Type 2 Feeling confused ….cocktail of diabetes medication…

[Molly56]

My partner (Type 2) was started on insulin back in February and is currently on Novomix 30 taking 28 units in the morning and 28 units before evening meal. In the morning he also takes 500mg Metformin (x 2) and Gliclazide 80mg ….plus the same dose with evening medication…
…other medication is also taken for high blood pressure (felodipine, Ramipril, bendroflumethiazide, doxazosin) and for neuropathic pain (duloxetine)

Yesterday the diabetic nurse suggested starting him on a new medication for diabetes…unfortunately I was not at appointment and he couldn’t remember name but from description given I suspect this is Forxiga (Dapagliflozin)

Just wondered if anyone else is on a similar cocktail of medication for Type 2 diabetes….my concerns I guess are that it seems a lot of different medications all trying to do a similar job and it will be difficult to know which ones are being effective……and which ones are perhaps acting against others and having unwanted side effects..

I would have thought that moving on to insulin would have meant less other diabetic oral medication but it seems the health professionals are just adding in more and more ….I assume they know what they are doing…

Are there any questions that I (or he) should be asking…

 

[Indy51]

Unfortunately, unless or until your partner decides to take his own diabetes and diet seriously, this is probably the path he will be following to the end. Medications can only do so much without the patient being willing to adapt and make lifestyle changes. And each added medication will bring its own share of side effects.

I still think the best thing you could do is sit him down and make him read Kman's thread "Terminal and Scared" because that's the path he's on.

 

[lessci]

I'm on Metformin, Sitagliptin and Forxiga, was on Gliclizide but caused weight gain and I'm already carrying extra weight. I'd be concerned at staying on the Gliclizide and Forxiga as they both can cause hypos, and with the insulin as well.... Just keep a close eye on their BG levels

 

[AndBreathe]

My partner (Type 2) was started on insulin back in February and is currently on Novomix 30 taking 28 units in the morning and 28 units before evening meal. In the morning he also takes 500mg Metformin (x 2) and Gliclazide 80mg ….plus the same dose with evening medication…
…other medication is also taken for high blood pressure (felodipine, Ramipril, bendroflumethiazide, doxazosin) and for neuropathic pain (duloxetine)

Yesterday the diabetic nurse suggested starting him on a new medication for diabetes…unfortunately I was not at appointment and he couldn’t remember name but from description given I suspect this is Forxiga (Dapagliflozin)

Just wondered if anyone else is on a similar cocktail of medication for Type 2 diabetes….my concerns I guess are that it seems a lot of different medications all trying to do a similar job and it will be difficult to know which ones are being effective……and which ones are perhaps acting against others and having unwanted side effects..

I would have thought that moving on to insulin would have meant less other diabetic oral medication but it seems the health professionals are just adding in more and more ….I assume they know what they are doing…

Are there any questions that I (or he) should be asking…

One can only assume that his levels aren't coming down as you hoped since starting on insulin?

 

[Molly56]

I'm on Metformin, Sitagliptin and Forxiga, was on Gliclizide but caused weight gain and I'm already carrying extra weight. I'd be concerned at staying on the Gliclizide and Forxiga as they both can cause hypos, and with the insulin as well.... Just keep a close eye on their BG levels

@lessci ...thank you for your reply...
He has not been started on the Forxiga yet but assume that when he does he will drop the Gliclazide...he also carries extra weight and has in fact put on a stone since starting the insulin....I assume from reading that this is a known side effect of insulin. When he started on the insulin he was told to drop the gliclazide but this has since been added back into the mix though at a lesser dose than the maximum he was on before.....am not sure what the reasoning was behind this move.
My assumption is that the Forxiga is being offered as an alternative to the Gliclazide to combat the increase in weight....I do have concerns about the possibility of hypos which I have discussed elsewhere and hope that this new medication (if offered) doesn't cause too many problems in that respect...

 

[Molly56]

Unfortunately, unless or until your partner decides to take his own diabetes and diet seriously, this is probably the path he will be following to the end. Medications can only do so much without the patient being willing to adapt and make lifestyle changes. And each added medication will bring its own share of side effects.

I still think the best thing you could do is sit him down and make him read Kman's thread "Terminal and Scared" because that's the path he's on.

