A Kick In The Teeth
 

So, I got my blood test results back this morning, and despite eating much healthier and stabilizing my weight this year, cutting out all junk these past 2 months and doing everything right diet-wise the past 6 weeks to the point where I have lost over 14lbs, my HbA1c level has gone UP from last year to 54mmol/mol (7.1).

Last year my diet and weight were out of control due to meds and Depression fuelled overeating. Now, I expected a marked improvement in my figures.

Does this increase signal a worsening of my Diabetes, and could this be the trigger for the needle sharp neurological pains I've been suffering in my feet, legs and hands since the start of the year?

Dave.

Hi Dave,

Hate to say it, but diabetes IS a progressive disease and some times, no matter how hard and diligent our efforts to do all the right things to control our blood sugar levels, they can and do go up despite our efforts. Many different reasons for this occurrence.

In the USA, the American Diabetes Association sets 7.0 as the "magic" HbA1C level to stay below so you are just a tick above it.

Do not get discouraged. Congrats on your work toward controlling your levels. Keep up the good work on it but you may need to have your meds adjusted to help you.

Does England have the same guidelines as the Am Diabetes Assoc (ADA) ?

Are you on any meds for your diabetes or just controlling it through diet and exercise?

Sometimes your body needs more "help" than whatever your current plan. Adding or increasing meds combined with your efforts will get your numbers down and may alleviate the peripheral neuropathy you are experiencing that may be diabetes related.

After 7 years with only small changes in my plan and meds, my diabetes went out of control the following year for no apparent reason other than the progression of the disease. We changed my medication regiment and I am hoping my numbers will improve on the new plan.

Let me know if I can be of any help to you as you fight to lower your numbers. We are in the same boat and I know the struggle.

Yes, it really does feel like a slap in the face or as you stated a kick in the teeth when we try so hard, and the results go in the wrong direction.

Take time to congratulate yourself on the weight loss and progress you have made. Just think what your number might have been if you hadn't done so much to improve. You may have been at a 9.1 instead of a 7.1 A1C. Your efforts have NOT been in vain. Don't give up. Your efforts will be rewarded with fewer complications.

Hi Hopeless,

The UK has 7.0 as the same 'magic number', and I have been bouncing along a little below with pre-diabetes for Donkeys Years, dxed May 8 '13 by Glucose Tolerance Test (remember the date cos 2 hours later I had cancer dx), then somehow managing to keep levels ok by diet alone. I cannot exercise at all - and it adds to the Depression - I have so much neuropathic pain, hypersensitivity (extreme allodynia), neck and spinal injuries and worse of all a heart that becomes Brady Hypotensive when put under any stress. Yep, I'm a mess!

I have been summonsed to my GPs next Thursday to discuss options, I assume this will include meds and daily blood tests. For the first time I AM feeling positive about a Diabetes appt because I am being pro-active in my diet and weight loss goals. This is a struggle that is being made easier by the support I get on the Weight Loss Forum.

Regarding the onset of these new pains, I am desperately searching for a cause other than further complications and deterioration from my ongoing issues. I would rather be able to name and blame high blood sugar as a cause - at least I have possible control over that.

I am sorry to hear your condition has started progressing again. You seem to have it somewhat in hand, and I hope that the meds change brings the desired results.

You are right, if my diet hadn't changed I would likely be staring at figures of 9.1 or higher. However, having Depressive Personality Disorder my brain never looks for the optimistic view. I always need nice Members like you to point out the positives.

So, thanks for your offer of help and advice, I will certainly take you up on it as our respective battles continue.

Dave.

Dave, diabetes is rather maddening.

But you know, it takes 3 months or more to make a visible change in the A1C. Your changes are more recent than that.

Also the A1C can reflect high post meal levels, and then your levels can be relatively normal the rest of the day. So in some respects, it is not 100% reliable.

There are some papers appearing that A1C varies with age and race too. I think we will see the A1C data changing in the near future. I personally don't think it is "cast in stone" by any means.

Also all the meds you take may be influencing things. Not all drugs have been tested to see how they affect blood sugars.
High stress also releases cortisol, and this will raise blood sugar levels too. Lots of things can be going on, therefore.

Hi Dave,

I think you are amazing. I knew you had other conditions and being able to lose any weight under your circumstances is extremely laudable.

I, too, have cardiac issues which severely limit my physical activities (also many other conditions contribute to my sedentary state) so exercise has not been a part of my life for several years. Just doing the slightest thing causes angina and SOB that stops me dead in my tracks. (Not to mention PAIN from other conditions.) And when I say the "slightest" thing, I do mean that literally.

