Hyperglycemia. Gliclazide MR Added.

[AmandaAnne]

Hello all

My diabetes is out of control and has been for quite a few Months now. My recent hbA1c was 79. Unfortunately I've not been able to get my levels down myself and my high glucose levels are having a bad effect on me and my body.

I have endless skin and eye infections, feel confused, severely fatigued, light headed, freezing cold or boiling hot, but it's not a fever. My mood is at rock bottom and I have very little motivation.

I spoke with my GP last Friday and he is very concerned that my levels remain high and wants to get them down quickly, so he has added Gliclazide MR 30 mg per day. I'm already taken 2000 mg of Metformin per day and Linagliptin 5 mg per day. He has said that it's fine for me to take all of these together.

I tested my bg before my dinner, it was 17.3, I hadn't eaten anything at all from yesterday evening, so I took the first Gliclazide before my dinner....I have now tested again, 2 hours + after dinner and my bg level is now 20.7.

Does this sound about right considering my high levels anyway please?

I really haven't got a clue what I'm supposed to be doing and would be so grateful for any advice and guidance....the specialist diabetes nurse from my surgery will be phoning me this coming Friday to see how I'm getting on.

Thank you in advance.

 

[kitedoc]

Hi @AmandaAnne, you do not appear to be having much luck!!
Written as experience of diabetes and reading, , not as professional advice or opinion:
Did your doctor give you any idea how long before this new addition to your treatment might take effect?
From sources like https://www.ncbi.nlm.hih.gov/pubmed/2373640 glicazide is best taken 30 minutes before breakfast.
What you need to realise is that Glicazide works by stimulating your pancreas to produce more insulin. https://beta.nhs.uk/medicines/glicazide. I am guessing that he/she thought you would know by Friday if it was having any effect. But the opinions on the net/forums etc vary from shorter to longer.
Also metformin dose is either taken twice daily e.g. 1000mg morning and night or . but once daily if it s slow release type.
Linagliptin is taken as one dose a day at the same time each day. medlineplus.gov linagliptin
You appear to have been struggling for months with high BSLs so I wonder if your GP is thinking that your pancreas gland is not coping.
To check this out further go to the Home screen and using the question box Right upper corner type in LADA (and no, this is nothing to do with motor cars)!! You will see that it mimics type 2 diabetes to begin with then may start to become more serious as the pancreas runs out of insulin. Also see the note on keto-acidosis - nasty thing.
What that all translates to is: perhaps ringing up the diabetes nurse now today, well before Friday and asking:
1) in case you have LADA how to obtain a machine to check for ketones. Some of the glucose meters have the ability to measure ketones with a different type of strip - a chart below will help give you an idea of what is what with ketones but keeping touch with your nurse and doctor about your BSLs and ketones in the most important thing
2) asking for blood tests for LADA - they take time to come back so better done sooner than later.
Best Wishes and if you are feeling nauseous unwell with high BSls the general thing is ring emergency, ambulance etc and get to hospital

 

[AmandaAnne]

Hi @kitedoc ,
Thank you so much for your informative and helpful reply.

Even though I've been diabetic for some years now, much to my detriment, I haven't really studied it anywhere near enough, I know the basics of the basics.

For years I had it perfectly controlled, taking only Metformin and just cutting down on my carbs. My hbA1c results were always perfect and I really had no problems at all.

Then suddenly it all went wild, I was getting recurring UTI's one after the other and a lot of skin infections, it was then that everything started going a bit crazy and my levels were going up, down and all over the place. It was thought that it was maybe the infections that were causing this, although my GP did say that it could be the other way round too!

Anyway more health conditions were coming to light at that point, including pernicious anaemia and an under active thyroid. I have 3 Monthly B12 shots and a tablet for the thyroid.

I've now just found out that I'm iron anaemic again, this has happened before and they have never found out where I'm loosing blood from, despite loads of different tests, I'm passed women's issues so that can be ruled out too.