@Indy51 ...thank you for your reply....
As an update my partner is taking his diabetes and diet far more seriously compared to six months ago and has made considerable progress in looking at what he is eating and trying to eat the right things / not eat the wrong things....he now looks at the carb content of food when purchasing and is much more aware of what he eats....he has recently taking to eating more salad and has virtually given up potatoes and bread...I only cook potatoes for myself now......he doesn't drink alcohol and has given up fizzy drinks....all he drinks is water and a daily cup of coffee...there are still a few poor food choices that he knows he shouldn't be having (at least he recognises this) but on the whole I would say that it is much improved...

@AndBreathe Since starting on the insulin bs levels have come down from the high teens he had before....morning levels are generally under 10...evening levels are still in the low to mid teens...but lower than previously...

Activity levels are unchanged and is as before...relatively inactive ....but other than that I do feel that some progress is being made...

I do still feel that the cocktail of medication is not necessarily helping as it is difficult to identify which bits are working and which are not....perhaps naively I thought that starting on insulin would mean less oral diabetic medication but this doesn't seem to be the case...

 

[CollieBoy]

@Molly56 Congrats to your partner on making a start.
Not a criticism but a hopefully a helpful suggestion.
You say that he is trying to give up potatoes & bread, but you have not. When I cut these out, it helped me tremendously when the rest of the family cut theses out too (at least in my presence). Just a little hint

 

[Enclave]

When I went LCHF the wife copied my diet completely. Nothing I could not eat was in the house, we eat together with the same food. This made LCHF easy for me as I was not looking across to forbidden foods. Your partner may find mealtimes easer if you eat the same !

 

[donnellysdogs]

Have a look at the NICE guidelines for T2 drugs and how they recommend patients should be treated... Ie if metformin fails.. Then glic.. Then mixtard etc...
One size doesn't fit all though.

My partner after 18 years followed my low carbing that I have done all my life. It never bothered me that he didn't eat the same as me...

I have intolerance to certain foods but if he wanted to eat it (as he has previously).. Well its his life....we are all individuals..why should he eat the same as me?? As much as it could encourage your partner, adults really should be able to make their own choices in life...

 

[Enclave]

Have a look at the NICE guidelines for T2 drugs and how they recommend patients should be treated... Ie if metformin fails.. Then glic.. Then mixtard etc...
One size doesn't fit all though.

My partner after 18 years followed my low carbing that I have done all my life. It never bothered me that he didn't eat the same as me...

I have intolerance to certain foods but if he wanted to eat it (as he has previously).. Well its his life....we are all individuals..why should he eat the same as me?? As much as it could encourage your partner, adults really should be able to make their own choices in life...

Good point, but the wife refuses to make two separate meals each dinner time .. So it was easier for both of us

 

[britishpub]

My wife says she has never felt better since she joined me in Low Carbing. She's Irish too so not eating Potatoes is like not breathing, but she loves it. Her (mild) Psoriasis has virtually cleared up as well, although we know of no clear link here.

 

[anne61]

My wife says she has never felt better since she joined me in Low Carbing. She's Irish too so not eating Potatoes is like not breathing, but she loves it. Her (mild) Psoriasis has virtually cleared up as well, although we know of no clear link here.

 

[anne61]

I am type 2 follow a healthy diet. Can't lose weight. Am onhumulig 50 mix. 60 in a morning 50 at tea. Saxagliptin and foxiga in a morning 2 x glucophage at night. I struggle with exercise due to back injury.everyone of us I different and for whatever reason we all rsact different to medications even when following a healthy diet

 

[weety]

My partner (Type 2) was started on insulin back in February and is currently on Novomix 30 taking 28 units in the morning and 28 units before evening meal. In the morning he also takes 500mg Metformin (x 2) and Gliclazide 80mg ….plus the same dose with evening medication…
…other medication is also taken for high blood pressure (felodipine, Ramipril, bendroflumethiazide, doxazosin) and for neuropathic pain (duloxetine)

Yesterday the diabetic nurse suggested starting him on a new medication for diabetes…unfortunately I was not at appointment and he couldn’t remember name but from description given I suspect this is Forxiga (Dapagliflozin)

Just wondered if anyone else is on a similar cocktail of medication for Type 2 diabetes….my concerns I guess are that it seems a lot of different medications all trying to do a similar job and it will be difficult to know which ones are being effective……and which ones are perhaps acting against others and having unwanted side effects..

