Hello I was hoping that I could get some help to deal my high blood sugars. I’m extremely frustrated and have done some reading both on this site and others but often find that the discussion moves towards how much insulin should be taken and when. I am a type 2 and I take 1250 mg of Metformin per day (500 with breakfast and 750 before bed) I am not on insulin and my doctor is very opposed to prescribing it for me and also wants to slowly increase my Metformin (I started with 500 mg per day for a month, then 1000 mg for a 2nd month, 1250 for the 3rd month and stayed at 1250 this past month but started taking 750 at bedtime instead of with dinner). She is in favour of intermittent fasting (diabetes educator and exercise therapist are not) using low carb, moderate fat and protein). I have been exercising (rowing machine, walking and weights), I’m struggling to make sure that I drink lots of water and I have really struggled recently to not drink Coke, Gingerale & root beer. I feel like if I could get my morning fasting blood sugar to below 7.5 (I know it is still too high) then I might have a hope at having lower sugars throughout the day. Would something like a 24 hour water only fast help to bring my initial reading down?
Today I woke up with 10.5
I had chia seed pudding (thank you Terry for the recipe) which normally produces a good number but even after a walk and some weights my 2 hour reading was 10.3
I’m so frustrated it is starting to make me quit testing!
Your advice on things that I can do, eat, not eat would be greatly appreciated. I will be having my A1C done towards the end of the month and will go over results with my doctor.
I wish you luck, it seems like you are doing the right things and understand what the challenges are.
Eliminating sodas seems like a really good place to start. And, while my experience is different from yours and I don’t know the history that leads your Dr to oppose insulin, I will suggest this as something to think about: For reducing & stabilizing blood sugar levels, insulin is particularly well-suited to the task, and remarkably efficient.
I think your doctor is not being fair to you, in that she will not prescribe you insulin / meds to get a proper control of your blood sugar.
It sounds like you are doing what you can and should (low carb, fasting, should all help), but it may not be enough, if your pancreas is not working properly. The low carb and fasting and exercise, will all help with reducing insulin resistance. If metformin is not helping enough then insulin is surely the next rational step.
Have you been tested for type 1 diabetes? Maybe you need antibody and c-peptide tested.
This is your skin in the game. High blood sugars cause damage. If your doctor will not allow / help you to treat your condition properly then I think a new doctor should be considered.
after I was dx 3 months ago gave up real soft drinks that day. thought they caused my dx used to avg. about
3 or 4 cans a day the amount of sugar in those cans is way to much. after 3 months forgot what they taste like
wish you well this dx is very though did not know what diabetics were going through until I became one.
I recommend removing the soda pop from regular consumption. (If you so love it, allow yourself a half can once a week.) Try other (no sugar) drinks that you may learn to enjoy: flavored seltzer water, different types of iced tea, etc.
Are you regularly eating any other simple carbs: white rice, white bread, potatoes, pasta? If so, work on eliminating them.
For me as a T2, with careful attention to diet & exercise + Metformin, for 4 years I was able to achieve an A1C under 6.0. But numbers began to rise–now I take a low dose of insulin.
I have always taken my metformin with supper,says take with food. This is how it works. You could add secondary oral medication before insulin , might be another option.Do you exercise? I understand it can be difficult. But trying different options you may discover something. Good luck. Nancy
Type 1s (especially those who are diagnosed later) often go through a phase called “the honeymoon.”
During my honeymoon, I was put on long-acting (basal) insulin. About 18 months in, my A1C skyrocketed from 6s to 8s to 10ish. When that happened, he tested me for auto-antibodies I we figured out I was Type 1. (And I stated using fast-acting insulin).
But every step of the way, my doctor responded to what was happening to ME. Adjusting my treatment in response to what my diabetes was doing.
If you can’t control your BG with oral meds alone, insulin is the best answer. Needing insulin doesn’t say anything about how good or bad you’ve treated your D. You just need insulin.