Last week I bought some urine testing strips, to check for infection or blood....there's no infection or blood, but there was an extremely high level of glucose in it....I've never had that before, is it normal for the glucose to be in the urine when the levels are high? I don't know but I'm guessing that the kidneys are trying to flush the excess glucose out of the body maybe?

I will contact my surgery to speak to them about LADA, I'd never even heard of it! Shows how out of the loop I am!

Once again many thanks, it makes me feel better to be able to talk to people who have diabetes and are well educated with it, I've learned more doing that than I ever have via the NHS.

 

[Rokaab]

I've never had that before, is it normal for the glucose to be in the urine when the levels are high? I don't know but I'm guessing that the kidneys are trying to flush the excess glucose out of the body maybe?

Yes, when glucose levels are high then you can expect there to be some in the urine, in fact when I was diagnosed (and some others on the forums as well) there was no home blood testing kits, you had to use urine testing sticks for testing sugar levels as that's all there was.

 

[kitedoc]

Hi again @AmandaAnne, Please remember to ask about the ketone measuring.
And I have a daughter with coeliac disease(CD) - a condition where the body reacts to gluten in wheat, rye, triticale, spelt and oats.
The small intestine becomes inflammed and may not absorb some minerals and vitamins. see mayoclinic.org - coeliac disease
A blood test can help detect it. provided one has been eating gluten in food.
It may be worth asking your nurse and doctor about including that in your next blood tests. The test is called TTG.
CD is another auto-immune condition like pernicious anaemia, LADA etc (and I have heard that sometimes it is not pernicious anaemia but CD causing low B12).
Best Wishes with the ketone and BSL measuring and the blood tests you request of the nurse today , now, as soon as possible.

 

[AmandaAnne]

Yes, when glucose levels are high then you can expect there to be some in the urine, in fact when I was diagnosed (and some others on the forums as well) there was no home blood testing kits, you had to use urine testing sticks for testing sugar levels as that's all there was.

Thank you for replying,

Wow! that must have been difficult to rely on urine tests only!

 

[AmandaAnne]

Hi again @AmandaAnne, Please remember to ask about the ketone measuring.
And I have a daughter with coeliac disease(CD) - a condition where the body reacts to gluten in wheat, rye, triticale, spelt and oats.
The small intestine becomes inflammed and may not absorb some minerals and vitamins. see mayoclinic.org - coeliac disease
A blood test can help detect it. provided one has been eating gluten in food.
It may be worth asking your nurse and doctor about including that in your next blood tests. The test is called TTG.
CD is another auto-immune condition like pernicious anaemia, LADA etc (and I have heard that sometimes it is not pernicious anaemia but CD causing low B12).
Best Wishes with the ketone and BSL measuring and the blood tests you request of the nurse today , now, as soon as possible.

Thank you,
My gastroenterology consultant tested me for CD last year and it was negative, he's now wondering if I have diverticulitis, I'm waiting for a CT scan result and blood results.
I'm on day 3 of the gliclazide mr, last Sunday my bs level was 24.....today, 2 hours after dinner, it was 16....so it looks like I might be going in the right direction, I have also been cutting my carbs more so it's probably a combination of them both. I know I've still got a long way to go, but it is nice to see some positive results.
Many thanks for your helpful replies, they are helping me.

 

[kitedoc]

Thank you,
My gastroenterology consultant tested me for CD last year and it was negative, he's now wondering if I have diverticulitis, I'm waiting for a CT scan result and blood results.
I'm on day 3 of the gliclazide mr, last Sunday my bs level was 24.....today, 2 hours after dinner, it was 16....so it looks like I might be going in the right direction, I have also been cutting my carbs more so it's probably a combination of them both. I know I've still got a long way to go, but it is nice to see some positive results.
Many thanks for your helpful replies, they are helping me.

Please get ketones checked and get LADA sorted NOW>