Risks Associated with Controlling to Non-Diabetic Ranges

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Risks Associated with Controlling to Non-Diabetic Ranges


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Old 04-16-2018, 04:15   #1
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Default Risks Associated with Controlling to Non-Diabetic Ranges

Trying to achieve A1c like a non diabetic is risky. Many doctors today (including mine) will warn patients that low blood sugar is far more dangerous than elevated blood sugar. Personally, I get severe symptoms when I'm anywhere near 100, which is OK for most people.
And, your doctors is correct that the more drugs we take, the greater risk of kidney damage; kidneys have to excrete whatever drugs we take. That applies to any drug.

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Old 04-16-2018, 15:24   #2
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Default Risks Associated with Controlling to Non-Diabetic Ranges

Quote:
Originally Posted by CMartin View Post
Hello ! Diagnosed with type 2 in February 2017 with A1C=11.3% A general practitioner prescribed Metformin 2000 mg a day, and with a strict diet in March this year my A1C was 5.8%

...

After seeing higher BG readings I expressed my concern to the endocrinologist and my GP that half the dose of Metformin will result in higher A1C. They agreed, but they responded that results bellow 7 are OK and nothing to worry about.

I believed our goal is to keep A1C as close as possible to A1C readings in non-diabetic people, and I believed our doctors will support it. But they don't.
There seems to be a growing amount of variability on the view of physicians and diabetes and I have experienced this myself - it tends to vary from doctor to doctor.

For the first 40 years of living with diabetes I had medical staff who didn't get caught up on A1C levels or strict diabetes control - as a result, as far as I know the best A1C that I ever achieved was 6.8 - usually it's above 7. But no complications, and I always felt great.

Then I moved, got a different doctor, who absolutely freaked with my high A1Cs - he got me to exercise tighter control and for the first couple of years with this new doctor - trying to achieve tighter control I almost died 5 maybe 6 times. He prescribed me statins and BP medication and my quality of life dropped significantly where I could no longer function like I used too.

So, now I don't see my doctor - I don;t take my statins or BP Meds, I'm convinced he was trying to kill me - and now in my 52nd year of living with type 1 my A1Cs continue to range in the 7s, I feel great, my lifestyle has returned to normal and have one good active lifestyle.

This is a little long winded - but be aware that not all doctors agree on their approach to diabetes management and some will actually use the risk of complications to scare you in to compliance to their belief system.

And as for tight control and complications or lack of - there is still debate on this - according to the latest research it appears to be the combination of gene mutations that predisposes diabetics (Type 1 and Type 2) to complications and less about control. What does this mean - you could have the best A1Cs in the world and still experience complications or you can have the worse A1Cs in the world and have no complications - there are diabetics that fit in both these categories.

But it sure is easier to market all your diabetes management tools when you can refer to industry supported studies that show a trend between A1c levels and complications - and although there is a trend or correlation there, it may not necessarily be the cause and affect that many people conclude and what advertisers use when marketing.

So - in light of this - it may not be wise risking your life for normal A1C levels when there may be no payoff. Just try to do your best and don't worry if you hit the 7s.

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Old 04-16-2018, 16:35   #3
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It is my understanding that for type II diabetic, it is VERY unlikely to experience a 'dangerously low blood sugar' unless they are taking fast acting insulin.

Now let me contradict that with some conditions....

Of course if one is on slow acting insulin, and grossly overdoes , it probably could be dangerous. As far as I know, Metformin would not cause a dangerous low unless you are taking much more than required for your diabetic condition. These seem to be the two basic drugs used by type II diabetics and actually preferred by most of us type II's on this website...my opinion of course. The reason I prefer these two drugs is that they are unlikely to cause a dangerous low, they are well tested in the market place for many years, and have few dangerous side effects. And generally they work if one watches carb intake....

I also recognize that their are 100's maybe 1,000's of 'other drugs' mostly new, that doctors may prescribe for type II diabetes, and no doubt some of them could cause a dangerous low. If one decides to take one of these, be sure to understand the known side effects and how they work, and know can they cause dangerous low blood sugars....

