands does not have to mean you are throwing it away. Be proud of your accomplishment, with continued success you will become more confident in the choices you make. With time, let your Dr’s. know how you are getting your great results, and don’t expect them to agree, and don’t feel bad when they don’t. You don’t need to feel like you have to convince them, and I wouldn’t try. But if we all began to “educate” these all knowing health care experts, maybe we could change part of this culture. Every great forest started with a few seeds.

…I’m expecting my next A1c in 30 days to be less than 6 (if my meter has any accuracy to it) by caring more than others about my own health. This would not be possible if I were following ADA guidelines. My dietician and D educator have stoped answering any of my e-mails to them. I have never argued with them only explained my reasons for doing what I’m doing. I do not want to go to my follow up with them, except for the fact it is in a group setting and we will be anouncing our 3 mo. numbers. Maybe someone there will ask me how I’m doing it and might become an opportunity help someone else. When diagnosed in Dec. 09 my fasting number was 383 and post meal was something like 540, I’ve now been 85-90 fasting 110-120 post. Can’t wait!

Thanks for the update!

…Got me thinking and had another thought. In regards to following Dr’s. advice. It seams to me that the medical community may have a higher tolerance for people, who in their view has a “weakness” or addiction, eg. overindulging in carbohydrates/sugar, smoking, etc… I wonder if patients in these situations are treated in the same way as those of us not following Dr’s. orders for other reasons. Not sure, but got me thinking as related to the smoking question. If true, what does that say about us and what should that tell us about our Dr’s. And, no I’m not eluding to a conspiracy (lol), It just struck me as being interesting. …Maybe weaknesses are easier to have sympathy for and to forgive, serving the Dr’s. purpose, to treat and help. In contrast, a person’s free will choice to be in charge of their own disease may be heard as an act of offensive defiance against a Dr’s. years of study, practice and sacrifice. If possible, it tells a lot.

Sorry Uta if I’ve hi-jacked your blog. I wanted to add the modern version of the hyppocratic oath that Dr’s. take when entering practice.

The Hippocratic Oath (Modern Version)“The Hippocratic Oath: Modern Version”. Doctors’ Diaries. NOVA. Retrieved 2010-02-08.

I swear to fulfill, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.

I will not be ashamed to say “I know not,” nor will I fail to call in my colleagues when the skills of another are needed for a patient’s recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.