I have recently lost weight (80 lbs) and would like to ask for a review of my medications – possibly reduce dosage or eliminate.
Reasons:
My A1C has been consistently low (5.3 last time) over last 6 months and my daily BS has been 80-100 consistently. I would love to decrease my metformin from 1000 x2 a day to maybe 500 x2 a day.
My blood pressure has been as low as 90/62 in the different doctor visits. I think the dosage needs to go down. I would love to decrease my lisinopril to once a day not twice.
Under what circumstances should you adjust meds? Should I have more reasons? Should I wait longer to make a request (not long enough of an improvement?) I think meds are based on weight to a certain extent and the weight loss is enough at this point to start adjusting? Are there other issues I should consider?
Thank you for your opinions.
You didn’t even list the meds that you are taking, other than met and lisinopril, or is it just those two? Regarding the met, I would think you should be discussing the dosage now, but I’m no T2. When in doubt, put in a call to your doctor!
I don’t like that BP. I don’t like how similar the top number and bottom number are. You getting light headed? Ask them if they feel like they should check an orthostatic BP.
Diabetes to a large extent is a DIY journey so I firmly believe in It’s easier to ask forgiveness than to get permission. A few years back, as an example, I was on lisinopril as well and had made adjustments to my lifestyle so I purchased a blood pressure meter that had a cloud based app and took baseline readings. I then cut my lisinopril pills in 1/2 for a month and measured my BP daily or even more often. My numbers were better than my last recorded doctor’s visit, so I then cut the pills out totally and continued to monitor and was still below my last doctor’s visit.
I printed out all the records and brought them to my next visit with my endo , ready for a fight but the lab results were in line with my home testing so she agreed that my lisinopril prescription would not be renewed.
With similar testing and lifestyle adjustments, I was able to cut my basal Lantus insulin out completely and reduce my Humalog consumption by over 70%.
My last really proactive project is to reduce my LDL cholesterol so that I can reduce my statin dose. My lipid profile analyzer is on order as well as test strips, pipettes, etc and I plan to test cholesterol once a week and adjust saturated fat intake as low as possible and still have a life to hopefully lead to lower dose or even elimination of statin all together.
Is it time to employ your super-power?
As a T1D, I long ago gave up having my endo in control of my insulin dosage decisions, but I did talk with her about it first.
At some level though, I think the “Trust, but Verify” approach should work for you. After all, we spend a massive amount of time dealing with D, and a relatively miniscule amount with our HCPs.
If you have a pill cutter, you could do 750 mg metformin dosing and see what happens.
GOOD NEWS!! After a lovely chat with the nurse practitioner my blood work said ROCK STAR – A1C 4.8, cholesterol awesome across the board and BP 118/76, lost another 20 pounds, I get to stop my Jardiance and next time we are reducing others (one at a time to be sure) and she is proud of me. Next time we are reducing metformin steady Eddie Bydurian stays for now. We are also deciding on blood pressure meds but she wants to conference with my GP first (we are a team so I agreed) When I see the GP next month, she will have an answer on cutting my Lisinopril to once a day.
Moral of the Story: I was proactive and decided to make changes for myself - things that I can control - in my diet - something I can control is important. I did not eat lots of little meals for my gastroparesis – it just keeps your insulin flowing which is bad – and ate twice a day so I could let my stomach have the time it needs to digest (I tested at 20% digestion rate). I am basically KETO and lost weight and that totally is turning my BS story into a success. My liver doesn’t miss its best friend the gallbladder and is doing very well without it. Cutting out the fructose really helped my liver.
ALL GOOD! I am having a great day.
We are in control of some things, cooperate with the doctor on others, and some of it is in God’s hands. Keep asking the right questions, research what you don’t understand, find what works for YOU.
Have a blessed day!
Awesome news Marcia - congratulations on your success and your decision to take care of your own health
Brilliant numbers - Happy 2020!
Congratulations @Marcia_Skidmore! What a great report to have and to share! You’re such an inspiration! 
Congrats on all your good health news, but more importantly on your take-charge attitude about your health. You must feel like a new person!