Type 2 Diabetes and Recurring UTI

desperate_dave

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I’m a 55 year old male who was diagnosed with Type 2 Diabetes two years ago. Since then I have been on Metformin 500mg tablets which I take twice a day.

Since the beginning of May, I have had a recurring Urinary Tract Infection (burning sensation when I urinate), a high temperature and a general feeling of being unwell. I wake up two or three times during the night, soaked with sweat. I went to see my GP and traces of blood and protein were found in my urine. The doctor prescribed a 7-day course of Amoxicillin 250mg and although these seemed to help bring my temperature down, I was still experiencing discomfort when passing water. My doctor prescribed a further 5-day course of Amoxicillin 250mg.

By the end of the second course of antibiotics the burning sensation seemed to have subsided. The practice nurse tested my urine on and confirmed that my infection had gone. However I wasn’t convinced that it had completely gone away because my urine still seemed to be very strong and smelly at certain times of the day.

My blood pressure has also been high since the onset of these infections. My GP has put me on Ramipril 2.5mg.

Another urine test two weeks later showed that my UTI had returned. This time, my GP prescribed a 7-day course of Trimethoprim 200mg. Initially these seemed to clear the infection but within three weeks of finishing the course, my UTI was back. The practice nurse suggested I ask my doctor to refer me to a Urologist. This I did but unfortunately had to wait two months for an appointment. In the meantime I was prescribed another 7-day course of Trimethoprim 200mg.

When I eventually saw the Urologist, he examined my prostate, which he said seemed to be ok, but arranged for me to have a PSA blood test. In addition to this I have had an Ultrasound Scan. Incidentally, at the time of my appointment I was once again feeling unwell. I asked the Urologist if he could prescribe something. He said something about there being a particular drug he’d like to prescribe but unfortunately it would mean I would have to come off Metformin for five months, so he decided it best under the circumstances not to prescribe anything.

The worrying thing is that every time my UTI returns it seems to come back with a vengeance. Last week my GP prescribed yet another 7-day course of Trimethoprim 200mg and I fear that my infection has built up a resistance to these particular antibiotics. To be fair they have cleared up my water infection but I still have the high temperature and the night sweats. Another worrying aspect is that my stools have been watery during this latest episode.

During the next two weeks I’m scheduled to go into hospital for the day to have a CT scan of my abdomen. A few days later I’m scheduled to go into hospital for a flexible Cystoscopy, where apparently a small piece of my bladder with be removed for analysis.

Needless to say, I’m worrying what the outcome of these tests will be and was wondering if anyone else on this forum had experienced similar problems.

I’d appreciate any comments.

Dave
 

Katharine

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You certainly have to get this bladder thing cleared up. It sounds miserable and any infection will worsen your diabetes control.

Your bladder may not be emptying properly and the urine that is left could be getting infected.

If you have previous microbiology culture and sensitivity tests you could ask your GP for a prescription of antibiotics to be used immediately you get the symptoms. If you gave a urine sample of pre-antibiotic urine in as soon as you could this could make life easier for you till you hopefully get this cleared up.
 

desperate_dave

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Thanks for your reply Katharine. Yes, you're right, when I had the Ultrasound Scan done, they scanned my full bladder and then my empty bladder. The nurse noted that my bladder wasn't fully emptying and said this could be the cause of my problems. I can't wait to have the CT scan and Flexible Cystoscopy when hopefully I'll find out the cause and they can treat it accordingly. I'm just keeping my fingers crossed it doesn't turn out to be the big C.

Thanks again, your comments are appreciated.

Dave
 

Pattidevans

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Dave

I don't normally post much in this forum, and so PMFJI, but having just read your other thread it sheds a lot of light on what may be the problem here. You said in the other thread:-
Incidentally, I do have a Blood Glucose Monitoring Kit and test my blood sugar once a week (as directed by my Practice Nurse). For most part I’m able to keep my blood sugar below 7.1, however when I tested it this morning it was a staggering 16.6. To be fair, this test was done after breakfast whereas I normally test my blood sugar before having anything to eat (again this was recommended by the Practice Nurse).
When you wake up your blood sugar is under 7.1 before you eat. BUT after breakfast it has risen to 16.6 which means that for a great deal of the time after meals your BGs are extremely high, very probably every single day after every meal. The gold standard is to be under 8 one hour after a meal and under 6.5 two hours after a meal. If you have only been testing once a week before breakfast then you cannot possibly know what your BGs have been after meals. That 16.6 should be a wake up call for you. You also say
However I wasn’t convinced that it had completely gone away because my urine still seemed to be very strong and smelly at certain times of the day.
That is indicative of having had high BGs because the glucose is leaking out of your kidneys causing the strong sweet smell in your urine. Long term this can cause kidney damage.

