Just got Type 2 diagnosis yesterday

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type2inCT Posted: Thu, Jun 28 2012 8:10 AM

I just got diagnosed with Type 2 yesterday. My A1C is 8.9 and glucose is 270. Doc wants to immediately put me on meds. I'm overweight and will focus on losing weight through diet/exercise. My question is should I avoid the meds and focus on losing the weight to see if that works on its own?  Or should I take the meds and still lose the weight and hopefully not need to stay on the meds long term?  I am still in shock over the diagnosis but I'm focused on learning as much as possible and focus on diet and exercise to manage this. 

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amrad replied on Thu, Jun 28 2012 5:54 PM

I would take the meds, and also focus on losing weight. It is possible after losing the weight and being on a healthy diet you may not need to be on meds, only time will tell.

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RobertIA replied on Thu, Jun 28 2012 7:16 PM

I believe taking the medication and also using diet and exercise for weight loss is an excellent idea.  Before accepting the medication have a talk with the doctor about losing the weight and exercise and if you succeed, will the doctor allow you off medications.  If he says yes, then accept the medication and get with the diet and exercise.  Most oral medications are not weight neutral so exercise is necessary.  Metformin (and preferably the ER (extended release) will cause less stomach problems) is weight neutral. 

If the doctor says no to allowing you off medications if you prove you can manage with diet and exercise, accept the medications and seriously consider finding another doctor that will agree.  Many patients have had success this route so take it seriously.  The reasoning for taking the medications is to assist in bringing your diabetes under excellent management as soon as possible to prevent further damage and to minimize complications.  Your readings indicate that damage and the onset of complications could well be happening.  Therefore, management of your blood glucose should not be neglected now.

Without knowing which medication(s) your doctor is wanting to prescribe, I cannot offer further suggestions.  Do not rule out insulin for quicker management of your diabetes.  Even insulin will cause weight gain initially unless a sharp reduction in carbohydrates is done in the beginning.  The basis for this is that your body now can store the extra blood glucose as fat instead of passing it in your urine.

Type 2 (10/2003)   Lantus and Novalog   Now added Metformin      Retired

 

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type2inCT replied on Thu, Jun 28 2012 8:30 PM

Thanks Robert. I did ask my Doc those questions and he said if I can get my A1C under 6 for a period of time and I lose weight, I can get off metmorfin. My BG was 320 this morning but went to 196 after dinner. I'm going to measure my BGs often, exercise and eat better and see how I do. I'll also take metmorfin every day as well. I'm 39 yrs old and really hope to live a long time.  Wish me luck!

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RobertIA replied on Thu, Jun 28 2012 9:33 PM

Hopefully you will be able to afford the extra testing strips as you insurance company will restrict the number per day they will reimburse you for. 

Your fasting blood glucose (FBG) reading goal should be between 80 mg/dl and 100 mg/dl (milligrams per deciliter).  What is called the dawn phenomenon (DP) may make them higher for a while until you have your exercise regimen is in effect for a while.  This, the DP, is because your liver dumps glucose into your blood stream to provide energy to wake you up and start the day.  Best to test as soon as possible upon waking as your liver can continue to dump glucose until your metformin settles in - approximately one to up to four weeks - for full effect.  If by cutting carbohydrates you can get your FBG readings under 140 mg/dl then you will know the metformin is working.  Eventually, your goal for postprandial (after meal readings) at the one hour after eating should be 140 mg/dl and at the two hour mark hopefully you will be at 120 mg/dl or lower.   You should strive to have preprandial blood glucose readings (before meal) at or below 100 mg/dl. 

Do not be surprised if you do not achieve these goals the first few weeks considering the current readings you are getting.  Be careful about eating at odd times and severely limit anything before bedtime as this will tend to drive FBG readings up.

Type 2 (10/2003)   Lantus and Novalog   Now added Metformin      Retired

 

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