We all have to be diligent in researching and asking questions about drugs we are prescribed to take.....

rsfletcher, I completely understand your position on controlling blood sugars and the possible onset of complications. Therefore I am not meaning to challenge or question your experiences or perspective....

But, my experience has been different, I too followed my doctors advice trying to stay below 7.0 on my A1c, I was successful for many years, until 2014 when I started seeing a steady increase in my BS! My doctor said, it is progressive and prescribed Januvia....dang near killed me....! I quit Januvia, as it did nothing for my BS, but it did make me very sick off and on for a year. I found a new doctor, continued with metformin and Lantus slow acting insulin. My feet were starting to burn, scratches on my legs and feet healed slowly and I could not feel cuts on my toes..? Then I found LCHF...and in 6 months, my A1c was at 5.8, weight down, health indicators all improved and my feet were much better....I going on 3 years now on LCHF and nothing but good stuff health wise, I will be 68 next month! So like you, based on my own results and observations and research, I believe controlling BS 24/7 does at least delay the onset and severity of complications.....and maybe even stop these complications all together!

I guess we all will find out what really worked or not worked in due time....as none of us will get out of this a live....

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Old 04-16-2018, 19:15   #4
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Default Risks Associated with Controlling to Non-Diabetic Ranges

There can be risks to trying to control your BG in normal non-diabetic ranges. What risks are more likely to be associated with diabetes type?

Many risks are real, and many risks are perceived, so when responding, please cite sources of your facts or backing of opinion, and keep it nice.

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Old 04-21-2018, 19:04   #5
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I seldom ever think to look at the ADA for information as I disagree with their type 2 recommended nutritional advice and what they deem as safe BG levels, but they occasionally post good stuff. Here is an older article, last edited in January about Tight Diabetes Control is better than standard control. It was a study of Type 1 diabetics, but I think it would also apply to Type 2s. The tight control was still a little above normal range so I see room for improvement. If a normal range is OK for normal people, then it should be OK for me too.

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Think I've had this since 2003. Told I was Type 2 lean on 2/13/12.
a1c 8.8 (8/2011) 5.2 (07/2019)
TC 183 LDL 102 HDL 65 TG 52 (02/20/2020)
Supplemental vitamins and electrolytes
64 YY Love the LCHF diet. The cheese goes well with my whine

updated 02//20
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Old 04-21-2018, 19:24   #6
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Quote:
Originally Posted by xring View Post
Trying to achieve A1c like a non diabetic is risky. Many doctors today (including mine) will warn patients that low blood sugar is far more dangerous than elevated blood sugar. Personally, I get severe symptoms when I'm anywhere near 100, which is OK for most people.
And, your doctors is correct that the more drugs we take, the greater risk of kidney damage; kidneys have to excrete whatever drugs we take. That applies to any drug.
I am going to respectfully disagree. As a type 2 diabetic. if you keep your BG between 75 and 100 (no medication) you will not be in any more risk than a normal non diabetic.

I take no medication and live between 75 and 100 and all my blood numbers are perfect and my doctors are thrilled with my numbers. Personally I have reversed all of the symptoms and live with my diabetes in remission (remission is my term).

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Here are some good starting points to read

Blood Sugar 101 - VERY informative and accurate
http://www.diabetesforum.com/diabete...ng-method.html a tried and true testing method
https://www.dietdoctor.com/low-carb lists foods for LCHF

""You take the blue pill, the story ends. You wake up in your bed and believe whatever the doctors want you to believe. You take the red pill, you stay in Wonderland, and I show you how deep the rabbit hole goes." "

Last edited by hftmrock; 04-21-2018 at 22:52.
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Old 04-22-2018, 00:10   #7
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After the study I linked above, other studies were ran comparing "tight control" with standard control to see the benefits. They didn't find any significant benefit for being in tight control over standard control. However, what was their definition of "tight" and how did they achieve it?

In a Harvard Medical School article, Controlling blood sugar in diabetes: How low should you go? which talks about the studies, I take it their "tight" is my definition of way too high.