Oral meds can only block glucose release or flog your pancreas to produce more insulin. If the horse is dead, no flogging in the world will make it go faster.
Ask your doctor if she knows who Dr. Ralph DeFronzo from the University of Texas Health Science Center is. Dr. DeFronzo was one of the biggest promoters of metformin in the U.S.and helped get it approved by the FDA over 20 years ago. Dr. DeFronzo and others thought at the time it was going to be a huge help in treating T2 diabetes.
At the BeyondA1c forum held last month Dr. DeFronzo was quoted as saying the following - "The most waste in type 2 diabetes is to continuously put people on metformin and sulfonylureas (glyburide, glimepiride, etc.). These drugs have no protective effect on the beta cell, and by the time you figure out what you’re doing, there are no beta cells left to save.” More on the forum is here https://diatribe.org/the-diatribe-foundation-and-tcoyd-11th-annual-forum
Why did Dr. DeFronzo change his mind you may ask? Well in practice he knew it was nothing more than the first step in prescribing more T2 meds and then even more. At the end of the ADA step program is insulin. He is also conducting a six year study in Qatar and found metformin was not only not helping it was causing other issues so they dropped it from the follow-on study.
Here is the deal. The biggest issue a T2 has is controlling meal time sugar spikes. In a non-diabetic meal time BG usually stays under 130. I can only guess what you may be spiking to 300? At 140 after a little while you are incurring microvascular damage. The bottom line is metformin will do nothing, let me repeat NOTHING to control your meal time spikes which you really do not want to spike to 150.
If you like your doctor you can keep your doctor but if your doctor is allowing you to be in this condition with the tools which are now available you may want to find another doctor.
Disclosure – I have T1D, not T2D but have done a lot of research to help family/friends.
Outside of the normal, talk to your doctor about supplementing with Alpha Lipoic Acid (ALA) – bioactive version (no conversion by body is commonly named R-Lipoic Acid – both work but the bioactive version works much faster). It works in 2 ways. 1) It will actually lower your blood glucose and help deliver glucose to cells and 2) it’ll also prevent glucose from glycating your hemoglobin thus “falsifying” your HBA1C test results. #2 has additional (long-term) benefit since glycated hemoglobin is believed to what causes organ damage. Usually recommended taking with your biggest meal of the day.
Another thing to talk to your doctor about that I found my doctor was aware and he was shocked when i mentioned it but it’s hard to find online – Make sure you’re eating foods with copper to get your ~900mcg/1mg average daily intake. There are some foods with higher than 10MG but 10MG+ is considered to be toxic but, albeit it’s another necessary mineral that people are getting less of due to watered bottle, water filters, etc. Zinc, in meats red meats, will work to remove it from your body. It has the potential to drop blood glucose very quickly. Best source is beef liver (yeah, we’re ALL deficient with it being the best source).
It’s always been my understanding that the only reason the glycation rate of hemoglobin was of interest to clinicians is that, with a known lifespan, one could derive the average blood glucose exposure over about a three month period.
But I’ve heard your take on things before. I’m not certain of the answer to this question but I do think that science and research knows the answer now.
But in reading and contemplating, what you asked are both one in the same, neither exclusive or explicit but two different ways of saying the exact same thing. It’s like asking what came first, the chicken or the egg?
To your understanding, the HBA1C test, in diabetics, is also inaccurate due to the ~90 lifespan is based on healthy individuals and it’s been proven that the lifespan of hemoglobin in diabetics is shorter than the 90 days which is used on the HBA1C average. There’s nothing better, yet, so it’s not discussed.
I think it’s possible my red blood cells live longer than the assumed life built in to the A1c test. My A1c is usually 0.5-1% higher than my average BG indicates as measured by my fingerstick meter and CGM.
These needs to be moved to another discussion, not wanting to divert from Fernsk original question. But I’d be interested to know how you think your hemoglobin lives longer than a non-diabetics, presuming you have T1D or T2D.