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Discussion Starter #1 (Edited)
Hello,

I've been on Meformin (2000mg), and Glipizide (2.5) since August of 2010. I was given glipizide because my A1c was 7.0 and eating VLC didn't seem to make enough of a difference.

My A1c has wavered between 6.3 to 5.9 over the last 2+ years. Lately, my numbers have been rising to 120s-140s fasting, so I've decided to try out the ketogenic diet and attempt the 80/15/5 ratio. WITH the drugs, my numbers plunged to 80s and 90s almost overnight. However, with the plunge, I was getting dizzy and felt ill. It felt like a low, even though the reading was 93 at the time. But that scared me, and I decided to go without the glipizide this morning.

Today's numbers:

Wake-up - 106
After breakfast - 108
After lunch 137

That's a pretty high after lunch number. When on glipizide, my numbers would go down after lunch and definitely after dinner. But I am exhibiting the same higher numbers prior to taking glipizide.

So my question is this.. if you are doing the ketogenic diet, are you able to really stay off the meds and maintain good numbers or are meds are definitely necessary? I am being really cautious now because last night scared me. I am thinking of probably doing this for a week to see if the number shoot way up or if it maintains.

Thoughts??

(oh and what I ate.. Over the weekend, breakfast has been 2 eggs scrambled with 1T butter and a slice of cheese and bologna, lunch and dinner chicken soup. Today's breakfast was 2HB eggs with 1T mayo with coffee with both 1T heavy cream and 1T coconut oil, and lunch was curry chicken (drumstick and thigh) with sauce made from 1TB diced onions, coconut oil and coconut milk with curry powder spice)

Thanks!
 

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Well, my thoughts were that I didn't want too many variables. I threw the Metformin in the trash on day 3 and started learning everything I could about diet, metabolism, etc. It is now 3 years and zero medications and all-normal blood sugar with no symptoms or problems of any kind. You can see my initial state in my signature.

Another thought for you that in the short term, even up to a year, readings of 180 or 200 are no real danger. The only way to really know if diet alone works is first of all establish what the best diet for controlling blood sugar is in your case and then give a GOOD test - at least 6 months to a year - before giving up.

If you scramble up diet, exercise and diet how will you ever know what actually worked? It will be MORE difficult to disassemble it all later on.

Also, diet is a lot of feedback and not very precise, so my feeling was that the only thing drugs would do is that I would just do enough with diet to get good numbers. That doesn't really give you the feedback you need or guide you to what can really be done with diet alone.
 

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I would cut down on the Glipizide and see where that puts you. As Smorgan suggested, higher numbers should be okay until you figure out how low you can go with just the Metformin and diet.
 

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Discussion Starter #4
Thank you for your responses. I guess it will take some time for my system to adjust. Will see how it goes after a while. And it's good to know that some high numbers is not worrisome, so long as it is not consistent? Keeping that 80% fat is rather hard sometimes. But it is AMAZING how little hunger I feel. I have to remind myself to eat. :)
 

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My thoughts are if the Glip was working you got on board insulin it just doesn't want to come out and play. There are other things that will help your body release insulin and slow down your liver. Dandelion Root Extract, Milk Thistle, Green Coffee Bean extract. When you eat your body is suppose to send out a signal from your gut GLP-1 that tells your pancreas to release insulin and for your liver to calm down on the glucose. Those supps will aid in that.
 
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Discussion Starter #6
My thoughts are if the Glip was working you got on board insulin it just doesn't want to come out and play. There are other things that will help your body release insulin and slow down your liver. Dandelion Root Extract, Milk Thistle, Green Coffee Bean extract. When you eat your body is suppose to send out a signal from your gut GLP-1 that tells your pancreas to release insulin and for your liver to calm down on the glucose. Those supps will aid in that.
I will give your suggestions a try, thanks!!

Although, I am slightly worried since the numbers are slowly creeping up again. :( Wake up is at 114, have coffee with coconut oil (2T), plus heavy cream (1T), and then a 1 egg, egg salad with just 1T mayo about 2 hours later. At 1hr check, it is 152, then 2hr 136. The total carb count for breakfast is 2g of carb! :( Maybe my pancreas is just dead or barely functioning at this point?

Will keep at this for longer, but kinda worried about higher numbers. I guess it is to be expected since I am not forcing pancreas to squeeze out more insulin, but still very disconcerting.
 

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I don't think your pancreas is dead its just not getting a strong signal to release insulin. If you like to experiment a bit with yourself try putting about 4grams of real sugar in your coffee and additional art sweetener. I drink a cup everyday with 4g of sugar, 4 packets of art sweetener. It provides me with a strong GLP-1 release, which leads to lower BG levels. Check your BG about 10-15 minutes after you drink the coffee, then again in about 30 minutes to see if its coming back down.