High BGs are perfect breeding grounds for all manner of infection, in particular fungal infections such as thrush, which can affect men as well as women, and bladder infections. It's a vicious circle because whilst you have an infection your body is under stress and will be producing Cortisol, a natural steroid that will push up your BGs in it's turn. The high BGs then nurture the bacteria causing the infection.

I would strongly suggest that you adopt a more stringent testing routine to find out how high your BGs truly are and I suspect that if you can reduce your BGs then your UTIs will reduce exponentially. For a testing regime which will actually tell you what is what I suggest you read this link http://www.diabetes-support.org.uk/joomla/jennifers-advice
 

desperate_dave

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Thanks Patti, for a very informative and helpful reply. I must admit I have always found it strange that my nurse tells me to test my blood sugar ONCE a week and BEFORE breakfast when there are people on this forum who clearly test their blood sugar levels three or four times a day. Despite what my nurse says, I think I will follow your advice and test myself more regularly. Like you rightfully pointed out, once a week is hardly going to give a complete picture.

Thanks again, Patti, I have learnt more from your reply than I have ever learnt from my nurse and I totally agree with what you say: If I can get my diabetes under control, then that's half the battle.

Dave
 

Pattidevans

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Dave if you only ever take one piece of advice, read the link I gave you to Jennifer's advice! It's absolutely gold standard for T2s and I know many who, armed only with that advice and a few test strips, have got their BGs under total control! I know some T2s who have reduced and even given up meds by following it. It's not a cure, it's just a way of managing your diabetes so it's well controlled!
 

desperate_dave

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Hi Patti,

I would just like to give you an update on my progress. I did as you suggested and am now keeping a food diary as well as regularly checking my blood glucose.

Okay, here are details of my readings from yesterday:

Before breakfast my BG was 5.3

After breakfast (which comprised of 4 x Weetabix, a little Canderel and Semi-skimmed milk) I took a reading approximately one and a half hours later and my BG was 5.7

Before lunch my BG was 5.2

After lunch (which comprised of 4 x sandwiches – wholemeal bread with Iceberg lettuce and wafer thin turkey and a little reduced fat mayonnaise) my BG (approximately two hours later) was 5.8.

Before evening meal my BG was 3.8 (a little on the low side I thought).

After evening meal (which comprised of homemade chicken curry with rice and chips) my BG (approximately an hour later) was 6.9.

I checked it again a couple of hours later and it had dropped back down to 5.4

I had been snacking in between meals with the odd apple or handful of grapes but all in all I was quite pleased with my results.

I can’t thank you enough for recommending I keep a food diary. I must admit I’m still a little green on what I can and cannot eat but I think with results like these I’m definitely on the right track.

And as regards to my UTI I am feeling a lot better (apart from having to get up six or seven times during the night to urinate but this is because I’m having to drink lots of water to help flush out the infection).

I can’t wait to show the nurse my food diary and my BG results when I go to see her next week. It’ll be interesting to see her reaction to the amount of times I’ve been checking my BG levels. If she’s still insistent that I should only do this once a week then maybe it’s high time I started looking for another nurse.

Thanks again, Patti and all those who have offered such wonderful advice.

Dave
 

wallycorker

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Hi again Dave,

You sound to be doing OK so far considering all the Weetabix, bread, rice and chips you are still eating! In fact, I'm surprised that you seem to be doing so well!

Now you are doing so well it might be a good time to start testing approximately one hour after finishing eating a meal to see how high your spikes are going.

As a Type 2 on diet and metformin only, you don't need to be too concernmed about a 3.8 before a meal unless you start to feel strange in any way - and if you do just eat something.

John
 

desperate_dave

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Hi John,

The reason I eat Weetabix is because this particular cereal was recommended by my practice nurse, as was wholemeal bread. I usually alternate between Weetabix and Oats So Simple and sometimes push the boat out and have a full English breakfast of bacon, sausage, egg, hash brown, mushrooms and tomatoes (cooked on a George Foreman Grill). Although to be honest, I haven't had a full English breakfast for about three weeks now. When my UTI was at its worst I'd completely lost my appetite and even the smell of frying bacon would make me feel nauseous. At the time I knew I had to eat to keep my strength up and was just about managing a little soup. I'm glad to say I'm gradually getting my appetite back although I still don't feel quite ready to face a full English breakfast... Maybe in a day or two, but it'll be interesting to see how my BG level fares after such a meal.

