Discouraged
 

My A1C was 8.2 when I got the call from my doctor that I had diabetes. I was scheduled for a physical in five weeks, so she told me we would talk then and in the meantime to make the diet and exercise lifestyle changes. Saw her the other day and I proudly told her in that time period, I had had no sugar, no potatoes (except for one stinkin' tater tot on Mother's Day), no pasta, and maybe three hamburger buns. I had also been exercising. Next day found out my A1C was 8.5. Now she wants me to go on Metformin and I really don't want to do that. I test every day and the highest it has run is 20 points over. Is that a lot? I have heard that Metformin can cause diarrhea. Is that true? And what do you all think? Should I give in or tell the doctor I want more time?

Not taking it scares me as I have relatives with diabetes and I have seen what it has done to them.

Being really new to all this, I am finding out I am just scratching the surface on knowledge.

My understadning is that A1c is indicator for average BG over some time like 3 months. I'd continue to avoid GPS (Grains, Potatoes and Sugar) as well as follow your physicians advise. Let them know you are going to try low carb as that may affect the amount of meds you'll need. We're not doctors here, at least I am not - so take heed. You're doctor was right in suggesting diet and lifestyle changes - but that depends on what those were. Can you explain what she said to change?

Good Morning, there is no need to be discouraged.
First, the HbA1c measure is of blood glucose over the past three months.[edit: as Thud answered] Although it may show decreases sooner, the doctor should have waited three months to re-measure it. By its very design, a decrease would have been unlikely in only five weeks. And up or down a few points can be normal lab variations.

When do you "test everyday"? and 20 points over what? 100? To get good information about the foods you are eating, suggest doing pre and post-meal BG tests. You go through a lot of strips but they can be purchased cheaply on-line.

Find the previous two threads you started. This one and the one in Intro. https://forum.lowcarber.org/showthread.php?t=482459 I had many questions about the food you are eating...do you cook or do you eat in a central dining room? If so, you need to ask about the foods purchased and how prepared. If you have been eating scrambled eggs...are they made from processed dried eggs to which starch has been added as a thickener? you may find the hamburgers are low fat with additives, or sugar is added to cooked vegetables, any number of surprises with institutional food. Basically you need to see the labels on purchased foods, check recipes, and count the total carbs of foods you choose to eat. Call me suspicious, but your diabetes diagnosis a few years after moving to independent living may not be a coincidence.

There are a number of previous threads on Metformin in the diabetes sub-forum, and GI distress can be one side effect. If you are not on any medications at this point, I would suggest trying very low carb (20g total carbs) first and giving diet and lifestyle enough time to see if your BG can come down further. Example, check all your carbs for a few days to see what you are eating now, but there would be no rom for a "few hamburger buns"
https://forum.lowcarber.org/showthread.php?t=439544

Hang in there and follow the above excellent advice. You can do this.

:)

Jey100 and Thud123, you make good points about the three month period between checks. That had gone through my mind also. As far as the foods in the dining room go, I only get ten meals a month and most of the time don't take advantage of that many. I usually cook for myself or go out. And when I go out, I usually order very plainly - a steak and a salad with dressing (mostly blue cheese on the side so I only do a fork dip). The menu in the dining room always has two health choices with nutritional information, including carb count, so I get one of those and a veggie. One thing I don't think I mentioned is that I have sleep apnea with severe sleep deprivation, even with the CPAP machine, and I do know that can bring on diabetes. I am a mess! The Metformin will be delivered today but I think I will hold off and give it more time. When I test my blood, I compare that number to information I was given regarding ranges for fasting, before and after meals. I am always within 20 points of the high range. And many times within the guidelines. I will start testing more than once a day. Thanks for your help

If you have that control over your food, it should be easier to keep carb counts very low. DietDoctor has some good ideas for no cook meals, simple preparation: https://www.dietdoctor.com/low-carb...pes/meals/quick

The ADA ranges for BG are too high. Understanding that it will take a diabetic a while to reduce their levels, Dr. William Davis has guidelines to first get to "no change" after meals.
https://www.wheatbellyblog.com/2015...no-change-rule/ Ultimately keeping BG under 100 is a good long term goal.

Sleep apnea can often be corrected, even if not at goal weight, by reducing inflammation around the airways. Here are some successs stories, the first, Christine's is inspiring. https://www.dietdoctor.com/?s=sleep%20apnea&st=any

Not everyone gets diarrhea from Metformin. I didn't. (There's also time released that may be helpful for those who do get temporary diarrhea.) I also found it to be an effective appetite suppressant when I first started taking it. (This effect wears off.)

I hate to be the bearer of bad news...but an 8.3 is an indication of diabetes. NOT pre-diabetes.
Metformin did NOT have that effect on me, but everyone is different.

I know how hard it is to break those old calorie-counting, low-fat habits, but that "fork dip" is definitely an easy one to break. You want all the fat you can get on your salad, especially right now as you transition from high carb!

Do you have a plan for the sleep apnea? You are not that heavy although I have know people who develop problems at pretty low weights. I wish you a lot of luck.

I never was diagnosed as pre-diabetic. My doctor was very surprised at the blood test results. And I have had sleep apnea for many years, starting when I was at a normal weight. I use the CPAP every night and it indicates good results as far as incidences per hour go, but I'm still not sleeping more than five hours a night. I am under the care of a sleep doctor. I know the sleep deprivation, weight gain, and diabetes are all tied together to a certain extent. Don't know where one starts and the other ends.

Yeah, that sounds really rough. I hope you can get it under control. Can't you go on Metformin and go off of it once you have things under control?

Even though I've lost my extra fat, my apneas continue, and I'm concentrating lots of effort into learning what I can do for myself and when I'll need to fold the doctors into the recipe. (Due to Medicare, my condition has been ignored.)

My diagnosis is 5 years old and I knew I would never use a machine.

Currently I'm using a wrist SpO2 monitor which tells me my O2 saturation 4 hours per night, in addition to my sleep stages.

Janet, is there an old thread on the Forum on Sleep Apneas?

one from 2011: https://forum.lowcarber.org/showthread.php?t=432363

A recent interview with Dr. Matthew Walker: https://forum.lowcarber.org/showthread.php?t=482087

A related one you commented on in 2016: https://forum.lowcarber.org/showthread.php?t=475452

When people list their NSV (Non Scale Victories) improved sleep apnea and snoring are often mentioned, and sometimes before reaching a heathy BMI. Sometimes just a few weeks of reduced inflammation can help.

Phyllis, have you tried Melatonin? I have problems waking in the night and not easily falling back to sleep. Read that larger doses of 3 or 5mg. do not necessarily work better. So for a few years I took the 500 mcg (or 1/2 mg) chewable from Trader Joe's when I woke up. Then read about Time-Realease or Sleep Cycle versions of Melatonin, NOW and Natrol sell it. I use the 1mg dose (there are 3 mg versions too) but about 1/2 is released when taken, the rest time-released. Feel better about taking it than a Benedryl ;)

Thanks, Janet. I'll have a look.