I would have thought that moving on to insulin would have meant less other diabetic oral medication but it seems the health professionals are just adding in more and more ….I assume they know what they are doing…

Are there any questions that I (or he) should be asking…

Hi im am also a type 2 diabetic have been for 15 yrs im on novomix 30 insulin 70 units am, 40 units dinnertime then 90 units at night, victoza 1.8 once a day, 850mg metformin 3x Aday, . I have duloxetine, ramapril, atorvastatin, larigtine x4 aday, also the forixa and pregabalin, northristerone plus on morphine, i get no side affects but i was told im insuilin resistant. Not making enough insulin but to be honest my sugars are all over the place sometimes high, sometimes low cant seem to get them to even out .

 

[BevW]

I'm type 2 since last May (2014), up until Dec I was managing ok then last bloods said i was double what i was in Dec, not changed diet really since then, I'm low carbing, no potatoes, rice, bread, pastries, cakes, sweets, limit what fruit i have. Dr upped my metformin to 4 tablets a day (2000mg) from 2 a day, gone on 2 gliclaczide a day too, keeping a diary now of my bloodsugars, but not noticing them going down, they are mid teens or higher, not seen them under 14 since Jan. Most annoying condition when you think you are eating well and test and .... 18, sigh. Going back to Dr end July.
Obviously every one is different and what works for one person won't work on another, very frustrating though.

Funnily enough as britishpub said about his wife, my mild psoriasis has cleared up also dry skin on shins has improved.... healthy eating has its benefits, i'm size 10/12 from an 18/20 and 5 stone lighter. Obviously doing something right, my pancreas needs to realise it too.

 

[servewithmintsauce]

Hi
Not an expert here but I just wondered what else you have tried for his BP? My mum is hypertensive but she's ok on indapamide..not a criticism and I don't know your story and I know that not everyone is the same but I was just interested as to why he is on 4 meds for BP?

 

[BevW]

Maybe you should make an appointment with Dr and discuss the medications if you are worried. It does seem to be a mix of medication.

 

[Molly56]

My partner (Type 2) was started on insulin back in February and is currently on Novomix 30 taking 28 units in the morning and 28 units before evening meal. In the morning he also takes 500mg Metformin (x 2) and Gliclazide 80mg ….plus the same dose with evening medication…
…other medication is also taken for high blood pressure (felodipine, Ramipril, bendroflumethiazide, doxazosin) and for neuropathic pain (duloxetine)

Yesterday the diabetic nurse suggested starting him on a new medication for diabetes…unfortunately I was not at appointment and he couldn’t remember name but from description given I suspect this is Forxiga (Dapagliflozin)

Just wondered if anyone else is on a similar cocktail of medication for Type 2 diabetes….my concerns I guess are that it seems a lot of different medications all trying to do a similar job and it will be difficult to know which ones are being effective……and which ones are perhaps acting against others and having unwanted side effects..

I would have thought that moving on to insulin would have meant less other diabetic oral medication but it seems the health professionals are just adding in more and more ….I assume they know what they are doing…

Are there any questions that I (or he) should be asking…

Just to update....he is now on the Forxiga starting tomorrow but is dropping the gliclazide and the bendroflumethiazide....
...he has also been given ketostix but doesn't know why or when he should be using them....unfortunately I was unable to attend the appointment with him so don't really know what the thinking is behind this change...will just have to wait and see what happens ...

 

[Molly56]

Hi
Not an expert here but I just wondered what else you have tried for his BP? My mum is hypertensive but she's ok on indapamide..not a criticism and I don't know your story and I know that not everyone is the same but I was just interested as to why he is on 4 meds for BP?

@servewithmintsauce ...I think he did have the indapamide at one point but had a strange reaction to it within a few days of starting on it....including quite vivid hallucinations and ending up in hospital....cannot be convinced it was the medication but is now one that I would suggest he avoids as don't want a repeat episode.....was all very odd and was perhaps more worrying for me being the person on the outside looking in....

 

[donnellysdogs]

Hi im am also a type 2 diabetic have been for 15 yrs im on novomix 30 insulin 70 units am, 40 units dinnertime then 90 units at night, victoza 1.8 once a day, 850mg metformin 3x Aday, . I have duloxetine, ramapril, atorvastatin, larigtine x4 aday, also the forixa and pregabalin, northristerone plus on morphine, i get no side affects but i was told im insuilin resistant. Not making enough insulin but to be honest my sugars are all over the place sometimes high, sometimes low cant seem to get them to even out .

Has anybody ever discussed the usage of u500 insulin with you?
Have you actually been tested for type 1?

U500 strength insulin is 5 times the strength of normal insulins and I believe it has only on a basal/bolus regime... However it would certainly lower the large amounts of the doses of insulin that you are having and probably reduce some if the cocktail of drugs too.