I'm still unsure as to what is best for T2 diabetics - Is it small regular snacks throughout the day or two or three larger meals? To be honest, I've never really been a big eater. My diet normally consists of sandwiches during the day and one large meal in the evening. Tonight, for example, I'm hoping to have pork chops, a little mashed potato, peas, carrots and gravy (depending on how I'm feeling). Failing that, it will probably be a couple of egg mayonnaise sandwiches on wholemeal bread... I will of course be logging everything down in my food diary.

Dave
 

cugila

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Hi Dave.

I'm like John. I am amazed at your Bg levels, almost as if you weren't diabetic at all. With what you eat if I tried it I would be like the 'side of a house ?' Do you know your weight at all ? Your BMI ?
 

wallycorker

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desperate_dave said:
Hi John,

The reason I eat Weetabix is because this particular cereal was recommended by my practice nurse, as was wholemeal bread. I usually alternate between Weetabix and Oats So Simple and sometimes push the boat out and have a full English breakfast of bacon, sausage, egg, hash brown, mushrooms and tomatoes (cooked on a George Foreman Grill). Although to be honest, I haven't had a full English breakfast for about three weeks now. When my UTI was at its worst I'd completely lost my appetite and even the smell of frying bacon would make me feel nauseous. At the time I knew I had to eat to keep my strength up and was just about managing a little soup. I'm glad to say I'm gradually getting my appetite back although I still don't feel quite ready to face a full English breakfast... Maybe in a day or two, but it'll be interesting to see how my BG level fares after such a meal.

I'm still unsure as to what is best for T2 diabetics - Is it small regular snacks throughout the day or two or three larger meals? To be honest, I've never really been a big eater. My diet normally consists of sandwiches during the day and one large meal in the evening. Tonight, for example, I'm hoping to have pork chops, a little mashed potato, peas, carrots and gravy (depending on how I'm feeling). Failing that, it will probably be a couple of egg mayonnaise sandwiches on wholemeal bread... I will of course be logging everything down in my food diary.

Dave
Hi again Dave,

I had the same advice about cereals Weetabix was one of mine and always on the recommended list from health professional. Also, I ate Oats so Simple mainly because all the health professionals recommended porridge as being about the best food anyone can eat - in fact my GP was suggesting to me that I ought to eat it for lunch. These days I don't touch either after what my meter reading measurements showed me! However, it wasn't just the fact that it was Weetabix and bread - it was that you stated four Weetabix and four sandwiches - i.e. it was the quantity. I'm amazed that you've been getting the results you quoted!

The breakfast off the George Foreman sounds a better bet.

Personally, I'd go for the small meals throughought the day.

You seem to be doing something right despite what you itemise in your posting - because your results are spot on -i.e. normal. Now I'd start looking at the one hour after finishing eating results and see what you find there.

John
 

phoenix

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I had the same advice about cereals Weetabix was one of mine and always on the recommended list from health professional. Also, I ate Oats so Simple mainly because all the health professionals recommended porridge as being about the best food anyone can eat - in fact my GP
I too am surprised that the weetabix doesn't cause a spike. For many people, (though obviously not Dave, another example of how we all have differences in what is best for us as individuals) choosing a breakfast cereal from the few with a lower gi would be better advice. This is where professionals sometimes make wrong assumptions they think that because weetabix is wholemeal and has fibre it is likely to be low gi. It isn't, it has a high gi of about 75
Similarly the gi of oats depend on the amount of processsing, something like oats so simple is highly processed so probably higher gi.Jumbo steel cut oats are likely to be lower. Even better is if they are used uncooked, as a basis for a muesli with other low gi ingredients.
list of cereals and gi(though only a guide as most from US or Australia)
http://www.gilisting.com/2004/05/glycemic-index-breakfast-cereals.html
 

hanadr

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Dave
you got the best availble advice from Katharine about the UTI. She is a GP after all
However. I can dd that you can make the process of urination more comfortable if you disperse some Sodium hydrogen Carbonate ( baking soda) in water and drink it. It raises the ph of the urine and damps down the burning sensation.
As to the weetabix and sandwiches.
I couldn't looka at those without a GIANT SPIKE and Oats-so -Simple is full of sugar, so worse. The Candarel sounds a good idea. I use Splenda myself, but have scrambled eggs for breakfast . Done in the microwave.
pm me for cookin instructions if you'd like
Hana
 

desperate_dave

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Thanks for all your replies.

