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bignick 12-11-2014 15:56

Lowering A1c More
 
Reading BS 101 last night I came upon an interesting article relating A1c to CVR. It mentioned that an A1c in the range of 4.8-5.4 is the beginning of cardiovascular disease risk.

I currently have heart disease and have tried everything stress, diet and exercise wise to minimize the effects of it. I have lessened the symptoms to nearly none and feel good heart health wise. I realized my FBG was elevated about a year ago and started LCHF and got into ketosis. In the very short term it seems my FBG went down, but for 6 months of testing I discovered I was using a meter that reads 10-30 points low.

Since July, using a more accurate meter it seems like my average FBG is in the weekly average of 105 to 118. I very seldom see anything below 100, ever. It seems also the numbers are trending upward. It doesn't matter if I eat a lot or fast, exercise heavily for hours or not at all. The numbers are within the range of 101 to 130 and usually spikes below 140 except rarely when a cheat food is consumed.

I'm thinking I may need medical intervention to do any better. I'm not satisfied with the status quo. I may ask my cardiologist to prescribe metformin for me when I see him next week. I don't have a GP or endo.

I'd like some thoughts from some of those that are familiar with what I'm going through.

John.in.France 12-11-2014 16:34

Nick,

I can only say that from what I've heard and read, metformin is our safest option to beat insulin resistance. Like everything, it's got a price - tactfully described as 'gastric distress'.

So, worst case scenario is that you try the regular drug and decide you can't handle the 'gastric distress' so you swap to the extended release version but after a month or so, you decide it's not a runner. What have you lost? A few bucks in cost and a few minutes discomfort in the smallest room.

Others on the forum who've used it may have other views but I don't see it as a problem for you.

The only thing I will say is that back in 2010 it was suggested to me that pushing for the 4% club wasn't really value for money in terms of the push needed. Although your reading of the information is right, the real upturn in risk doesn't hit until you're up with the ADA 6.5% targets.

macksvicky 12-11-2014 16:38

Sometimes meds are needed. You are doing a great job though. Maybe you can speak with your Dr. about metformin (the extended release is easier on the digestive system) It is a good 1st med to start with, low, if any side effects and it works well. But don't worry overly much about getting lower than 4.8 A1C, a lot of us can't get that low and use various meds and insulin. Just do the best you can do without getting into some of the more dangerous meds, there are some out there that can really harm you and not worth it just for some lower numbers. But I do like my met ER and Lantus :)

Sojodave 12-11-2014 17:13

I just switched from regular Metformin to Metformin Extended Release. The ER version is easier on my stomach and I haven't had any problems and it seems to help with DP. You might ask your DR. about the ER version. It cost the same at the pharmacy.

gotsomeold 12-11-2014 17:31

Nick, I think that is a very good plan.

grammaB 12-11-2014 19:50

I'm with everyone else, give metformin a try. I take the regular met, and as long as I remember my probiotics, I don't have any problems with it. The good thing about it is it has so many other side benefits that I will take it for the rest of my life just for those!

mbuster 12-11-2014 20:44

Quote:

Originally Posted by bignick (Post 773777)
Reading BS 101 last night I came upon an interesting article relating A1c to CVR. It mentioned that an A1c in the range of 4.8-5.4 is the beginning of cardiovascular disease risk.

I currently have heart disease and have tried everything stress, diet and exercise wise to minimize the effects of it. I have lessened the symptoms to nearly none and feel good heart health wise. I realized my FBG was elevated about a year ago and started LCHF and got into ketosis. In the very short term it seems my FBG went down, but for 6 months of testing I discovered I was using a meter that reads 10-30 points low.

Since July, using a more accurate meter it seems like my average FBG is in the weekly average of 105 to 118. I very seldom see anything below 100, ever. It seems also the numbers are trending upward. It doesn't matter if I eat a lot or fast, exercise heavily for hours or not at all. The numbers are within the range of 101 to 130 and usually spikes below 140 except rarely when a cheat food is consumed.

I'm thinking I may need medical intervention to do any better. I'm not satisfied with the status quo. I may ask my cardiologist to prescribe metformin for me when I see him next week. I don't have a GP or endo.

I'd like some thoughts from some of those that are familiar with what I'm going through.

That was a big thing for several years when I was told by a couple of doctors I was borderline diabetic. My BG wasn't too high (right around 120-125) fasting and my cholesterol wasn't too high, but one or the other needed to come down or I would have to take meds.

So, makes me wonder, is it maybe the A1c, or really the high insulin load floating around that may be the culprit. If higher insulin doing the damage is the case, maybe us on low carb high fat, though we have as high and higher A1c's than the range you mention, but don't have as much insulin in circulation doing the damage as the higher carb eaters do, maybe we are at a much less risk than them. I can see where that would make diabetics with much higher A1c, eating regular diets, insulin resistant so even more insulin in circulation, would be much more susceptible to having higher risks.

Maybe your cardiologist could give more details on this subject and cite some references when you visit next week.

silvertiger 12-11-2014 21:02

There are people with 4.8 A1C whose BG still goes over 7.8, maybe for brief periods. Then some people with 4.8 A1C may never go over 7.8. Average those together and you'll get some people with damage to their bodies. IMHO, the key is never going over 140 (7.8).

skb 12-12-2014 07:52

Quote:

Originally Posted by bignick (Post 773777)
Reading BS 101 last night I came upon an interesting article relating A1c to CVR. It mentioned that an A1c in the range of 4.8-5.4 is the beginning of cardiovascular disease risk.

I think what they meant was "above" the given range & not "in" it, as far as risk is concerned.

I had a similar FBG pattern that you mentioned, and after some analysis, I decided to stop all artificial sweeteners. It worked, the FBG dropped to between 90-100 within a week. Worth a try.

bignick 12-12-2014 16:18

Quote:

Originally Posted by skb (Post 774569)
I think what they meant was "above" the given range & not "in" it, as far as risk is concerned.

I had a similar FBG pattern that you mentioned, and after some analysis, I decided to stop all artificial sweeteners. It worked, the FBG dropped to between 90-100 within a week. Worth a try.

From BS101 re heart disease risk:

"What Can You Do To Reduce Risk?

Your first step should be to stop worrying about total cholesterol and LDL, instead look at your A1c and triglycerides. If they are high, you know you need to cut back on carbohydrates.

If your A1c is between 4.8% and 5.4% your risk is beginning to rise."

Thanks for the tip but have never used artificial sweeteners and I quit using sugar many years ago. I also do not eat processed food or packaged food. Most all of my diet is fresh vegetables, eggs, meats and fish. Most all sauces and enhancements are made from scratch all the time. I may cheat on a meal however once or twice a month.


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