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Odd problem, may have lost a little too much weight...
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adaptomom posted:
Hi, I realize this may be an unusual problem but...I was diagnosed type 2 10 months ago based on a fasting glucose of 136 and an A1C of 6.2. I was put on metformin 500mg 2x/day and worked with a nutritonist who advised limiting carbs to 3-4 exchanges/meal and 1-2 exchanges/snack. Following this regimen I have lost 53 lbs. I am 5'8" and weighed 180 lbs at diagnosis, now I am 127 lbs. I feel very healthy (really didn't think I felt bad before diagnosis; no thirst, fatigue, etc., but I have to say I do feel much better now), but really don't think I should lose anymore weight. At my checkup this month my A1C was 5.9, my Dr. also checked my thyroid which was within normal limits.
I would like to put on 5-10 lbs, but want to protect my glucose levels (daily testing range: 84-108). Anbody have this problem? If so, any suggestions?
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phototaker responded:
You sound like you've done wonderfully. Maybe "possibly" think about lowering the Metformin. I am not on medicine, and do it by diet and exercise, alone. I'm an A1C of 5.9. It really depends on how well your pancreas is doing, how much you exercise, and how closely do you follow a healthy food plan. How tall are you?
I'm not suggesting being off medicine is the answer, but if you're getting too thin, asking your doctor about possibly lowering the dose a little.
 
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flutetooter responded:
Check out your height and weight on Web MD BMI Plus Calculation (put all that in your "Google" slot) and you will probably find that you are at the lower end of the healthy range in weight even though your A1c could be a tad lower. A1c 5.7 is, I think, the bottom of the "prediabetic range", with 5.6 being the top of "Normal". You will never be really normal, just Diabetic, in control, because the minute you don't watch everything you eat, stop all your meds, and quit exercising, your numbers will go up again. You are doing great!

That said, try to get those A1c numbers down just a bit more before you stop your metformin by cutting back on carbs only, and INCREASING just a bit your lean protein and good fats (olive oil, nuts (especially walnuts), salmon and other fish, avocados (also high in carbs, so just have a spoonful, and hummus. That should lower your A1c but not your weight, because your total calories will be increasing.
If at first you don't succeed, try, try again!
 
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DavidHueben responded:
Adaptomom:

I agree you should not lose any more weight. While your BMI is 19.8 (at the low end of the healthy range), the BMI is not always a complete story.

I am currently 5'8" tall and weigh 167 pounds (male). My doctor wants me to gain some weight (about 8 pounds). That still makes me technically "overweight" according to the standard calculation. Neither he or I could care less about a standard BMI calculation. It does not take into consideration such things as body type, age, level of physical activity a person is able to engage in, or other medical conditions.

Your A1C is perfectly fine as long as it is below 6.0%, according to my doctor. But, as was stated, it will require watching. A normal non-diabetic A1C (according to the AACE clinical standards guidelines) is below 6.4%. However, regular lab testing is suggested, because it could be indicative of being pre-diabetic.

I think you have made good progress and have little to worry about. Just watch what you eat, gain a few pounds, and keep an eye on the A1C.

Have a good holiday weekend!!!

DMH
"We sleep soundly in our beds because rough men stand ready in the night to visit violence on those who would do us harm." - Winston S. Churchill
 
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Haylen_WebMD_Staff replied to DavidHueben's response:
And in case anyone is interested, click here for a link to a BMI Calculator (thanks Flute)

http://www.webmd.com/diet/calc-bmi-plus
 
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betaquartz replied to Haylen_WebMD_Staff's response:
Under the guidelines for BMI, at any site, including yours, my weight is at the middle of the chart for healthy. When married I was 125 and looked like a bone rack. Now at 150 people say I look skinny. When I was losing weight, I hit 145 because I tried to measure calories to match my activities. In the end I started eating until I felt sated not full. My weight now balances at 150 to 152 with weigh ins every day. I know that I should not go below 150 with my current activity levels as I would be visibly too thin, maybe not statistically. At 5'9" you don't see many men 62 with 30" waists, 42 inch chests, weighing in at 150-no no fudging the numbers here.
 
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adaptomom replied to betaquartz's response:
Thank you all; I'll try increasing my lean protein intake (not a big fish eater, but I'll try. I do eat a lot of chicken, and I could do the walnuts without a problem. The different opinions on the A1C are a little confusing. At my visit my Dr. did talk about the possibility of decreasing my metformin, but when her nurse called with the A1C results she said I was to continue the current dose of metformin.
 
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phototaker replied to adaptomom's response:
I'd go with what your doctor says, and get your A1C down a little more, then start tapering off your Metformin. It's a struggle for me to keep my numbers lower. I have no medicine to help me. If I eat too many carbs at once, my numbers go up. You might want to keep on the medicine, if it's working well, and then decide what to do if you get your numbers down more.


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