First of all, Ken, my weight was originally 15 stone when I was first diagnosed with T2 two years ago (I’m 5ft 4 ins tall btw) but I managed to get it down to just over 14 stone, in fact I weighed 14st 4lbs when I was weighed at the hospital last month. However, due to my UTI and lack of appetite my weight drastically fell to 13 stone in the space of four weeks! I’ve just weighed myself now and I’m 13st 4lbs. Please excuse my ignorance, Ken, but I don’t even know what is meant by BMI (I’m still pretty new to all this). :oops:

John, I tested my BG on waking up this morning and it was 4.4.

I tested it again an hour after breakfast (which again consisted of 4 x Weetabix, a little Canderel and Semi-skimmed milk) and it was 8.6.

Incidentally, I normally take my medication straight after (or during) meals. Could this affect the readings?

Hi phoenix, the Weetabix certainly seemed to make my BG spike this morning. Would this be because I only waited an hour before testing my BG whereas yesterday I waited an hour and a half (Would a half hour really make that much difference?) I’m still pretty much confused by all the different cereals. Would I be okay to eat Nestle Raisin Oats & More or would the sugar content be too high?

Hi hanadr, and thanks to Katharine (apologies if I failed to give credit where it was due. There are so many helpful people on here that it’s sometimes hard to keep track of everyone’s name). Thankfully my UTI isn’t too bad at the minute. I no longer have a burning sensation and my urine seems to look and smell normal. The 10-Day course of antibiotics (Amoxicillin 250mg – one capsule to be taken three times a day) prescribed by my GP last Tuesday seem to be doing their job. Yes, I had heard that baking soda was supposed to be good in treating UTIs. Is baking soda the same as Bicarbonate of Soda? I also read somewhere that Alka Seltzer were meant to be good in combating UTIs but I was a bit dubious about trying them in case they conflicted with my regular medication. I believe unsweetened Cranberry Juice is supposed to be good in preventing UTIs but it isn’t very good as a cure. Also, according to one website, Cranberry Juice should never be used while on antibiotics. Apparently Cranberry Juice reduces the effects of the antibiotics.

hanadr, I would appreciate that recipe for scrambled eggs (I will PM you in a little while).

I’m just about to test my BG again, and again about an hour after lunch (haven’t decided what I’m having yet) but I will post the results.

Thanks again everybody, as always, I appreciate your comments.

Dave
 

cugila

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First of all, Ken, my weight was originally 15 stone when I was first diagnosed with T2 two years ago (I’m 5ft 4 ins tall btw) but I managed to get it down to just over 14 stone, in fact I weighed 14st 4lbs when I was weighed at the hospital last month. However, due to my UTI and lack of appetite my weight drastically fell to 13 stone in the space of four weeks! I’ve just weighed myself now and I’m 13st 4lbs. Please excuse my ignorance, Ken, but I don’t even know what is meant by BMI (I’m still pretty new to all this


Congratulations on the weight loss, well done !! :D

BMI is Body Mass Indicator.
From a straight forward calculation the BMI factor can be gained and gives a measure which can be used to determine if a person is underweight, of normal weight, overweight or obese.

Here is a link to this sites BMI calculator. Enter your details via the sliders.
http://www.diabetes.co.uk/bmi.html
 

cugila

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I tested my BG on waking up this morning and it was 4.4.
I tested it again an hour after breakfast (which again consisted of 4 x Weetabix, a little Canderel and Semi-skimmed milk) and it was 8.6.

4 Weetabix has 64g carbs in it. That is more than my usual daily intake of carbs. :shock:

How your readings get back to normal so quickly is amazing. However, today you state that it was 8.6 mmol/l at 1 hr. I wonder what it was at 2 hrs and then 3 hrs ?

Sorry to be a pain about this but there is something here which just doesn't seem to add up. Your metabolism is just strange compared to a lot of us and I would love to know what it is and why ? :?
 

desperate_dave

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Cheers Ken,

According to the calculator my BMI is 31.9 which, according to the chart, anything above 30 is considered obese, so I guess I still have a little way to go yet before I reach my ideal weight.

Dave
 

desperate_dave

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No problem, Ken, I'm just as curious as you are.

I've just checked my BG (still haven't had any lunch yet) and it's 3.5.

I know it's a bit late in the day but I'm going to see if I can manage that full English breakfast I was talking about a couple of posts back and I'll report back with my BG results in an hour or so.

Dave
 

cugila

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Hi Dave.

English breakfast at 4 in the afternoon. It's a hard life.......suppose someone's got to do it ? :lol: