Blood sugars

[diane20]

Hi help needed. I'm type 2 have taken my metformin meds, blood sugar still high and climbing, any suggestions what I could do to help get it down please

 

[britishpub]

Hi and welcome

The biggest influence on Blood Glucose is what you eat. Carbohydrates are the biggest culprit as they become glucose/sugar once they are digested.

The welcome post that @daisy1 will post in a while will give you fabulous information.

After you have read it ask any questions you need.

Metformin is the standard first line drug for people diagnosed with T2D but it is not a powerful drug that will have any instant noticeable effect on your readings. It takes many months to build up in your system.

 

[Carol-P]

Some people have found it necessary to starve for a day when they're too too high. I have never had to do it myself. I guess you have to find out what's getting you to high and, if you are eating sensibly, it is possible you have an infection. You may be advised to seek doctors advice! I hope this helps!

 

[Robbity]

I agree with @britishpub - you should definitely watch and reduce your consumption of all carbohydrates as these generally have the biggest impact on our glucose levels. Reduce them and you should also see a drop in your blood sugar levels too: the right diet will usually do more to help us than all the metformin in the world...

But you should also be talking to your doctor and/or diabetes nurse if you're worried about rising levels.

Robbity

 

[Li4m79]

what are your sugar levels??

When I was diagnosed not long back, my levels were high and I was prescribed Glipizide to bring my levels down, they worked a lot faster..

But main thing I think as mentioned, cut your carbs, and watch your sugar intake... good luck

 

[DBolding]

Metformin doesn't actually lower your BG all it does it make you less insulin resistant so that your body can use what it has better. Metformin takes quite a while to establish itself. Sometimes up to three months. It's not a quick fix.

 

[DavidGrahamJones]

Metformin doesn't actually lower your BG

I've seen this statement so many times now that like an urban myth, it's likely to be believed.

Here's a quote from our very own global diabetes community.

Metformin is a type 2 diabetic drug, and helps diabetics to respond normally to insulin. Like most diabetic drugs, the ultimate goals of Metformin are to lower blood sugar to a normal level and maintain this level.

If this statement is wrong then perhaps I can stop taking it and tell everyone I'm cured. Oh, we should also tell diabetes.co.uk that they're wrong.

 

[DBolding]

I am so pleased David that you read my entire post rather than just quoted one section completely out of context.

Maybe in my original post I should have stated metformin doesn't directly lower your BG but makes your cells more receptive to Insulin which your body is already producing. So it doesn't actually lower your BG but helps your body to use what it makes

If Metformin was to lower BG on its own I would be able to stop taking Insulin injections and I would be cured!

 

[Oldvatr]

I've seen this statement so many times now that like an urban myth, it's likely to be believed.

Here's a quote from our very own global diabetes community.

Metformin is a type 2 diabetic drug, and helps diabetics to respond normally to insulin. Like most diabetic drugs, the ultimate goals of Metformin are to lower blood sugar to a normal level and maintain this level.

If this statement is wrong then perhaps I can stop taking it and tell everyone I'm cured. Oh, we should also tell diabetes.co.uk that they're wrong.

A goal is a nice thing to have, but it is just words. How does actual reality compare?
http://www.ncbi.nlm.nih.gov/pubmed/9428832
In this relatively short term trial, the HBA1c was observed to drop by between 0.6% (500mg dose) to 2.0% (2500mg dose).

The following study is a meta data study and has similar (but lower efficacy results).
http://care.diabetesjournals.org/content/35/2/446.full

Both studies agree that Metformin lowers HbA1c, but whether it reaches the goal you quoted above is unlikely for many diabetics. Many would say that the effect is small compared to other treatments. I would say that in many cases, proper control of diet has a greater effect than this med.

I continue to take it, and my bgl levels are now ok, but Metformin is only part of my toolkit. I have dropped my own HbA1c from 99 down to about 36, which i much greater than the 2% shown for Metformin only.

It is a useful drug, and for those of us who can tolerate the side effects, then there are other benefits in using it.

I think the goal statement should be ammended to read "......are to lower blood sugar and maintain this level."

 

[Bluetit1802]

I have always understood that Metformin works on the liver, helping to reduce the amount of natural glucose the liver produces and may therefore help to a limited extent with our liver dumps. What it doesn't do is reduce post meal spikes, so diet is the key to this. It may well help with insulin resistance, but I understand this occurs only because it reduces appetite and therefore helps with weight loss, and the weight loss is what helps reduce insulin resistance. Metformin is known to be more beneficial to those with excess weight and less beneficial to those without excess weight.

 

[DavidGrahamJones]

I understand this occurs only because it reduces appetite and therefore helps with weight loss, and the weight loss is what helps reduce insulin resistance.

