DRUG number 4 now

[Robo42]

I have had, 4 weeks of Metformin 2 x 500mg then 4 weeks on Metformin SR 1 x 500mg , not good, stomach etc. Then put on Gliclazade 1x 30mg put up with for 9 weeks , not too bad but muscle aches, some stomach problems feeling tired on all these drugs. I have just started on Dapagliflozin, from what I see on the forums there are a lot of problems. Is there anyone that is fine on Dapagliflozin? The doctors sell Metformin as an elixir of life but seem to struggle as to what to go for otherwise with all the drugs working in very different ways but all seem to have a lot of side effects. I felt so good before I had to start medicine a few months ago.

 

[MellitusTrap]

I started Empagliflozin today
Might be similar.

The metformin - take it during meals. That might curb the stomach stuff.

 

[4ratbags]

Have you tried controlling your BS by diet or were you placed straight on medication.

 

[Robo42]

I have been diet controlled for over 10 years, but the ole hba1c seemed to creep up and at 54 the Drs said needed medication, though I wanted to try harder with diet. After 3 plus months on Metformin and Gliclazade the hba1c was 46, bit disappointing also feel to many side effects. Bit concerned on all the effects I have read about Dapagliflozin, but so far 1 day OK we will see.
I don't agree with the DRs that ALL people diet controlled will have to have drugs eventually, there are cases where people have turned around as it looks like you have done well. I have always been low GI carbs and quite low generally, knowing what affects me with testing, but can be better so still willing to try to get off meds which my Drs say not recommended.

 

[Daibell]

Hi. Can you let us know what your BMI/weight is. Metformin SR is usually well-tolerated but not always. Gliclazide rarely gives problems. I can't comment on Dapagliflozin. If your weight is around normal then do consider the possibility of being a Late onset T1 and not T2. Let us have more info.

 

[Robo42]

Lets see, not checked for a while, BMI 24.4, weight 12st 2lb, slightly lower since on drugs. Hba1c 46mml/mol or 6.4dcct %. Probably 14 years diet controlled, there do seem to be changing NHS guidelines that are generic and last year I would not have been put on drugs but recently Drs quote over 50 hba1c got onto metformin.

 

[Daibell]

Hi and thanks for the info. Sounds like early days for the diabetes and difficult at this stage to tell whether it's T2 or Late onset T1. Metformin is always a good start. It doesn't do a lot but is a good safe drug and does reduce blood sugar a bit for all of us. Hopefully with the good diet and Metformin your blood sugar will remain good. If it starts moving up despite all this into the teens then suspect Late onset T1. Gliclazide can be increased up to 320 mg which I was on for years assuming it isn't the cause of your current unwellness and does help push a failing pancreas although going onto insulin earlier rather than later is better but only if you are actually T1.

 

[sally and james]

Probably 14 years diet controlled

@Robo42 , what sort of diet have you been using for 14 years? Was it low / very low carb or more of an NHS diet of cutting down on added sugar and avoiding fats?
If Low Carb, has there been carb-creep, i.e. gradually increasing levels, which has resulted in the slowly rising HbA1c?
Sally

 

[Robo42]

Well to clarify, I was put on Metformin, bad effects, so changed to Metformin SR, told to give each a month, then change to Gliclazade, put up with for 8/9 weeks better stomach effects but aches & tired. So now its just on Dapagliflozin for 2 days now, looks like Metformin is no for me.
S & G, on my diet originally I saw a dietician but good that I did not take too much notice as I am sure I would not have lasted on the food recommendation, too much carbs and fruit suggested. I tested my blood sugar for weeks pre & après meals logging what I ate this gave me a good idea of what affected me. What came out of this was, no Carbs for breakfast, except Oat based now & then, low GI Carbs & a guide of food with no more than 4% sugar have kept me quite good, low fat (which on this site seems to go for the opposite) and yes no added sugar. I don't think the Doctors saying don't test my blood myself and just have 6 monthly hba1c tests helps and refusing any more test strips on prescription. Because I am quite good I have had the the odd treat, piece of dark chocolate, odd biscuit over time. So I still hope being a bit more vigilant I can still get off meds, but the Drs insist that everyone gets worse over the years, but we hear of people that do manage to. It does seem since I have joined this forum that my low carb might not be that low.

 

[sally and james]

It does seem since I have joined this forum that my low carb might not be that low.

Many of us do find that the Low GI and oats ("healthy whole grains") approach doesn't quite achieve desired results. May be if you dropped some of these you could get back to less and even no drugs. Worth a thought. You won't be short of advice on this forum, should you need it!
Sally

 

[freddy2]

as Sally said, you may need to do more.

My opinion would be to look at the total carbs and not just the sugar. a lot of T2 can't have a bowl of oats for breakfast without spiking.
a lot will cut their grains and grain products, starchy veg like potato, fruit/juice honey and other sugary stuff

although you weight is ok, a LCHF way of eating should help your BG and replace the lost energy from the carbs with healthy full-fat food.
you may also see an improvement in you blood trygliceride/cholesterol levels next blood test

a long page and a few good video’s
http://www.dietdoctor.com/lchf
http://lowcarbdiets.about.com/od/lowcarb101/a/firstweek.htm

From the @Southport GP study, who posts here
http://www.practicaldiabetes.com/SpringboardWebApp/userfiles/espdi/file/March 2014/PP Unwin final proofs revised.pdf

 

[Osidge]

@freddy2 can you provide the evidence that oats for breakfast spikes the blood of a lot of people with Type 2 diabetes? Interestingly, the Southport study had a central aim of weight loss and advised against a lot of calorific fat.

