Problems 4 years into type 2

[Angelc]

Hi Everyone

My name is Angela.

I've been tottering along fine with my diabetes well under control for 4 years on glucophage. Recently I was moved onto powder form metformin as I have a swallowing problem and those glucophage are monsters!

Recenly I have got into hot water with my blood sugar, the week before last it was averaging around 27 and I was feeling ghastly, placed onto gliclizide, taking 320mg a day eventually during the week alongside the metformin then the following week when not much improvement had sitagliptin added.

Unsufficient control means my doctor is now going to put me on either Victosa or Byetta, really need to avoid the weight gain of insulin. I am just waiting for the go ahead from the specialist clinic during the next week or so, feeling a bit wobbly with all the sudden changes. My eyes are pretty swishy at the moment too, but glad to have found this place, and thanks to the friend who sent me here.

 

[wallycorker]

Hi Angelc,

I'm Type 2 for more than nine years now and I'm feeling just fine, Sorry to hear that you are feeling as you do.

As I have just said to another poster, I suppose that you are aware of the effect that starchy carbohydrate has on blood glucose levels? Cutting back dramatically on things such as cereals, bread, potatoes, pasta and rice usually leads to a big and quick improvement in blood glucose levels.

Have you tried doing that?

Best wishes - John

 

[Angelc]

Hi Angelc,

I'm Type 2 for more than nine years now and I'm feeling just fine, Sorry to hear that you are feeling as you do.

As I have just said to another poster, I suppose that you are aware of the effect that starchy carbohydrate has on blood glucose levels? Cutting back dramatically on things such as cereals, bread, potatoes, pasta and rice usually leads to a big and quick improvement in blood glucose levels.

Have you tried doing that?

Best wishes - John

Hi John

Thank You for that. Over the years I have cut right back on carbs and I guess that's how I have maintained a reasonable control. In order to get things back on track from how they were over the past couple of weeks I cut down even more, which resulted only in a very big telling off from my doctor and little improvement in by blood glucose unfortunately. It seems every tiny bit of carb is pushing my levels up and up. I hope the victosa helps. I don't know how insulin can help if I am totally resistent to it though

 

[cugila]

Unsufficient control means my doctor is now going to put me on either Victosa or Byetta, really need to avoid the weight gain of insulin. I am just waiting for the go ahead from the specialist clinic during the next week or so, feeling a bit wobbly with all the sudden changes. My eyes are pretty swishy at the moment too, but glad to have found this place, and thanks to the friend who sent me here.

Hi Angelc.
Welcome to the forum. So, you may be going on to Victoza (Liraglutide) or Byetta (Exanatide) ? Both seem to be excellent drugs although Byetta has been out the longest. We have two extensive threads about each in 'Diabetes Discussion's'. Have a good read there and if you have any questions just fire away. I am a Byetta user since January 2009 and can vouch for it's effectiveness.

As regards your high levels can you tell us something about your diet, other medications and any medical conditions which might have a bearing on your dietary requirements ? With more information we might be better able to advise you of some ways to get those levels down, or point out why they may be high (medications). High blood sugar levels by the way can and do make your eyesight blurry. So, if we can help you get the Bg numbers down then that too should improve.

Well, ask questions, help us out with information and a big 'Thank You' to your friend who pointed you here....the best Diabetic website on the net for overall information and advice.

 

[Angelc]

Hi

Wherever do I start? I am thyrotoxic, for the second time, being treated with carbimazole and beta-blockers, am Ataxic and have arthritis....(I'm only 46) think that's it! Oh, just been diagnosed with glaucoma as well.... so for meds at the moment:-

Propanalol
Carbmizole
Sprironalactone
Metformin oral sachets
Sitagliptin
Gliplizide
Xalatan
Atorvastatin
Cetirizine

I've quit smoking recently, I thought my patches were affecting my blood glucose initially, although I'm told not, but am obviously on Nicotine Replacement Therapy. I haven't increased my food intake in relation to stopping smoking, so that can't explain it.

As for my diet, I've lost 2 stone quite easily, due to the thyrotoxicosis I believe, although this has levelled off now, am keen not to go on insulin and put it all back on again!

I'm pretty careful with my carbs, and try to stick to slow release and keep them pretty low and avoid sugar vigorously, although I do use aspartame sweeteners to replace.... any help in there?

 

[cugila]

Hi Angelc.

Thanks for that list..... As it is quite lengthy we will have to take some time to go through it, we will get back to you with any known side effects that are relevant or any contraindications.

As regards your carbs ....do you know what the average daily intake would be ? grams. You mention sugars, however it is carbs that are more important as they include sugars and as you probably know convert directly to Glucose, so elevating Bg levels.

