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Permalink Reply by Alyssa Downing on September 19, 2009 at 9:25am

My last a1c we 6.3 and i was pretty excited! i use to be really good with my a1c's and the highest they would be was like 6 then when i started hs i like wouldn't test and just bolus! and like it was 9.4 but then i got back on track because my mom bribbed me it worked though I managed to bring my a1c down to 6.3 (which i think is pretty good!)

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Permalink Reply by Todd T. on September 19, 2009 at 10:10am

Some would say that 6.3 is great. I am with your mom, you need to keep up on it to stay below 7. If you think about it, I am sure that you feel much better when you are better controlled. I know that it is easy to ignore this disease, but in the long run you will better off if you stay on top of it. Keep it up, kid.

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Permalink Reply by Teena on September 19, 2009 at 9:31am

Congatulations on your improved A1c Todd. Well done! Happy for you. I think being rid of medications, a well controlled BG, a healthy lifestyle and no complications are most if not all of type 2 diabetics goal. Personally Im working hard for it. I may not be the perfect nor ideal model (the fact that I'm stubborn sometimes with regards to carbs consumption), but I eat healthy and make exercising or physical activities a part of my routine everyday. I would say I have some successes since I have managed my bg pretty well. From the time I was first diagnosed (2 years ago), I managed to decrease metformin dosage intake from 500 mg plus 2mg of glimiperide twice daily to present 500 mg metformin once daily. Another year or two perhaps? :)

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Permalink Reply by Todd T. on September 19, 2009 at 10:14am

A couple years ago the Dr put me on Glipizide which stimulates your pancreas to make more insulin. I hated the lows and was worried that it would wear my pancreas out sooner. I took myself off and controlled my diet & exercise better. Did you lower your metformin yourself or with the advice from the dr? Great job on your progress.

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Permalink Reply by Teena on September 20, 2009 at 10:47pm

My doctor lowered the dosage about 9 months ago. She removed the glimiperide first about 12 months ago. I see the doctor and have laboratories tests every 3 months. Thanks Todd. Im really hoping in time I can be off medications :)

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Permalink Reply by tmana on September 19, 2009 at 9:48am

This is something you need to discuss with your doctor. Some doctors don't want to take you off medications unless you're under 4.5 (the A1C Bernstein advocates); others will let you try going off if you're under 6.0. Another thing they look at is what your bg checks are like. There are certain protective aspects to metformin, so some doctors don't like to take you off it unless you have issues going too low when you are on it. My doc lowered my metformin prescription after I went down into the 50's over a 24-hour fast, and then took me off it completely four months later. Five and a half years later, and I'm still diet-controlled.

What you need to do is to discuss the issue with your doctor. It sounds like you'd rather be not-taking pharmaceuticals than taking them; if so, make sure your doctor understands this is your preference and is willing to keep you on the lowest possible doses needed to keep you healthy.

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Permalink Reply by Todd T. on September 19, 2009 at 10:18am

Great job. I plan to talk to my Dr after my next A1c if it is still low. I am sure he will go along with it.I haven't measured anything in the 50s or even 60s but often have a 70. I don't even need a meter since I can feel it when it is that low. Thanks for the advice, I will keep working on it.

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Permalink Reply by Kelly Rawlings on September 19, 2009 at 9:59am

Congrats on the great A1C and the efforts that got you there. That's impressive.

Do keep in mind that the metformin (a cheap drug, compared to the cost of other diabetes meds) has helped you get there. I think many people fail to realize that diabete is progressive and that a person must stay on top of it, in eating and exercise as well as medications. And not just blood glucose-lowering medications. Blood pressure and blood lipid (cholesterol) control is highly important.

The typical "curve" of type two is that the body starts to be more resistant to its own insulin. This is caused by many things, including obesity, inflammation, and genetics. The blood gluose starts to increase. As the blood glucose increases, the body churns out more insulin in response. Which helps a bit, but the blood glucose continues to increase because the body just doesn't use its own insulin very effectively. Then the insulin-secreting cells get "tired." Insulin production starts to dwindle (it's estimated that when most people are diagnosed with type 2, they are producing only about half the level of insulin they used to produce) and may eventually stop altogether. As insulin supplies dwindle, other meds may be added. Those types of meds encourage the body to secrete more insulin. But depending on how long a person lives with type 2, they may reach a point at which their body makes no insulin. Then insulin injections, pens, or a pump are the only treatment.

Because metformin helps your body use its own insulin more effectively, it may help your body from overproducing insulin and thus tiring your insulin-secreting cells so much that they stop producing insulin.

Only you and your doctor can determine what meds are right for you. Just don't be too hasty to drop a medication that may actually be doing you a lot of good! Best wishes and, again, congratulations.

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Permalink Reply by Todd T. on September 19, 2009 at 10:25am

Thanks for the encouragement, Kelly. My other tests have been within tolleration. I am also on a statin and have low Vit-B & D without supplements. My BP has always been good. I have read a lot about moving to insulin but do not feel like I need to do that anytime soon. My Endo actually said, "...you will eventually be on insulin, move type 2s will". I apprieciated that he is up front with me but it is not necessarily good news. I like the way you call the cells "tired". I have referred to them as "lazy", just like I was when I was 35lbs heavier when I was diagnosed.
I would like to be off the drugs if I can maintain accepatble levels. Cheers.

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Permalink Reply by Gerri on September 19, 2009 at 1:47pm

I've read recent research that more doctors are encouraging insulin for more Type 2 patients, often along with oral meds. Insulin protects remaining beta cells & prevents burn out. Many can't have good control without the addition of insulin. Of course, many doctors/CDEs/RNs aren't recommending lowering carb intake either, though they do stress weight loss & exercise.

You've done great by limiting carbs, exercising & losing weight & may never need insulin, but please don't fear insulin if you should need it.

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Permalink Reply by Todd T. on September 19, 2009 at 2:38pm

Thanks, Gerri, I know insulin is an option for me and do not fear it and if it helps, I actually look forward to it. Right now things are going well and I am enjoying it. Type 2 is tricky since there is no one treatment.

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Permalink Reply by Gerri on September 19, 2009 at 3:06pm

Glad you're not. From what I've read here, many people are. Somehow it's seen as the end of the line, or that they've failed in some way.

Type 2 is very tricky! Different meds, combos of meds, new meds coming out & some with not fun side effects. In my diabetes ed class I was the only Type 1. Several people said they felt sorry for me because I had to take insulin. I didn't envy them having to take pills that made them feel ill. Pretty much bites for us all.

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