I really admire you and your accomplishments. Keep up the GREAT work. It may be time to add something to your arsenal in fighting off those elevated blood sugars. Metformin is the FIRST line med and does not have the adverse low blood sugar level risks that is associated with many of the other types of diabetic drugs.

Many people complain about stomach issues with Metformin as I did when I was first started on it. It made me so sick to my stomach, there was NO way I was going to be taking that everyday. (Side note: I can't stand to be nauseated. Pain is much more tolerable in my book.) I requested to change to the extended release form of Metformin and have been taking it for 8 years with absolutely NO side effects at all. It does NOT upset my stomach in the least bit, even if taken on an empty stomach.

Many people adjust to the regular Metformin after a few weeks but I could not take the nausea long enough to even wait for my body to "adjust" to it. Thank goodness I did my own research and requested the extended release as the physician I had at the time did not know it came in an extended release form. When he told me that, I immediately changed doctors. When I am more informed than my physician, I have doubts as to the care I will receive from him. :) Adore my NEW doctor of the past 8 years.

In MY opinion, I think the extended release form works better, too. That is only an opinion and not necessarily a valid assumption I have made.

The ONLY thing I do not like about my Metformin is the SIZE of the pills. I have never been very good at swallowing oral meds but have learned out of necessity.

Out of all the medications I take for various conditions, the largest oral med is the Metformin but I am now very used to swallowing them. To most people, they probably are not large but for someone that has ALWAYS disliked swallowing pills, I did find them big. There are no larger than some antibiotic meds I have taken in my life for acute issues but I knew they were not for more than X number of days.

It did take me a few weeks to adjust to the idea that I might be swallowing these pills for the rest of my life, but I think nothing of it now. I STILL take my Metformin ER, I just have added more medications to my regiment.

You are an inspiration. If you can lose 14 pounds, I should be able to lose a few myself.

Added: I eat "properly". I must admit, though, that I DO have a problem with portion control if it is something I like. I am known to eat a LARGE portion of brussel sprouts, cabbage, broccoli, etc. I just LOVE cabbage. Not the best thing for my blood sugar levels at large portions due to its natural sugars.

Thanks for talking with me.

Thanks mrsD.

I have personally experienced elevations of my blood sugar levels directly related to stress. You are so right.

Thanks for your post to Dave.

Testing your levels is not bad once you get used to it. How often you need to test depends on the individual (and their physician).

The more information you have, the better you can control your levels.

MrsD,

It IS maddening. I did not know A1c could be affected by a meal spike, but this is never the case for me. I always have my bloods taken between 9 and 10am - for anything - and I never eat in the morning - nausea issues, I just cannot stomach it. So last food intake was a small snack with meds 10pm the night before - 3 hours before sleep:(

I will ask my GP for another test in a few months, whether he prescribes meds or not, to see where I'm going.

Hopeless,

We really are fighting the same battle. Before I was rxed Diltiazem last year I had near-constant heart pains from microvascular disease over the angina attacks. It really does hurt more (as does an actual heart attack) when you have Hypersensitivity/Neuropathy.

If my GP goes down the meds track I will ask about extended release Metformin. I suffer constant nausea for which I take Metoclopramide 3 times a day and Lansoprazole - now THAT is a horse tranquiliser sized cap.

As for fruit and veg, cabbage etc… Diabetes.co.uk recommends eating all of them as it is unlikely they are the cause of a person's high blood sugar, and the vitamin/mineral benefits far outweigh the potential negatives.

I have cut nothing out of my diet except the junk. I weigh everything and now stick to proper recommended portions instead of 2-3 times the amount. Doing this allows me to count calories and target 1200-1400kCals per day, which my GP is happy with. I am already finding I would rather have a nectarine at 44kCals mid afternoon than 6 biscuits I used to have at 70kCals EACH - 420kCals total.

I am doing well on this diet, still a long way to go, and this Community is so supportive and encouraging it makes me feel I am not alone, even in this. Why not think about joining us when you are ready?

Dave.

Hi Dave & Hopeless
Congrats on the weight loss Dave - commiseration on the dx.
Just a wee tip on swallowing large pills - my father had sjogrens for years and had difficulty swallowing - he found that by having a spoonful of lite plain yoghurt just before taking the pill it coated his dry throat and then he would place the pill in another spoonful of yoghurt to take it. Then he would wash the lot down with water.