First A1c Since Keto & Help Talking to Doctor

(Athena) #1

Hi everyone,

I was diagnosed with Type 2 diabetes on April 23, 2014 with an A1c of 6.9. At that time I was put on glimepiride, which is a sulfonylurea. I started Keto on August 2, 2017. I stopped taking the glimepiride about two weeks after I started Keto.

Here are my most recent A1c test’s:

6.4 May 18
6.2 Aug 24
6.1 Nov 15

In May I was completely on the glimepiride. In August I had only been off of it for 2 weeks. And November’s test reflects me off of it. The lab says “5.7-6.4% Increased Risk of diabetes mellitus” so am I now pre-diabetic?

I see my doctor for an appointment to go over my test results on November 27th. I have not told her about my new way of eating or stopping my medications. (I stopped taking my statin, as well.) I’ve been really scared to have the conversation with her. Now that I’ve lost 35lbs and my A1c looks better without medication I feel less scared, well, still scared to talk to her about the statin. My cholesterol test is way overdue and I don’t even want to bother taking it because I don’t care about the results.

Please help me with how to talk to her, what to say?

Thanks!

(VLC.MD) #2

mildly odd first choice.

First choice should be metformin unless your renal function is low.

Don’t do tests you are going to ignore.

Skipping the cholesterol test until you are at your goal weight for 3 months is a very good idea.

Your health is in transition. Say you’ll do more blood tests when things stabilize. Testing while you are losing weight is a bit of a waste of time.

(Athena) #3

I was unable to tolerate metformin.

(Athena) #4

That’s a good idea. I remember reading somewhere that while actively losing weight cholesterol goes up.

#5

More like post-diabetic. :+1:

(Consensus is Politics) #6

Unless presented with data otherwise, I would say I’m still diabetic even with an HBa1c of 5.7%. I’m diabetic without the disease diabetes influencing my health. I’m still insulin resistant (I think, not willing to test that). I’m fairly sure eating a lasagna with real pasta is gonna put my BG through the roof.

There should be a term for this. Something like “Diabete sub imperium” . Too many syllables. Maybe “victus diabete”

(Richard Hanson) #7

Hi Athena,

It is important to remember that your doctor is working for you. You are in charge and there should be no reason to feel apprehension about discussing issues with your doctor. If she does not understand the fundamental nature of the relationship, if she does not respect your right to make decisions for yourself, she should empower you to do exactly that, then it might be time to think about finding a new doctor.

There is no reason to ever accept any test or medication that you don’t want. There are no “Dr. Orders”, there are only “Dr. Suggestions” and the final decision is always yours. First, last, always, you have an irrevocable veto.

An A1c < 6.5 would be an indication of pre-diabetes, but this is just a rather arbitrary number. What is great is that your number is moving in the right direction and that you have lost an amazing 35 lb. Congratulation! Awesome! :slight_smile:

A statin will lower ldl but there is at best only mixed clinical research that shows that a lower level of ldl has any impact on coronary heart disease, and then primarily for men who have already had a heart attack. The situation is even more dubious for women, and lower levels of ldl have been associated with higher mortality from all causes. I also decided to stop taking a statin and my doctor gave me a thumbs up ,“I am not a statin pusher”.

Knowledge is power over our fears. There is a wonderful YouTube video by Ivor Cummings - The Cholesterol Conundrum - which will give you a great introduction to the subject. As you are eating keto, you are already doing more for your heart health than any statin will ever accomplish.

If you do decide to test your lipids, remember you are the boss and that is your decision, pay the most attention to your triglyceride/hdl ratio. This is more indicative, not necessarily predictive, of health then your ldl number which is close to useless. One of the reasons there has been so much attention payed to cholesterol is because a test for cholesterol was discovered a long time ago when nutrition science was just getting started. They test for it because they can and since that time they have been trying to prove that the test is useful.

I would continue to track A1c as an indication of how you have done in the recent past, and I would also consider getting your insulin level tested. The spectrum of metabolic dysfunction, from Metobolic Syndrome, to pre-diabetic, to type 2 diabetes is an issue of insulin resistance and hyperinsulinemia. If you can get your fasting insulin number to move lower over time, that is just as wonderful as getting your A1c to decline.

What to say to her? Whatever you say … you are in charge!!!

Keto for Life,
Richard

(Randy) #8

[quote=“amargolis, post:1, topic:23695, full:true”] I’ve been really scared to have the conversation with her. Now that I’ve lost 35lbs and my A1c looks better without medication I feel less scared, well, still scared to talk to her about the statin. My cholesterol test is way overdue and I don’t even want to bother taking it because I don’t care about the results.

Please help me with how to talk to her, what to say?