Quote:
3. Patients who take insulin and others who aim for tight blood sugar control should monitor their own blood sugar levels. They should also learn to recognize symptoms of hypoglycemia, including anxiety, racing heart, sweating, tremors, and confusion, and they should know how to raise excessively low sugar levels and how to get help in emergencies.

While the ADA guidelines remain important, many experts believe that one size does not fit all, that blood sugar goals should be adjusted according to the needs of individual patients. In general, an HbA1C target of 7.0% to 7.5%, which corresponds to an average blood sugar level of about 150 to 170 mg/dL, seems reasonable for many patients with type 2 diabetes. Medical therapy should be intensified when HbA1C levels exceed 8%, which corresponds to an average blood sugar level of about 180 mg/dL.

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Think I've had this since 2003. Told I was Type 2 lean on 2/13/12.
a1c 8.8 (8/2011) 5.2 (07/2019)
TC 183 LDL 102 HDL 65 TG 52 (02/20/2020)
Supplemental vitamins and electrolytes
64 YY Love the LCHF diet. The cheese goes well with my whine

updated 02//20
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Old 04-22-2018, 04:16   #8
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Quote:
Originally Posted by hftmrock View Post
I am going to respectfully disagree. As a type 2 diabetic. if you keep your BG between 75 and 100 (no medication) you will not be in any more risk than a normal non diabetic.

I take no medication and live between 75 and 100 and all my blood numbers are perfect and my doctors are thrilled with my numbers. Personally I have reversed all of the symptoms and live with my diabetes in remission (remission is my term).
I was referring to diabetics whose blood sugar is too high without insulin or medication; not lucky ones whose diabetes is mild & stable. I also controlled my blood sugar without insulin or meds & had an A1c of 6.0 - for the first four years. Then everything changed.

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Old 04-22-2018, 07:05   #9
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Quote:
Originally Posted by xring View Post
I was referring to diabetics whose blood sugar is too high without insulin or medication; not lucky ones whose diabetes is mild & stable. I also controlled my blood sugar without insulin or meds & had an A1c of 6.0 - for the first four years. Then everything changed.
I was 396bg... it was not mild. but i have only had it for 2+ years so i guess time will tell.

i believe living a keto lifestyle will prevent me from getting it back in any real bad way

no carbs = no problem

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Here are some good starting points to read

Blood Sugar 101 - VERY informative and accurate
http://www.diabetesforum.com/diabete...ng-method.html a tried and true testing method
https://www.dietdoctor.com/low-carb lists foods for LCHF

""You take the blue pill, the story ends. You wake up in your bed and believe whatever the doctors want you to believe. You take the red pill, you stay in Wonderland, and I show you how deep the rabbit hole goes." "
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Old 04-22-2018, 15:19   #10
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Hypoglycemia is certainly a risk for those taking insulin (type 1s and 2s) or medications that force the pancreas to produce more insulin (type 2s). Hypoglycemia is generally defined as a BG level below 70 mg/dL (3.9 mmol/L). There can be a differences between type 1 and type 2 at this point, due to a loss of hormones for type 1s that would call on the bodies natural defense system to react to lowering BG levels. Severe hypoglycemia has been said to be when BG drops below 54 mg/dL (3 mmol/L) and where symptoms may first start appearing for those that are not hypo unaware. Beginning counter measures at 70 mg/dL (3.9 mmol/L) and dropping would hopefully halt the drop before getting to that point.

I know I've seen something somewhere that listed what happens at different levels of BG as it lowered but haven't been able to find it this morning, but I found this article on Beware the Perils of Severe Hypoglycemia interesting.

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Think I've had this since 2003. Told I was Type 2 lean on 2/13/12.
a1c 8.8 (8/2011) 5.2 (07/2019)
TC 183 LDL 102 HDL 65 TG 52 (02/20/2020)
Supplemental vitamins and electrolytes
64 YY Love the LCHF diet. The cheese goes well with my whine

updated 02//20
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