Overweight-actively dieting for 3 wks...A1C 8.1-start meds??

[mdouth]

Hello-

I came across this site while hunting for diabetes information. I am a guy who currently weighs 297 (5'10"). I have been on a diet for 3 weeks now...starting weight was 318. I just received a call from my doctor who told me that my A1C from blood taken one week ago was 8.1 . He prescribed Metformin (Glucophage) extended release, 500mg and scheduled me for a meeting with a diabetic nurse.

My father is a retired internal medicine doctor. When I told him about the labwork and med prescribed, he said that my young doctor (40ish) is overreacting. That my A1C is not high enough...that it is elevated because of my overeating in the last months that A1C was measured, and that I shouldn't start the meds-just continue dieting and re-check in 3 months. At the very least, I would like to meet with the diabetic nurse, get the glucometer and diet suggestions.

So, my question is: does anyone have any experience with this type of situation? Would it be harmful delaying medication with the assumption that it will go down since I am dieting? I have a long history of overeating with a few periods of great weight loss (80-100lbs). What would be the best approach to this situation? My doctor is my age with a young family, so, my wife thinks he is taking an understandably cautious approach.

Thanks for your input.

[matingara]

an HbA1c of 8.1 is high enough to mean that you must do something. Diet or exercise or medicine.

so why not do all three!

what is contained in your typical diet? do you eat alot of carbohydrate?

i would definitely go to the Diebetic Nurse and get the meter. It never hurts to know what your BGL is - especially after eating certain foods!

:)

-- Joel.

[CaptainMike]

I'm sorry to tell you this but an A1C of 8.1 is not pre-diabetic, it's diabetic. With the amount of weight you have to lose, It is likely that you will be able to get your blood sugar within normal range with just diet and exercise, but in the meantime, the metformin may help jumpstart the process, the sooner you get your BG down the better. Good luck to you!

[xMenace]

The question is: is your current diet and exercise program doing the job?

If it were me, I'd be testing my own blood sugars daily. I'd test the fasting when I wake up and before and after one meal - pick a different one each day - then maybe before bed. That's 4 a day, maybe 3. If my numbers were in range, I wouldn't take the meds. If I was out of range, I'd take the meds. It's not instantaneous action, so it needs time to build up. After say six weeks of losing weight and getting healthy, I'd stop the med. When my tests crept back up, I'd go back on.

This is just me. I prefer to work with as live data as possible, and I prefer not making assumptions. Your doctor assumes you need the meds and your dad assumes you don't. Let the meter tell you what to do.

But that's just me. Discuss it with each.

[Dan Gato]

Wellcome to the Forums.

First of all, you're going to get different opinions here.

I would take the Metformin, it takes a few weeks to act on your liver. also, a side effect of Metformin is control hunger, so it'll help you to lose weight.
In my opinion you should also be on Glipizide to lower your bg's even more.
Get the meter right away, even if you have to pay for it.

The A1C of 8.1 is too high, the glucose may be damaging your eyes.

[Ronin]

Hi Mdouth!

First of all welcome to DF. I have to agree with Dan, you will get different opinions. I also agree that medication, in your case, is probably going to be helpful. I also agree that you are probably a Type-2 already.

Your father's advice, however well meaning, avoids the fact that your weight is a significant detriment to your overall health. While I congratulate you on the weight loss you have achieved, the reality is that your "healthy weight" is a at least 100 pounds below where you are today, and probably more like 150 pounds lower. That weight loss is going to take a long time to achieve. In the mean time the high BG levels that you have indicate that there is a strong potential for the onset of diabetes induced health problems that include vision and neruopathy conditions.

With an increase in exercise, a better eating life-style you may get past the point where medications to control your BG levels is no longer needed. However, in the moment, it is my opinion that you will not do yourself any harm by taking the prescribed medications.

By all means get the meter and start checking. Learn how your body responds, or fails to respond, to the various foods you eat and the exercises that you do. There is a lot of help here to guide you as you work towards a leaner and lowered BG level person.

There will be ups-and-downs, you will get angry, frustrated, and elated (often in the same day) with the whole process of managing your BG levels as well as your weight. You will even fall off the plan. We have all "Been There Done That."

Let us know how we can assist you in your journey.

[mdouth]

Wow! All of this is information that I was looking for that can only come from people who have experiences. From your input, I plan on meeting with the nurse on Thursday, learn to use the glucometer and record levels for 2 weeks/4 times a day. Then, maybe I can get a better idea on whether to start the med. I found your idea of the med not hurting and even giving me a jumpstart on lowering my BG.

I'll check back in and update on my progress. Any additional input would be greatly appreciated.

Regards-
mdouth

[Emm]

Just to say ditto... I think the metformin is a good idea. an A1c of 8.1 is way too high to leave alone - especially as you're already dieting. (Is your diet diabetes friendly?)

HUGE Congrats for looking after yourself - it's great you're doing this!

[Kim_in_TN]

I'll tell you like my Doctor told me the day I was diagnosed. You can't be just "a little bit" diabetic. You either are or you aren't. If your fasting BG and A1c are over the range, then you are diabetic ... period. I just kept on trying to get my doctor to say that I wasn't "really" diabetic and I finally had her laughing at me. I was just so stunned that I could have this illness. Being overweight puts so much strain on your heart and other organs and high BG makes it even worse. Don't try to second guess it, take your doctors advice and do whatever he/she and your diabetes nurse recommend. I'm sure your Dad is very knowledgeable but new studies are always coming out and Diabetes is now in epidemic proportions!

Stay here and let us all help you through this! ;)

[BriOnH]

Wow. It might be, as some once very, very wise men said, a communication breakdown, but I am shocked your father of whom is/was an endo give such advice on that A1c reading. Not ripping on your dad brother, that would be way un cool, which leads me to believe information was miscommunicated or he knows something that's abnormal in your family pedigree that doesn't fit the standard. I am still in shock. If you follow your dad's advice and all info was conveyed correctly and you get your A1c back to near normal PLEASE let me know. That's journal worthy if correct.

[Larry H.]

Welcome,

Lots of nice helpful people here. I had a similar situation although not with the same AC1 your seeing. My new doctor who was young was up on the latest research and thankfully started me to see I was headed in the wrong direction if I didn't take action. I lost weight and exercise daily. Things have for the most part improved, but your going to have ups and downs numbers wise, I know..
But when the young doctor decided to become a diabeties specialist and left town, my old doctor came back part time. His view are much in line with your father. In there day those were probably numbers that seemed right. In fact some doctors here still see them as correct. But all the evidence to date has pointed to lower numbers being better for you. Not too low, but lower. Your experience is not that different that some of us. You just have to sort it all out. I agree that although I try to resist medications and so far have, if I had a number such as yours I would be very inclined to use it, at least till I got things well under control. The down side is the higher the numbers the more difficult it is to maintain lower numbers and sometimes is nearly impossible.
You need to watch your carb intake and do your walking and some strength building for your muscles. Hope you see better numbers soon. Stay around and learn.