I will give your suggestions a try, thanks!!

Although, I am slightly worried since the numbers are slowly creeping up again. :( Wake up is at 114, have coffee with coconut oil (2T), plus heavy cream (1T), and then a 1 egg, egg salad with just 1T mayo about 2 hours later. At 1hr check, it is 152, then 2hr 136. The total carb count for breakfast is 2g of carb! :( Maybe my pancreas is just dead or barely functioning at this point?

Will keep at this for longer, but kinda worried about higher numbers. I guess it is to be expected since I am not forcing pancreas to squeeze out more insulin, but still very disconcerting.
 
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You know, going on insulin isn't the end of the world either and may be preferable to using a med that stresses the pancreas. In your place I'd keep the Metformin and go on low doses of insulin while staying low-carb, then see if I could reduce the insulin over time.
 

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Discussion Starter #9
You know, going on insulin isn't the end of the world either and may be preferable to using a med that stresses the pancreas. In your place I'd keep the Metformin and go on low doses of insulin while staying low-carb, then see if I could reduce the insulin over time.
I asked my doc about possibly switching to insulin and was rejected. I don't think she is willing to switch it unless my numbers are bad. :(
 

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peeka73 said:
I asked my doc about possibly switching to insulin and was rejected. I don't think she is willing to switch it unless my numbers are bad. :(
Well remember its not your doc at risk for complications. We have to be our own strongest advocates when it comes to our care and treatment. If my old pcp knew even a quarter as much as I do about how my body works with diabetes I would have listened. But since he gave me textbook responses and treatment, well lets just say I'm glad he retired before we had those conversations.

You need to get your doc on board to what you consider a viable plan, or he better have good reasons why not because a foot hurts no matter whose backside it hits.

Sent from my iPhone
 

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At the urgent care center, they added glipizide to my meds since the metformin wasn't bringing my bg <200 (this was in the beginning.) When I saw the endocrinologist, he said it was okay short-term, but he wanted me off of it. It stimulates the liver to produce more insulin, which the liver has a finite capability of doing, so borrows from the future. I dropped it in a couple of weeks.

If I was no longer able to control my diabetes through diet, or diet + met, I'd definitely go to insulin. Why not? That's what I'd ask my doc. And am with David - she should have a very good explanation or respect your desired approach.
 

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Discussion Starter #12
My doc felt that the meds were working, that the little dose of glipizide (2.5 1x a day) was enough to keep things in check. She didn't want me to get onto insulin because she believes it will be difficult to monitor. But did say that if I am still concerned, she will refer me to an endocrinologist for another opinion. I am not sure about the endo route. Will they even take my concerns seriously? With an A1c of 6.2, which I am unhappy about, seems to be a happy number with most physicians. I just get that awful feeling they will just shoot me right back to square one.

Not sure if this is an acceptable question to ask, so I apologize in advance if this isn't.. but does anyone here live in MD and can recommend a good endo? I live in the Baltimore county area. If I am going to get a second opinion with an endo, it would be easier with one that would be sympathetic to my concerns.

It does seem that unless I keep a very tight control on what I consume, my numbers sky rocket. And even so, I am not getting good numbers.

Typical bfast: 1-2 eggs with mayo, coffee with coconut oil and heavy cream. (on weekends, 2 eggs scrambled with 1T butter, 2 strips bacon)

Lunch: Usually homemade curry, roast chicken. No more than 3oz, more than that, numbers shoot WAAAAY up.

No snacks, since this diet makes me not hungry.

Dinner: Cream of chicken soup with shredded chicken, made with 1 package of creamed cheese, cup of heavy cream, 1 stick of butter. I usually eat about 2cups of this and add a cup of spinach to the soup when reheating.

And my numbers are usually in the 140-160 range. My numbers typically rise 20-30pts after eating. BUT, once supplementing with green coffee extract and milk thistle, it went down about 10-20pts 2hrs after eating. But if I wake up with 140 or 160, my numbers remain high all day.

SO. While it is nice the supplements help, and VLC eating (usually 10-15g of carb ALL day).. I don't think I can sustain this without additional medicinal help. Until I can figure this out with my doc or possibly another doc, looks like I might have to use glip for a while. Keeping numbers this high can't be good for me in the long run. What I am noticing is, it increases by 10-20 every day. :(

While the green coffee extract made a difference, I do have to point out.. how do you guys afford it? It costs 20 a bottle! :eek:

Thanks to all for your encouragement and help.
 
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If the green coffee bean helped, I'm glad it did, thought it might, go for the dandelion root extract, one or two with every meal, it's a lot cheaper
 
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