If this post had a title it would be:
"Dropped Januvia, Blood Sugar Control IMPROVED"If you remember from my initial post in this thread, back in early August, after 4.5 months of healthy eating, I unilaterally stopped taking Januvia -- the expensive patented diabetes medication. (I was, and am still, also taking Metformin.)
When I stopped taking it, it was partly because I was dead broke and didn't have the 200 bucks for another month of pills, and partly because my blood sugar numbers were looking so good, I honestly didn't think I needed it any more.
I saw my doctor a month later, in late August. He liked my blood sugar numbers -- my A1C was 5.5 and my mean plasma glocose was 119 -- but he was clearly very skeptical that this would persist without the Januvia. However, he cheerfully "allowed" me to continue not taking the Januvia "if you'll come back and see me in six weeks to get another A1C taken."
Well, I did, though due to rescheduling it stretched to almost two months. But I saw him yesterday regarding blood labs taken on October 20.
Results:A1C 5.4 (down .1)
Mean Plasma Glucose: 115 (down 4)
In other words, my blood sugar numbers continued to improve!
Well, that's no surprise to
us. But my doctor was clearly not expecting that result. It also caused him to look back and my charts and notice the extent of my recent weight loss. He made a good show of encouragement and urged me to keep it up, too. But still it was funny when he said "I guess we'll take the Januvia off your chart, then..." His tone of voice said "I can't believe I'm hearing myself saying this, I've never done this before..." Being fair, I go to an extremely rural/poor clinic, where the expected course of diabetes progression is something like:
Step 1: prescribe metformin
Step 2: prescribe more expensive diabetes drugs
Step 3: shit, now the patient needs insulin too
Step 4: double shit, the patient has ulcers
Step 5: woeful day, time for patient's first amputation!
Step 6: patient is going blind
... and all downhill from there.
He was also complimentary about my blood pressure, but I didn't make a lot of progress convincing him to cut back on those three meds. I did lay some groundwork though for next time.
It turns out that he'd also ordered a lipids panel on me, which I was not expecting. In the fifty days between tests:
1) My total cholesterol went up ten points from 142 to 152
2) My HDL went from 25 to "less than 15"
3) My LDL went from 75 to "N/A"
4) My triglycerides went from 211 to 200
As
I mentioned here, my doctor couldn't explain why we didn't get an LDL number back, but he clearly thought the lack of a number likely indicated a low result. He said the total number "is still real good" even though it went up a bit, he said "when your other numbers are good I don't worry too much about the low HDL, though you should exercise more", and then he said "with these other numbers going down, you're doing just fine."
As for me, I was just pleased to see the trigs continuing to drop. I find the LDL business puzzling, but my diet's been good so I don't really care. The slight increase in total cholesterol is a surprise, but then again, I don't know what the daily range of variability or the lab margin of error for this test is, so I'm not proposing to worry about it unless it becomes a trend. (I'm scheduled for another checkup, meds review, and blood labs after Christmas.) And as for HDL vanishing off the bottom of the chart, I still find
Dr. McDougall to be very persuasive on that subject.Edited to add: Isn't it funny how persuasive we find people who are telling us what we want to hear?