# HbA1C 111



## Evie (Jul 14, 2018)

Hi All, I am joining today because my type 2 is out of control. I have been on 3000mg metformin with my old GP. Recently moved home, job and surgery. My new Surgery has a specialist diabetic doctor and she was not impressed that my HbA1C was 111 and I was on 3000mg metformin, so she's reduced me to 2000mg metformin and added in 320mg Gliclazide.  Last week my bloods were averaging 11 to 14 and this week they are 18 to 24. My diet has not changed so do you think it just the meds working themselves out?

Many thanks
Evie


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## Brando77 (Jul 14, 2018)

Hallo Evie. What's your diet consist of? Could be the problem. Welcome to the forum btw


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## Northerner (Jul 14, 2018)

Evie said:


> Hi All, I am joining today because my type 2 is out of control. I have been on 3000mg metformin with my old GP. Recently moved home, job and surgery. My new Surgery has a specialist diabetic doctor and she was not impressed that my HbA1C was 111 and I was on 3000mg metformin, so she's reduced me to 2000mg metformin and added in 320mg Gliclazide.  Last week my bloods were averaging 11 to 14 and this week they are 18 to 24. My diet has not changed so do you think it just the meds working themselves out?
> 
> Many thanks
> Evie


Hi Evie, welcome to the forum  Sounds like it was a good move since your previous GP obviously wasn't very on the ball with things. As far as I know 2000mg is the maximum dose for metformin, and with an HbA1c of 111 it was clearly not sufficient to help you maintain control. At what times are you measuring your blood glucose levels? I would suggest starting a food diary and following a testing regime such as the one described in Test,Review, Adjust by Alan S so that you can begin to determine whether changes to your food choices can help you to better levels. How long have you actually been diagnosed, and how did your diagnosis comeabout? What sort of dietary advice have you received up until now, and has your new surgery given you any new advice?


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## Evie (Jul 14, 2018)

Thank you, I am testing 4 times a day b4 b'fast, b4 lunch b4 dinner and b4 bed, as per my new Dr request. My new doctor is seeing me again in 3 weeks, referred me to the dietician at the surgery, to have my feet and eyes tested and to do an Xpert course. I have been diagnosed 3 years ago and started on Metformin 500mcg then May year I felt very unwell and lost 5 stones and my HbA1C was 138 so they upped my metformin to 3000mg. I never had another doctor appointment until my new surgery last week. My diet is mainly fruit  smoothies for bfast, chicken, steak salad, porridge, eggs, but this is only recent in the past 6 weeks. Before that I was a big carbs addict.


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## Evie (Jul 14, 2018)

Brando77 said:


> Hallo Evie. What's your diet consist of? Could be the problem. Welcome to the forum btw


My diet was mainly carbs up until 6 weeks ago where I have changed to fruit smoothies for bfast, chicken, steak, salad, porridge atm. I am being sent to a dietician and on the Xpert course. You are right though, my diet is a problem


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## Northerner (Jul 14, 2018)

Evie said:


> Thank you, I am testing 4 times a day b4 b'fast, b4 lunch b4 dinner and b4 bed, as per my new Dr request. My new doctor is seeing me again in 3 weeks, referred me to the dietician at the surgery, to have my feet and eyes tested and to do an Xpert course. I have been diagnosed 3 years ago and started on Metformin 500mcg then May year I felt very unwell and lost 5 stones and my HbA1C was 138 so they upped my metformin to 3000mg. I never had another doctor appointment until my new surgery last week. My diet is mainly fruit  smoothies for bfast, chicken, steak salad, porridge, eggs, but this is only recent in the past 6 weeks. Before that I was a big carbs addict.