Sometimes what you might think are 'healthy' foods are sometimes not all that they seem. Glad to see you are aware of the Glycaemic load with the slow release carbs.

I totally understand your reluctance to go on to Insulin, however sometimes we don't have any options....let's see what we can come up with here which might help you to stave off that day.
No promises mind !

Back later..... :arrow:

 

[totsy]

the thyroid problems will cause blood sugar problems until they are on an even keel. i sympathise with you as i was in ccu with thyrotoxicosis 13 yrs ago, i have now a non working thyroid so take thyroxine(my endo blames the thyroid 4 my diabetes),
hope we can be of some help to you

 

[cugila]

Hi again Angelc.

Exactly what Totsy has said. However after trawling through ALL your meds there is only one drug which has a specific side effect of Hyperglycaemia.......Atorvastatin. Have you been on it long ?

In the circumstances I think my advice would have to be discuss it with your Dr. Do you see a Consultant or is everything handled by your GP ? You have too many meds to narrow anything down to one in particular. They must be able to make further tests to see what is going on.

Still be interested to hear about your diet though ??

 

[Angelc]

Oooh heck, diet! I don't weigh anything.

Example of yesterday any help? For breakfast I had half a teacup of oats made into porridge with skimmed milk (milk seems to be pushing my glucose up even though i don't have a lot) for lunch I had a chicken salad, salad veg, no pasta or anything like that, and a tangerine. Then the doctor told me to stop eating so few carbs, so I ate a very small jacket spud in the afternoon, and chilli con-carne, with 2 tablespoons of rice/veg, about the same of refried beans, some guacamole and a little sour cream for my tea. My usual breakfast is porridge, although I sometimes have bran flakes, and either a salad or an omellette, like bacon and mushroom, and for my dinner generally pasta or rice with meat and veg, I don't nibble in between these days, although I do have fruit usually, but recenlty that's been pushing the numbers up, so not as much now, rarely I will have a piece of cheese in the evening, I rarely drink alcohol, but drink loads of diet lemonade (I have to in order to get my powdered metformin down, it tastes nasty). Apart from about 6 cups tea coffee a day that's about it.

Is that any help at all... I was on simvastatin, but it didn't work on my cholesterol, so they changed it to atorvastatin, although my cholesterol dropped right down in response to my thyrotoxicosis.

Really appreciate your help. I rang diabetes UK to see if anything I could change in my diet and they couldn't see anything, Doctor says my pancreas has basically packed up now all this has happened over a couple of weeks. I had my 3 month blood test a month ago and it was 6.5.

 

[cugila]

Oooh heck, diet! I don't weigh anything.

Example of yesterday any help? For breakfast I had half a teacup of oats made into porridge with skimmed milk (milk seems to be pushing my glucose up even though i don't have a lot) for lunch I had a chicken salad, salad veg, no pasta or anything like that, and a tangerine. Then the doctor told me to stop eating so few carbs, so I ate a very small jacket spud in the afternoon, and chilli con-carne, with 2 tablespoons of rice/veg, about the same of refried beans, some guacamole and a little sour cream for my tea. My usual breakfast is porridge, although I sometimes have bran flakes, and either a salad or an omellette, like bacon and mushroom, and for my dinner generally pasta or rice with meat and veg, I don't nibble in between these days, although I do have fruit usually, but recenlty that's been pushing the numbers up, so not as much now, rarely I will have a piece of cheese in the evening, I rarely drink alcohol, but drink loads of diet lemonade (I have to in order to get my powdered metformin down, it tastes nasty). Apart from about 6 cups tea coffee a day that's about it.
Yes it does help. There are many carbs in your day, your Gp obviously is a firm believer in plenty of starchy carbs. Is there a medical reason for this ? Carbs are what elevates your Bg levels, my advice would be to reduce them down perhaps to the levels you were eating before when your Bg levels seemed better controlled.

Really appreciate your help. I rang diabetes UK to see if anything I could change in my diet and they couldn't see anything, Doctor says my pancreas has basically packed up now all this has happened over a couple of weeks. I had my 3 month blood test a month ago and it was 6.5.

Your Dr may be right about your Pancreas in that respect, if so then Insulin is going to be the only option for you. I would think that you will be having more tests for Pancreas function soon ?

Just as a matter of course, Diabetes UK has NO connection with this website Diabetes.co.uk. Many of us do not think much of their dietary advice, so I am not really surprised that they thought it was OK ??? I wouldn't say that at all. That advice nearly killed me and made me put on weight so quickly it was unbelieveable ! By NOT following that advice, I have lost 5+ stones and my Bg levels up until a recent illness were 98% on target every day. Draw your own conclusions...!

