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JanetP

What the heck?

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Talking to my PCP today who is diabetic herself (LADA and on a pump) about my diabetes management and my desire for very tight control.  She told me of a study that links a higher incidence of "cardiac events" to A1C's lower than 6.5 due to hypoglycemia.  I think I know what study that is, but can't remember the name and I dimly recall something about that study being refuted because the study population had pre-existing cardiac disease.  And, of course, I got the usual lecture about refusing to take statins.

 

She is very big on a method called "Whole 30" which I am currently investigating.  Does anyone out there have experience/ opinions on that?  I don;t know anything about it. . . yet.

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My latest doctor told me that anything under 7.0 was great.  I winced but didn't say anything.  At least he didn't do the opposite and freak out from my latest results.

 

I don't know a lot about Whole 30, but have looked it up out of curiosity.

 

Its basically whole food focused so no processed foods, etc.

Its very similar to keto or paleo.  Allowed are meat, fish, eggs, vegetables, nuts and seeds, healthy fats, root vegetables, and fruit.  Not allowed are grains, legumes, dairy, alcohol, sweeteners of any kind (even natural ones like honey or stevia or artificial ones like splenda), and I think soy.  Which confuses me because fruit is also full of natural sugars so I don't really see the difference.

 

After 30 days you're supposed to be able to reintroduce things left out of the diet, but I am unsure if its a just return to normal or if there's a limit on what can be reintroduced, like with atkins induction.

 

Being diabetic I'm wary of the carbs of course though I see no reason why if something is allowed that it means it has to be eaten. 

 

I've seen claims that its supposed to reduce inflammation, but in all honesty, inflammation is such a buzz word anymore that I don't know how accurate that claim actually is or if the not allowed foods are all inflammatory.

 

I am game on any diet that encourages people to reduce or eliminate processed foods from their diets.  I haven;t tried it though as I seem to be doing fine with lchf.

 

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For me the only diet is what keeps my meter happy, as long as I mostly don't peak over 120

and nothing less than 70  I am happy. 

Edited by Fraser
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If what Kit said is true I wouldn't even consider trying such a diet. It seems crazy to me that you are allowed fruit but no sweeteners

 

It is my understanding that there is a very slim chance of those not on insulin going low. In 4 years I've never had a low--even a false one and my A1C has been in the 5's since the second or third month after being diagnosed. I think I'll stick with what I know works

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4 hours ago, dowling gram said:

 

 

It is my understanding that there is a very slim chance of those not on insulin going low. In 4 years I've never had a low--even a false one and my A1C has been in the 5's since the second or third month after being diagnosed. I think I'll stick with what I know works

 

 

I am surprised that the doc would through that "chance of hypoglycemia" thing at me since I am not on insulin.  She does not want to increase my metformin dose for that reason but lately fasting sugars have been 120-130.  I am not happy.

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Janet-- have you told the doctor that you understood the chances of going low when you are not on insulin are slim to none or is your doctor one who you can't talk to? That would have been my first reaction to her comment.

It sounds to me that your doctor does not know much about diabetes and is clutching at straws. If she's not willing for you to try things your way I'd look for another doctor. In my opinion the doctor patient relationship should be an equal relationship with both having input and working for the best outcome for the patient. That's the way my doctor is. She's young and I think that's the secret. There's a vast difference in the way the new doctors look at the doctor patient relationship

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Most doctors have a great fear of patients going low and are more inclined to have their patients being on the higher side. It's very possible to have an A1C in the 5s without having lows, just not having any highs. Apparently a lot of doctors just don't get it that you can eat very well without going high so you don't need to have lows to get an A1C lower than 6 or 7.  

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My Doc is young and she is a DO. With a more holistic approach.  I am not on meds, she just lets me do what I am doing. As long as my numbers are good.,

One point of correction on the chances of lows if not on insulin,  that was the thought when I started this 9 years ago.  But the chances of going low on metformin are slim not none.  Read the current info on side effects of  Metformin.  Since metformin is designed to inhibit your liver from producing or leaking excess glucose, it can also prevent your liver from dumping the excess glucose that is needed during heavy exercise (see the information that comes with the meds) .    

Eventually after being in the 50's from just walking and only taking large doses of metformin we thought it might be time to reduce it.  Then I just stopped it. I have a lot less of an issue managing my BG levels now while running.   