Thanks!
[/quote]

Congrats on your results.

It is a pet peeve of mine that we are conditioned to think of doctors as authority figures.

YOUR DOCTOR WORKS FOR YOU!!!

I point blank told mine that what she was taught about diet and nutrition was wrong, and it’s time for her to study the current research.

She also wanted to “talk to me about cholesterol lowering medicine”.

I told her if she can show me any studies that show statins lengthen life expectancy in any meaningful way, we can revisit the topic.

I haven’t heard back. :smile:

We’re in charge of our own lives. It’s time we remember that!!!

Good luck and KCKO!!!

#9

DAMN STRAIGHT!!!
I almost laughed when my Dr tried giving me nutritional advice that even Ancel Keys admitted was wrong decades ago… it wasn’t the first crappy outdated advice he’s tried foisting on me… along with statins.

(Consensus is Politics) #10

It’s a natural tendency to think of doctors as being very intelligent, or smart, or intuitive. But my experience has shown me on average they are as clueless as the average American.

Back in 2004 I worked for Cox communications doing telephone support for cable TV/Internet/phone. It always amazed me how when speaking to a doctor, and they usually let you know they are a doctor, “don’t call me Mr Smith, I am Dr Smith!” These same “doctors” couldn’t comprehend what it meant to have your TV input set to the correct input, or on the correct channel to work with the cable box. When it came to troubleshooting the connection over the phone, their ego would get in the way, “don’t you think I tried that already! I didn’t get a PhD and learn nothing like people on phone support” only to find maybe they didn’t even have the power turned on. Or There was a thunderstorm, and power was out in their neighborhood. It was an everyday occurrence. And we often marked the accounts to say “prefers to be called “Dr Smith” and we knew what we were in for when we pulled up their account.

I’m not saying their stupid, or less than anyone else. Obviously they are not. It indeed takes a special individual to go through what it takes to receive the title off Doctor. I belittle it not. But they are human and subject to the same vanities as everyone else. Including or should I saw especially not admitting to being wrong about something. Especially when it comes from an inferior lower class individual.

So my thinking is we need to take it easy on them. And at least treat them like equals. Much the way we would like to be treated. :cowboy_hat_face:

(Jen ) #11

A.) Your doc should be doing a happy dance over your weight loss!!
B.) Doctors are people, too. They have bad days and good days and some have a God complex. If your doc thinks she’s God’s gift to medicine and won’t listen to you after seeing the results; it’s time to find a new doc.

Personally I have had to see many, many specialists and anyone who wouldn’t look me in the eye when I asked the hard questions was fired. They make per patient seen, which is why they're stressed and always running behind, but if they can't have a little compassion they won't make off of me.

(Crow T. Robot) #12

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(Dave Corbett) #13

I just wanted to wish you luck and share my experience!

My doctor was not a fan of Keto or low-carb diets when I met her in March 2017.
I was a very bad diabetic in that I wasn’t taking the disease seriously or watching my diet.
My A1C was 13.5% - I was in very bad shape.

I found Keto and told her my plan to try it - she put me on Metformin and said “We’ll see what happens”.

I went full Keto 100% - No cheat days ever. I really didn’t focus on calories much. I immediately saw good results in my blood-glucose numbers.

My A1C began to drop like a rock!

3/3/2017 13.5
4/24/2017 7.5
7/24/2017 5.4
11/16/2017 4.9

In early October I tried an experiment and stopped taking my Metformin. My blood-glucose numbers stayed low by them selves! I called my doctor for an early appointment and asked to go off the medication. She has been amazed at my progress and agreed!

So please believe me when I say there is real hope for you. You have total control over the sugar/carbs that go into your mouth - and then show up on your glucose meter. Use your meter as a tool as you experiment with different foods so you can eliminate anything that causes spikes.

I found that fasting and walking 2 miles a day really helped burn off glucose. I now just eat one meal a day and sometime fast 2-4 days at a stretch. I’ve lost over 40 lbs /20 kg in the last 8 months. BONUS!

Keep calm, Keto on and beat that Beetus into submission!

(VLC.MD) #14

Incredible.

Can you start a thread about that time period ?

Say Jan 2017 -> April 24, 2017 ?

I’d like to learn more about the details where you went from an A1c of 13.3 ro 7.5 ! I think every diabetic in the world needs to read your story. And apparently that is alot of people.

I think it could also be a way for you to solidify what you did well and help you keep your fantastic new life trucking along in the right direction !

Please consider it ! (and congrats again !)

So good. Needs it’s own thread !

(KCKO, KCFO 🥥) #15

Doing a happy dance over here for you @oldcrow66. That is just an awesome result in very little time.