 

[wallycorker]

..........Example of yesterday any help? For breakfast I had half a teacup of oats made into porridge with skimmed milk (milk seems to be pushing my glucose up even though i don't have a lot) for lunch I had a chicken salad, salad veg, no pasta or anything like that, and a tangerine. Then the doctor told me to stop eating so few carbs, so I ate a very small jacket spud in the afternoon, and chilli con-carne, with 2 tablespoons of rice/veg, about the same of refried beans, some guacamole and a little sour cream for my tea. My usual breakfast is porridge, although I sometimes have bran flakes, and either a salad or an omellette, like bacon and mushroom, and for my dinner generally pasta or rice with meat and veg, I don't nibble in between these days, although I do have fruit usually, but recenlty that's been pushing the numbers up, so not as much now, rarely I will have a piece of cheese in the evening, I rarely drink alcohol, but drink loads of diet lemonade (I have to in order to get my powdered metformin down, it tastes nasty). Apart from about 6 cups tea coffee a day that's about it.................

Hi again Angelc,

You don't mention bread - it's good that you don't seem to be eating any of that. However, as Ken has pointed out you do still seem to be eating quite a lot of starchy carbohydrate. Cut right back the cereals, potatoes, pasta and rice and see what happens then - I expect that it might give a sudden and big improvement in your blood glucose levels. If you cut these foods out you will soon see what you are capable of achieving.

If your pancreas has packed in then that will be a different matter. However, in my opinion, it would be worth you seeing whether you have any possibililty to keep away from having to use insulin.

I have found diet to be far more powerful than I would have ever thought possible.

Good luck and best wishes - John

 

[Helena88]

Hi,

I'm pretty sure that I've heard that beta-blockers can affect your BG levels, might be worth having a look at the side effects leaflet inside the pack. As for cutting your carbs even further I would be reluctant to recommend this after your doctor has specifically told you not to.
Hope you get thing sorted - feel better.

H

 

[Angelc]

Well guys, thank you for all your advice, I'm listening hard and trying to learn

Was told to start checking my ketones if my bg is over 14 consistently, which it is, and these have been totally negative until the last couple of days when I have started to get somewhere between a trace and a small amount.

Who knows at what point I need to be concerned about this, because although I was told to test, that was all I was told!!!

Fruit seems to shoot my bg up (and leave it up!) as does milk!!! I'm trying to stick to more complex carbs rather that reducing them dramatically, particularly as my doc doesn't want me to take them too low.

Just a few more days and I will find out if I am suitable and can start on Victosa, does anyone know if you continue to take your other diabetic meds at the same time? I take Metformin (powder) Gliclazide and Sitagliptin at the moment and was wondering if these would drop off once I started on Victosa?

Sorry for so many questions, I've never had a chance to ask any before! :?

Angela

 

[cugila]

Well guys, thank you for all your advice, I'm listening hard and trying to learn

Was told to start checking my ketones if my bg is over 14 consistently, which it is, and these have been totally negative until the last couple of days when I have started to get somewhere between a trace and a small amount.
Who knows at what point I need to be concerned about this, because although I was told to test, that was all I was told!!!
Have you read the Patient Information Leaflet that should have come with your testing strips ? I wouldn't be concerned about the low level small traces you have mentioned. I would be concerned if it started heading up into the + Small ++ Moderate +++ or ++++ Large readings. You really do need to clarify this with the GP/Nurse

Fruit seems to shoot my bg up (and leave it up!) as does milk!!! I'm trying to stick to more complex carbs rather that reducing them dramatically, particularly as my doc doesn't want me to take them too low.
Fruit. All depends on what type of fruit it is. Some fruit is fine but some fruit is definitely not ! Check the carb content and the Gi/GL so that you know what effect these things may have on your Bg levels.

As for more complex carbs.....the advice you may have been given to eat more starchy carbs is the standard NHS/DUK dietary advice. Many of the members here do not subscribe to that view. Many agree that you need to reduce carbohydrates in the diet. By what amount only you can tell by testing before and 2 hrs after meals.

Diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars. The main carbs to avoid or reduce are the complex or starchy carbohydrates such a bread, potatoes, pasta and rice also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly. Therefore it would make sense to reduce them surely ??
Difficult to go against a Doc's advice I know. Your choice though.

Just a few more days and I will find out if I am suitable and can start on Victosa, does anyone know if you continue to take your other diabetic meds at the same time? I take Metformin (powder) Gliclazide and Sitagliptin at the moment and was wondering if these would drop off once I started on Victosa?

What should really happen when you start on any of these drugs is that your medication should be reviewed and in most cases lowered. If it isn't it is possible to go too low at times and suffer from a hypo or it's warning signs.

Sorry for so many questions, I've never had a chance to ask any before! :?

Angela