Hi Evie, I think alarm beels would have really rung with me if I lost 5 stones - over what sort of time period? Do you have any history of diabetes in your family? I'm wondering if you may actually be a slow-onset Type 1 - has this been investigated, do you know? I'm gussing the answer will be 'no', given the lack of care you have received up until now. It's possible that you pancreas has been slowly losing its ability to produce insulin, leading you to very poor blood sugar control - without insulin your body can't process the glucose created from the digestion of your food, and this can lead to rapid weight loss as your body has to turn to other sources of energy, such as body fat and muscle fibre. It can also make you feel very ill, and metformin will not help. Also, if you are a slow-onset Type 1 (sometimes also called Type 1.5 or LADA - Latent Autoimmune Diabetes in Adulthood) then gliclizide may also be of little use, as it works by prompting your pancreas to produce more insulin - if it actually can't produce more then the medication won't really help.

I'd suggest you ask whether you might be a slow-onset Type 1 - there are some tests they can do to help determine this and a lot of what you say suggests it may be a possibility. It's relatively rare in the population so many GPs wouldn't be aware of it, or consider it, assuming an adult must be Type 2, but we have had many, many members here over the years who have been misdiagnosed. It's most important that you get the right diagnosis so you can receive the appropriate treatment


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## Northerner (Jul 14, 2018)

Evie said:


> My diet was mainly carbs up until 6 weeks ago where I have changed to fruit smoothies for bfast, chicken, steak, salad, porridge atm. I am being sent to a dietician and on the Xpert course. You are right though, my diet is a problem


That diet certainly won't have been helping at all, and it's pretty appalling (although, unfortunately, not that unusual ) that you were not given better advice. I'd still ask about the potential Type 1 as suggested in my previous post


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## Northerner (Jul 14, 2018)

p.s. I'd suggest having a read of the excellent Maggie Davey's letter, which gives lots of good information about diabetes and how it can be managed well, including a guide to the types of food that are 'diabetes-friendly' - it would be worth having a read before you see the dietician and attend the course as it may help you to ask questions if things aren't clear


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## Evie (Jul 14, 2018)

Northerner said:


> Hi Evie, I think alarm beels would have really rung with me if I lost 5 stones - over what sort of time period? Do you have any history of diabetes in your family? I'm wondering if you may actually be a slow-onset Type 1 - has this been investigated, do you know? I'm gussing the answer will be 'no', given the lack of care you have received up until now. It's possible that you pancreas has been slowly losing its ability to produce insulin, leading you to very poor blood sugar control - without insulin your body can't process the glucose created from the digestion of your food, and this can lead to rapid weight loss as your body has to turn to other sources of energy, such as body fat and muscle fibre. It can also make you feel very ill, and metformin will not help. Also, if you are a slow-onset Type 1 (sometimes also called Type 1.5 or LADA - Latent Autoimmune Diabetes in Adulthood) then gliclizide may also be of little use, as it works by prompting your pancreas to produce more insulin - if it actually can't produce more then the medication won't really help.
> 
> I'd suggest you ask whether you might be a slow-onset Type 1 - there are some tests they can do to help determine this and a lot of what you say suggests it may be a possibility. It's relatively rare in the population so many GPs wouldn't be aware of it, or consider it, assuming an adult must be Type 2, but we have had many, many members here over the years who have been misdiagnosed. It's most important that you get the right diagnosis so you can receive the appropriate treatment




Thank you for your help. The 5 stone weight loss was over a year, I was highly stressed over being made redundant at the same time to loosing my dad within a 6 week period of finding out he had stage 5 pancreatic cancer(he was type 2 as well), so a my old GP put a lot of the weight loss down to those factors. My new GP has no old GP notes yet so will see me every three weeks now and has already suggested insulin as a solution if things do not improve quickly. I have never heard of slow-onset Type 1 so will take a look. I have a history of autoimmune disorders with no thyroid or parathyroid glands since 18 (now 47) when they took them both out plus early diagnosis of seronegative rheumatoid arthritis.


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## HOBIE (Jul 14, 2018)

Evie said:


> My diet was mainly carbs up until 6 weeks ago where I have changed to fruit smoothies for bfast, chicken, steak, salad, porridge atm. I am being sent to a dietician and on the Xpert course. You are right though, my diet is a problem


The right way to go. Knowledge is king. Good luck on course & well done for loosing a few  Welcome !


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