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GP appt - need advice please

M

Maggie75

Well-Known Member
Messages
166
Hi everyone,

I've started a new thread for this (don't know if this is the right thing or not?) as I really need some advice after speaking to GP today. My blood sugars have been high over the last 9 days, highest being around 18 and much higher every day than they've ever been since I was diagnosed 5 years ago even with following a low carb diet. Couple of decent readings with a very low carb meal or just not eating anything for a good few hours.
Anyway, I went to see GP today as there were no DN's available, apparently all the nurses in my Dr's practice are on leave so I headed to see GP with a urine sample and my meter readings to show her, I was put on 3 day course of antibiotics last week for potential urine infection, this made no difference to my blood sugars. Urine was tested, she was confident it didn't show ketones, she wanted to check this with a machine but couldn't find one. She was not overly concerned with my readings apart from the super high ones.
I'm currently taking one Sitagliptin 100mg per day, this was changed a couple of months ago from Alogliptin, that's when all the problems started I think. Anyway, the GP today decided to start me on Glicazide 40mg one per day which I told her I do not want to take, I know this can cause hypo's and my body has already reacted violently to diabetes meds including Metformin so I am terrified to take something like this. She says it would possibly just be short term to reduce my blood sugar and she would speak to DN when she's back next week but I really don't want to take this medication, I was so upset today I just haven't stopped crying, I'm completely freaked out by this. She's also put me on another 3 day course of antibiotics for this potential urine infection.
My last HBA1C was 68 which was last month, she sent me for another one today so I should know the results of this in a day or 2. Is that a level where this medication would usually be prescribed? Surely there has to be something else I could try which doesn't cause hypo's?
I feel as though everything I've been doing in the last 5 years (low carb) when I've been able would need to be turned completely around, and I'll be completely honest, my mental health just couldn't take it. I can already feel it slipping. Why have I not taken my diet more seriously and worked harder at this.
Does this seem to anyone else like a knee-jerk reaction from GP, I just do not believe if I'd seen a DN today they would have put me straight onto Glicazide. Sorry for the long and slightly freaked out post, I'm just struggling with this.

Maggie
 
Sorry that your visit didn't go better for you.

Don't have much in way of advice that i think is relevant for the particular meds you've been prescibed. Advice that I can offer is to keep a detailed food diary record.

I paniced with having to inject insulin multiple times a day (t1/lada) fear of hypos (alongside needlephonic). I was started with a relatively low dosage,which was increased fairly slowly. I find that dr's generally start with very low dosages to see how body reacts to something. have been pretty lucky here with honeymoon period (t1/lada) kicking in and was able to decrease meds. Simular experience with some nsaids i take. Taking the new med does not automatically mean it will cause hypo.

To answer your question on guidance here is Nice Guidlines : https://www.nice.org.uk/guidance/ng28/chapter/Recommendations#reviewing-drug-treatments
1.7.17
Introduce drugs used in combination therapy in a stepwise manner, checking for tolerability and effectiveness of each drug. [2015]

1.7.18
For adults with type 2 diabetes, if monotherapy has not continued to control HbA1c to below the person's individually agreed threshold for further intervention, consider adding:
Click to expand...

Did you discuss the current impact issues have with your current mental health side of things at your appt? Some CBT could assist. I got some help for needlephobia and general anxiety/low mood/depression. felt almost completely hopeless when inititally told, actually surrprised myself at able to do what was needed, albeit was a struggle and did delay (still do delay somethings which i really shouldn't).

Blaming yourself should not be doing. Somethings are with out own control and needing a little extra help at times is sometimes a necessity and there is nothing wrong with that. I posted in your other thread couple of links free trial dexcom/libre. Unsure if you've had both of either or those, perhaps they can at least short term basis may help to give you some needed confidence? https://dexcom.com/en-GB/dexcom-one-plus-sample https://www.freestyle.abbott/uk-en/getting-started/sampling.html

sorry for your struggles, wishing you the best
 
40mg of Gliclazide is a very small starting dose (the max dose is 160g) so whilst it’s good to be aware of the possibility of hypos it’s unlikely given your current levels and the dose that it will happen.

Are you aware of the signs of a hypo? It’s good to understand that even if you start to go hypo you will have time to deal with it. Keep your testing kit with you, and also some simple sugar. I find fruit pastilles good as they are easy to carry, two or three are usually enough to lift me out of a hypo.
 
I stopped taking Sitagliptin after a few weeks because it was making my post-meal readings worse, not better. Don't know why that would happen, but it did.

I'm actually going to ask for Gliclazide or some other sulfonylurea, or even a meglitinide, because a side effect (hypos) that allows me to eat sugar doesn't personally scare me. As long as you've always got sugar on hand, and / or eat enough to stop them coming on in the first place, I don't think they're to be feared, especially if the medication is otherwise helping you.
 
agylli said:
The maximum dose of Gliclazide is 320mg not 160mg.
Click to expand...

Nhs website said:
Dosage and strength
Doses of gliclazide can vary. Take this medicine as prescribed by your doctor.

The maximum daily dose for standard gliclazide is 320mg. If you need to take more than 160mg a day, it should be divided into 2 equal doses.

For slow-release gliclazide, the maximum daily dose is 120mg.
Click to expand...
above quote from https://www.nhs.uk/medicines/gliclazide/how-and-when-to-take-gliclazide/ has different max dosages depending format prescribed.
 
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