Regards

Doug

 

[freddy2]

oats have carbs, carbs spike BG a bowl of oats contain a lot of carbs. As well as myself and a search will show numerous T2 here have said it does spike BG, google also has references https://www.google.com.au/search?q=...&oe=utf-8&gws_rd=cr&ei=fzx3Vo3fGcKvmAWL-bigAQ

I used the study because it is very good. Depending on your, what a 'lot' is but where does he advised against calorific fat.?
Some of his sources that he quotes are ketogenic high fat. and that can be in the 70% fats
page 1
"Studies have shown good results
for a low carbohydrate/higher fat
diet in people with type 2 diabetes
and in those with central obesity.
2,3,7"
2. Volek JS, Feinman RD. Carbohydrate restriction
improves the features of Metabolic Syndrome.
Metabolic Syndrome may be defined by the
response to carbohydrate restriction.
Nutr Metab
(Lond)
2005;2:31.
3. Nordmann AJ,
et al.
Effects of low carbohydrate
diet vs low fat diets on weight loss and cardiovas-
cular risk factors: a meta-analysis of randomized
controlled trials.
Arch Intern Med
2006;166:
285–93. [Erratum in
Arch Intern Med
2006;
166:932.]
7. Accurso A,
et al.
Dietary carbohydrate restriction in
type 2 diabetes mellitus and metabolic syndrome:
time for a critical appraisal.
Nutr Metab (Lond)
2008;5:9.

 

[Osidge]

Carbs do not necessarily spoke bg levels. A portion of oats, which is low GI as well as being a valuable source of soluble fibre, does not spike my blood glucose. Clicked on your link and the first reference seems to back appropriate oats: http://www.healthline.com/health/diabetes/oatmeal#Overview1. According to the Portsmouth study it was about weight loss and, like the Newcastle diet, was about low calories. Obese or overweight people will use stored fat, such as that in the organs and adipose tissue, to feed ketosis.

Doug

 

[4ratbags]

You do have to remember we are all different and what may not cause a spike for you may cause a spike in someone else that is why it is advisable to have a meter to check which foods each individual can tolerate.

 

[NoCrbs4Me]

Oats sure spiked my blood glucose and weren't low GI for me! Oats may not spike your BG, but you have no idea what they do to your insulin levels. Also, the dose makes the poison, so oats might spike your BG if you have more.

 

[Osidge]

After 17 years I have a good idea of how foods affect me. I have oats often and my HbA1c is always below 6 and, more often, around 5. I also have no complications. That, however, is just me and I appreciate how we are all different. I appreciate that my pancreas releases insulin in response to the gradual conversion of the oats (proper oats and not "instant porridge"). My HbA1c readings along with my lack of complications after 17 years indicate that what I do works for me.

By the way, @4ratbags I have always had access to testing strips at all the surgeries I have been registered with. I am also sold on the fact that we are all different.

Regards

Doug

 

[freddy2]

yes, instant sometimes have added sugars with flavours and such and are worse than the whole oat. I can't eat a bowl of oats, I would struggle with carbs of a morning.

Remembering that a GTT glucose tolerance test is 50-75g QA glucose

http://www.calorieking.com.au/foods/portionwatch/?action=viewcat&cat_id=7
Serving size Oats cooked with water.
1/2 cup (45g raw), yields 140 grams cooked 30.5g carb 170cal
1 cup (90g raw), yields 280 grams cooked 61g carb 340cal

 

[NoCrbs4Me]

Even regular oats spiked my BG.

 

[freddy2]

Carbs do not necessarily spoke bg levels. A portion of oats, which is low GI as well as being a valuable source of soluble fibre, does not spike my blood glucose. Clicked on your link and the first reference seems to back appropriate oats: http://www.healthline.com/health/diabetes/oatmeal#Overview1. According to the Portsmouth study it was about weight loss and, like the Newcastle diet, was about low calories. Obese or overweight people will use stored fat, such as that in the organs and adipose tissue, to feed ketosis.

Doug

Portsmouth study? I don't know what you refer to and I don't think I've refered to it here.

What I did link was from the @Southport GP , Low carbohydrate diet to achieve weight loss and
improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general practice

I posted a quote above from it saying.
"Studies have shown good results for a low carbohydrate/higher fat diet in people with type 2 diabetes and in those with central obesity. 2,3,7" and listed his #2,3 and 7, as sources

Conclusions
"Based on our work so far we can understand the reasons for the internet enthusiasm for a low carbohydrate diet; the majority of patients lose weight rapidly and fairly easily; predictably the HbA1c levels are not far behind. Cholesterol levels, liver enzymes and BP levels all improved. This approach is simple to implement and much appreciated by people with diabetes"


yes, it's just a google page of mixed results, some would recommend eating oats. Perhaps if you looked further down the page, you would have seen people who say they can't eat oats because it spikes them, perhaps some more on page 2 too.