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Advice needed

mumblemac

mumblemac

Member
Messages
8
Location
dorset
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi Ive been type 2 diabetic for 12 years and when I had my review recently my hba1c had jumped from 58 to 68 so they changed my meds i take metformin 2000mg once a day , 4mg glimerpiride once daily and now they have added alogliptin 25mg one daily. I am a nurse work 12.5 hr shifts very busy . I monitored my sugars for a few days before starting the alogliptin and they are no more than 8.5 no less than 5 . today i added the alogliptin one pill, im not at work today my sugars went from 6 mmols to 3.5 mmols and i struggled to get them back to 5mmols and i havent taken my metformin yet. Im really worried as I dont think I need the alogliptin and dont know what to do for best . when I had my hba1c I had been ill with a chest infection for three weeks and wonder if that contributed to my poor result. Im going to contact my gp tomorrow but wonder if anyone has some advice about this drug combination.
 
Hi. Metformin rarely causes low blood sugar and the same for the Gliptin family. The Glimepiride (a sulfonyl urea?) can cause low blood sugar as it stimulates the pancreas to produce more insulin. If you are a T2 with some excess weight you might want to (tactfully!) ask the GP why you are on Glimepiride as you may already have enough natural insulin but can't use it? As you say, illness can cause raised blood sugar. Are you following a low-carb diet which is very important.
 
Hi @mumblemac .. and welcome
I'm new here (diagnosed T2 Feb 17th) and I don't know enough about diabetes (yet) to be able to comment on your meds. What I can say, though, is that you have joined an extremely welcoming, informative and friendly forum .. so, ask your questions and you can be confident that you will get the answers that you need ..
 
Daibell said:
Hi. Metformin rarely causes low blood sugar and the same for the Gliptin family. The Glimepiride (a sulfonyl urea?) can cause low blood sugar as it stimulates the pancreas to produce more insulin. If you are a T2 with some excess weight you might want to (tactfully!) ask the GP why you are on Glimepiride as you may already have enough natural insulin but can't use it? As you say, illness can cause raised blood sugar. Are you following a low-carb diet which is very important.
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Hi
Daibell said:
Hi. Metformin rarely causes low blood sugar and the same for the Gliptin family. The Glimepiride (a sulfonyl urea?) can cause low blood sugar as it stimulates the pancreas to produce more insulin. If you are a T2 with some excess weight you might want to (tactfully!) ask the GP why you are on Glimepiride as you may already have enough natural insulin but can't use it? As you say, illness can cause raised blood sugar. Are you following a low-carb diet which is very important.
Click to expand...
Thanks for your reply yes I am cutting carbs and have done for a while . I don't like glimepiride because of the hypos but haven't had one in a while till today on starting the new med with it and I would love to not take it and I am a little tubby type 2 :-). I will ask my gp as I know them well and its too much of a risk for me when I'm caring for others to have hypos.
 
AM1874 said:
Hi @mumblemac .. and welcome
I'm new here (diagnosed T2 Feb 17th) and I don't know enough about diabetes (yet) to be able to comment on your meds. What I can say, though, is that you have joined an extremely welcoming, informative and friendly forum .. so, ask your questions and you can be confident that you will get the answers that you need ..
Click to expand...
Thankyou :-)
 
I too have had a chest infection for a few weeks and during that time I was wearing Libre sensors and monitoring continuously. I am now convinced that the advice that illness raises blood sugar levels is true. I would not like to be assessed while suffering a chest infection and I believe I can remember my nurse once saying that they wouldn't take the sample if I had a cold. She had seen me blow my nose when in the waiting room and thought she was on to something.

3.5 is too low in any event so something needs to be done so contact your DN/GP. The good news is that Metformin is not known for lowering blood sugars by much and in that sense is a safe drug.
 
mumblemac said:
today i added the alogliptin one pill, i'm not at work today my sugars went from 6 mmols to 3.5 mmols and i struggled to get them back to 5mmols and i haven't taken my metformin yet.
Click to expand...

Nobody can or should advise on drug combinations but we can point to documented facts. Alogliptin supposedly exhibits relatively little risk of causing hypoglycemia, and exhibits relatively modest glucose-lowering activity. Alogliptin is commonly used in combination with metformin in patients whose diabetes cannot adequately be controlled with metformin alone.

It could be that having a chest infection for 3 of the 8 - 12 weeks prior to the HbA1c may have skewed the results a bit. Either way dropping from 6 to 3.5 isn't good so your GP is the best person to advise.
 
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