Posted on 03/06/2018 10:41:01 AM PST by upchuck
The American College of Physicians (ACP) has issued new guidance on managing type 2 diabetes -- including relaxing the long-term blood sugar target called hemoglobin A1C.
The A1C is a blood test that gives doctors an estimate of your blood sugar level average over the past few months. For most adults, the American Diabetes Association recommends a target A1C of below 7 percent. This goal may be altered based on individual circumstances.
However, the new ACP guidance suggests that A1C should be between 7 and 8 percent for most adults with type 2 diabetes. For adults who achieve an A1C below 6.5 percent, the group suggests stepping down diabetes treatment to keep that level from going even lower.
The American College of Physicians, which is a national organization of internal medicine doctors, also says that management goals should be personalized based on the benefits and risks of medications, patient preference, general health status and life expectancy.
And, though the doctors' group has relaxed the suggested A1C targets, that doesn't mean type 2 diabetes isn't a serious problem.
"These changes should in no way be interpreted as diabetes is unimportant," said Dr. Jack Ende, ACP's president.
More than 29 million Americans have diabetes. Over time, high blood sugar levels can lead to vision loss, nerve problems, heart attacks, strokes and kidney failure.
"Diabetes is such a prevalent problem, and there are so many guidelines and conflicting information out there, we wanted to do an assessment that would give our members the best possible advice," Ende said. "Also, A1C targets are being used now as a performance measure."
(Excerpt) Read more at cbsnews.com ...
Different people react differently to treatments and diets. A family member was switched from Januvia and Metformin to Janumet and that seems to work better. But diet remains important.
Severely limit or stop potatoes, grains, fruits, (except berries), legumes, and, of course, zero sugars except sugar alcohols; increase animal fats, moderate your protein intake, and report back in 6 months. (Contrary to what we’ve been taught for 60 years, fats are NOT unhealthy -— carbohydrates are.) Your cholesterol will be normal, as will your blood sugars. Or....just keep doing what you’re doing; your body apparently works differently than most. :)
As a retired RN, I detest newer drugs. Metformin has been around for a while, and is relatively safe, but I cringe every time I see a commercial for new drugs, especially when they nonchalantly start listing all the side effects, “including death”. Naturally, they can’t ALL be bad, but it usually sounds like the cure is worse than the disease.
Coming from a family of natural/organic lifestyle types, I’m also of the admittedly cynical opinion that clinical norms for every damned thing have been lowered so that pharma and many docs can maximize profit by having as many people as possible on multiple meds and having tests all the time-the more invasive and costly, the better. The high carb, grain-based diet recommended for so long has caused a spike in obesity, diabetes II and other related diseases-and every new drug out there is a lawsuit cash cow in 2 years or less-so there is real harm being done-but it is profitable to dispense drugs and treatment-encouraging people to eat fresh, healthy food-not so much...
I live in a rural area, eat the way I did as a ranch kid-no processed food, no grains but occasional brown rice, no refined or added sugar, a few carbs from fresh veggies and fruit-but not potatoes-they are almost nutritionally neutral-just empty carbs. I eat fresh, home grown or local veggies, organic, free range and grass fed meat/poultry-no margarine, refined oils, etc either-just butter and natural oils and fats.
I’ve never used prescription or illicit drugs other than antibiotics a couple of times in the far past-I do use natural remedies and supplements. I drink wine sometimes and smoke 2-3 cigarettes some days-I hike and work out 2-3 times per week with weights and resistance.
I’m in my 60’s, have a physical job and work 5-6 days per week when business is good-I weigh the same 106-108 lbs as I have since 17-so I guess I belong to the borrowed time club, too...
Thanks for posting!
Dr. said I was pre- diabetic, so that plus not being able to have wheat or dairy will help me do Atkins.
My husband has bad reactions to most drugs so the list of ones he can take is small. Thankfully he does not need to take anything but a baby aspirin as a daily medication.
What does all this mean on a standard glucose meter?
Straight from my med record Diabetes type 2:
Component Your Value Standard Range
Hemoglobin A1c 5.9 % 4.5 - 6.2 %
Hgb A1c 4.0-6.0 Non-diabetic %
The American Diabetes Association considers a result of Less Than 7% to be the goal of diabetic therapy. When results are consistently Greater Than 8%, the ADA suggests reevaluation of the treatment regimen. The testing method used is certified traceable to the Diabetes Control and Complications Trial reference method.
Estimated Average Glucose 123 mg/dL mg/dL
The ADA considers an eAG result of Less Than 154 mg/dL to be the goal of diabetic therapy. Estimated Average Glucose calculated from hemoglobin A1c by use of the ADA recommended formula.
My doctors were in shock over my last A1c ..... 5.9. Last year during an 8 month period, I lost 50 pounds. I feel close to how I did in my 40s. I plan to lose another 30 pounds over time. My family doctor and heart doctor were very pleased.
I am very carful with carbs...Thanksgiving was a tough time.
My secrets: I eat baked chicken almost every day...even for breakfast. I eat lots of soups and salads that I make for myself. I still eat steak and 1/2 of a small potato once a week, and pork chops on Wednesday. I have always been a meat, potatoes, gravy, biscuit and bread kinda guy. Most of those days are gone, but I still get to treat myself from time to time. ;>)
I keep moving....heck, I bought a new Stihl 661 36” chainsaw a couple weeks ago, and I have been making trees into lumber....at 69 years old...70 in October. I do my best to stay off the computer. When I am done milling the 35 logs I have on the ground, I’ll go play on our Kayak. When not playing on the Kayak, I’ll go for long drives in my Z06 Corvette.....it too can keep me moving. LOL Fishing, camping, shooting on my range, photography, playing in the dirt on my John Deere tractor.....I rearrange entire yards on our property.....it doesn’t seem to matter as long as I stay busy.
Last winter we remodeled most of the interior of the main house...now there is T &G knotty pine all over...we love the wood feeling. This winter we remodeled and partially rebuilt most of our 3 stall garage.
I have more ideas on keeping me busy than I have years left to live....but it became fun.
Damn the diabetes, full steam ahead.
Chickens fear me.
Can’t agree with you more.
A1C of 6.5 means significant excurions north of 120. Any excursions north of 120 are harmful to pancreatic beta cells and other cells besides.
Pancreas and other organs are happiest when glucose hums along south of 100, preferably south of 90.
What ever you do, do not screw around. I was told I was pre-diebetic and two weeks later I was diagnosed as diabetic and started on insulin and Metformin. Do not drag your feet.
Only because the ‘official diet’ includes so many carbs that medication to ‘cover that’ becomes necessary.
If it makes your sugar go over 120 post prandial. Don’t eat that.
“nonchalantly start listing all the side effects”
That certainly will get someone’s attention, if nothing else does-especially the way the actors are all smiles and happy music playing while a cheerful voice says “respiratory infection, flu, possible serious bleeding, liver problems that may result in death”, etc. And then there are those personal injury law firm commercials saying to call if you have taken one of those drugs...
My guy does only supplements like me, but was still eating a good bit of processed food and sugar-he actually thought pumpkin bread from the supermarket bakery was “healthy”-until I asked him to read the nutritional info on the box out loud-he now eats as paleo as I do and has more energy-he works outside the county 3-4 days per week to work...
Google is your friend :)
“Normal” A1C is 6 or below. It used to be 7. After overnight fasting, blood sugar should be below 175.
Carbs are clearly the villian. Metformin works and has a long track record.
Treatment depends on the reason for high blood sugar, mostly its genetics, then, a high carb diet, then, a lack of exercise.
Muscle, other than insulin, directly metabolizes blood sugar. A good diet and enough exercise nearly always ends type II diabetes.
Lowering stress lowers insulin resistance.
Good dental care is essential, any gum disease raises insulin resistance, gargle a lot.
Last deployment I caught a bug in Yemen, MRSA in my blood. Beat down my liver and pancreas.
A1C was 13, blood sugar was a 545. I was barely alive. Gave me an IV 3 liters of saline.
I started walking, then running, then added 2 a days.
6 months my A1C was at 7, blood sugar around 150. My pancreas has recovered somewhat, probably the best I can expect.
Doc says with continued exercise I will live a normal life and may not even need metformin.
Eat well and PT every day.
Sounds similar to me. Mine was 13.9 when I was diagnosed. The ‘official diet’ 15 years ago was basically zero fat, little protein and the rest carbs.
Unsurprisingly my number went UP when I started the diet because I cut out fat and protein and replaced them with carbs. (even ‘healthy whole grain carbs’ will jack your sugar, simple biochem 101).
Was shouted at by the MD and put on metformin. He actually accused me of LYING about my food consumption.
Then I found Protein Power and Atkins. Within a year my A1C was under 5. Yes, UNDER 5. It’s stayed between 4.9 and 5.2 since.
I’ve found that as I get older large amounts of protein will jack my sugar more than I like. I don’t like my sugar ever getting over 100 if I can help it. A steak will send it to 110 or 120ish. So now it’s a half a steak and some homemade buttermilk ranch dressing on a salad.
If it makes your sugar go up. DON’T EAT THAT!
Or just have one taste. Unless it’s a trigger food, then just don’t have it in the house at all. If you MUST have it, eat it somewhere else and leave any leftovers there!
I’m not ‘cured’ however. Carbs will still jack my sugar in a dose dependent manner. Even after I’ve lost 80+lbs.
These are excellent for breakfast. I make them in the 1cup pyrex storage bowls. Perfect size. Split them, toast them, schmear one pat of butter on each half and enjoy with a piece of bacon or a one egg omelette. The ones made with cashew butter are the best IMHO but making them with peanut butter is good too.
https://www.sugarfreemom.com/recipes/low-carb-paleo-english-muffins-grain-free-gluten-free/
I ditched metformin a couple of years ago. It’s likely a mitochondrial toxin.
There are bajillion recipe sites like these https:
https://peaceloveandlowcarb.com/
https://alldayidreamaboutfood.com/recipes-index/
etc.
The ‘English Muffin’ recipe link I posted in a previous post is a standby at my house. SAMS has bobs redmill almond flour in 3lb bags for about 15 bux and that goes a long way. I also make them in the 2c pyrex bowls and we use them as hamburger buns or for chicken or pork sandwiches. Hubby makes ‘egg mcmuffins’ with them by cooking his egg in the same size bowl.
Lots of the recipes use artificial sweeteners. Those are ‘OK’ if you’re looking to squealch a craving but long term will, IMHO, still leave you looking around for something sweet.
A good article posted just a few days ago right here on FR:
https://www.freerepublic.com/focus/f-chat/3636132/posts
“Is Keto the Cure for Type II Diabetes”
Pre-diabetes.
I have it and already have symptoms of diabetes such as diabetic neuropathy.
I am currently trying to turn it around with diet, etc.
But my first question I had was the same as yours. It sucks.
Yep metformin. Hoping to get off of it next time
Fruits? Whole grain? Oatmeal? Legumes like beans and peas? Black eye peas and unsweetened corn bread are like a basic food group to me.
I do pretty well on NO WHITE STUFF. None, period as a near obsessive goal. It is hard to find the hidden white stuff but it is in lots of our prepared food.I
I allow myself maybe 4 ounces of red wine, not too sweet, maybe twice a week of at all.
Clarify if I have misread your suggestion please. I’m a little different but not that much. I also just cold turkey quit my chewing tobacco habit of 50 years over a year ago. It isn’t hard at all. You just quit buying it.
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