Diabetes varies from person to person . Last AIC was 5.7 

 

 

 

Edited by Fraser
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2 hours ago, dowling gram said:

Janet-- have you told the doctor that you understood the chances of going low when you are not on insulin are slim to none or is your doctor one who you can't talk to? That would have been my first reaction to her comment.

It sounds to me that your doctor does not know much about diabetes and is clutching at straws. If she's not willing for you to try things your way I'd look for another doctor. In my opinion the doctor patient relationship should be an equal relationship with both having input and working for the best outcome for the patient. That's the way my doctor is. She's young and I think that's the secret. There's a vast difference in the way the new doctors look at the doctor patient relationship

 

I thought that she was one that I could talk to, especially as she is also diabetic, but apparently not.  I asked her to take over my diabetes management because of the recent snafu with my endo who did not respond to several messages warning her that I was most likely allergic to glimiperide.  After I had the allergic reaction and it took a month for me to be seen I decided not to go back to her.  

 

I tried to engage my PCP in a discussion about Dr.Bernstein's research and methods.  She had never heard of him and was not interested in learning about him.  I will continue to do my own thing in spite of what she says, although I do think I need more metformin.  She did not want to increase my dose.

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Your doc is LADA which means she is a type 1 diabetic.  I don't think that gives her any insight into treating a Type 2, unfortunately.

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My old doctor pulled that one on me 10 years ago when I wanted to increas my Metformin from 1700 to 2550. He resisted and said it wouldn't work. But eventually he wrote the Rx and I lowered fastings from 140 to 100 without any lows.

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Its hard to believe, but doctors really have no clue how metformin actually works, do they?

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2 hours ago, Kit said:

Its hard to believe, but doctors really have no clue how metformin actually works, do they?

Not very hard for me to believe. Doctors know very little about drugs. A lot of the time they go by what drug reps. tell them. Pharmacists know about drugs. It was their main field of study.

 

I think people have to be their own health advocates. They have to be strong willed and not take no for an answer. Doctors can learn from patients. My doctor was insisting I take statins. I stopped her short and asked her if she knew why doctors recommend ststins when there are so many horrible side effects from them. Without stopping for a breath I asked if she had ever read Ancel Keys research. If she didn't know who that was it was his research that doctors interpreted as Cholesterol is bad. He refuted their conclusions but no one listened. I said if she could give me undeniable proof that cholesterol causes heart attacks I might consider taking them but until then my answer is no.
 

Doctors are only educated people not Gods and they are capable of making mistakes. My respect is not given freely, they have to earn it. Therefore I make sure my doctors decision is also mine

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Janet--keep making appointments and keep pecking away at her. She may get so sick of hearing from you that she'll give you what you want.

Years ago when I was young I wanted to get pregnant and it wasn't happening I asked my doctor for a referral to an OBGYN. She kept saying give it time. Frustrated I said Refer me or I'll call you every day until you do. It took a week of constant phone calls but I got my referral and a beautiful baby boy and she got the boot.

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Here is a copy of an email message I just sent to my PCP.  The battle continues.

 

Thanks for the notification about labs and x-rays. So far massive doses of lactase and dietary control have significantly decreased metformin side effects.

 

 I am still not happy about fasting blood sugars averaging 120 in spite of severe carbohydrate restriction and this has been going on since early July.  Metformin does not increase insulin secretion and those of us with Type 2 diabetes rarely have issues with hypoglycemia if we are not on insulin or insulin stimulating drugs and control our diet.

 

Microvascular disease occurs with blood sugar averages above 140.  My objection to the ACCORD study is that microvascular disease was already present in the study population when the study began and I have yet to find a study done on patients who had no little or no disease before treatment. This is what I am trying to avoid with my insistence on tight control as MV disease is impossible to reverse and I think I have done a good job considering that I am 5 years post diagnosis with few complications. I don't want to reverse my trend.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4911847/

 

End of rant.

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Janet, you go girl. I think more of us need to be more proactive when talking to our doctors. I had an old internist who used to cringe when I brought up any new study that contradicted what he said, Gone are the days when our PCP knew everything. I have been in the max of Metfoemin for 10 years and never had a low. In fact it rarely brings me below 100. I am glad the Lactase is working. I had to give up almost all dairy except yogurt because of GI problems.

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