When I was first diagnosed I only took Metformin and it worked perfectly although it didn't reduce my appetite and I didn't lose weight. I think it's important to note that we will all react differently to any drug that we take. I'm concerned that a statement like "Metformin doesn't lower BG" becomes a de facto truth, when it obviously acts differently in all of us who take it.

 

[DBolding]

What I meant to say is that Metformin does not directly lower BG. Yes it helps with the lowering of BG but doesn't lower it directly. Metformin allows a diabetic to use the insulin they produce better. For example. You can't go and have a high carb meal and expect to pop a pill and your BG will be fine.

Sent from my SM-G928F using Diabetes.co.uk Forum mobile app

 

[Oldvatr]

What I meant to say is that Metformin does not directly lower BG. Yes it helps with the lowering of BG but doesn't lower it directly. Metformin allows a diabetic to use the insulin they produce better. For example. You can't go and have a high carb meal and expect to pop a pill and your BG will be fine.

Sent from my SM-G928F using Diabetes.co.uk Forum mobile app

http://www.amjmed.com/article/S0002-9343(97)00254-4/abstract

 

[JohnEGreen]

You can't go and have a high carb meal and expect to pop a pill and your BG will be fine.

A friend of mine who when first diagnosed and put on metformin thought exactly that as she had been told it would reduce BG. A trip to A&E in an ambulance soon corrected that misconception.

 

[Mep]

I know everyone has responded with questioning your diet and carb intake, but you make no mention of it so it could well be you watch your carb intake as suggested. Then maybe it could be the issue also. Further to this I'm thinking that maybe you also need more than metformin to control your sugar levels. Most docs like to introduce glipizide or other drugs to help lower sugar levels if metformin alone isn't helping. That is certainly what happened in my experience.

Another question I should ask you is were you diagnosed with type 2 based on all the diagnostic tests? eg. hbA1c, GAD test, and c-peptide test. If you were only diagnosed based on the hbA1c alone I would suggest you ask your medical team to run the diagnostic tests to check whether or not you are definitely type 2 or if you're in fact another type altogether. If things haven't been done properly to diagnose you, this could be the issue. Eg. you may in fact need to be on insulin if you don't produce much of it.

I wish you the best.

 

[Oldvatr]

I know everyone has responded with questioning your diet and carb intake, but you make no mention of it so it could well be you watch your carb intake as suggested. Then maybe it could be the issue also. Further to this I'm thinking that maybe you also need more than metformin to control your sugar levels. Most docs like to introduce glipizide or other drugs to help lower sugar levels if metformin alone isn't helping. That is certainly what happened in my experience.

Another question I should ask you is were you diagnosed with type 2 based on all the diagnostic tests? eg. hbA1c, GAD test, and c-peptide test. If you were only diagnosed based on the hbA1c alone I would suggest you ask your medical team to run the diagnostic tests to check whether or not you are definitely type 2 or if you're in fact another type altogether. If things haven't been done properly to diagnose you, this could be the issue. Eg. you may in fact need to be on insulin if you don't produce much of it.

I wish you the best.

The OP is recently diagnosed, and appears to be on single medication (Metformin) only. IMO it is a bit early to start talking of requiring insulin. We do not know the current dosage, or how long OP has been taking it. We also don't know what the OP considers to be high bgl, or what their testing regime is.

There are many other drugs that can be added to help control bgl, and the advice given here regarding diet may well be sufficient to help the OP solve the current situation. If not, then we need to advise them to seek further help from GP. Not all T2's get the full gamut of tests on initial diagnosis. if their bgl at DX is not hyperinflated, then it is normal to start with simple diet and lifestyle changes to see if this affects levels. (As per NICE guidelines, I believe)

The OP does not appear to have received the welcome message from @daisy1

 

[Mep]

The OP is recently diagnosed, and appears to be on single medication (Metformin) only. IMO it is a bit early to start talking of requiring insulin. We do not know the current dosage, or how long OP has been taking it. We also don't know what the OP considers to be high bgl, or what their testing regime is.

There are many other drugs that can be added to help control bgl, and the advice given here regarding diet may well be sufficient to help the OP solve the current situation. If not, then we need to advise them to seek further help from GP. Not all T2's get the full gamut of tests on initial diagnosis. if their bgl at DX is not hyperinflated, then it is normal to start with simple diet and lifestyle changes to see if this affects levels. (As per NICE guidelines, I believe)

The OP does not appear to have received the welcome message from @daisy1

Yeh, I was just asking questions. I'm not in UK so I don't know your procedures there.

 

[daisy1]

@diane20

Hello Diane and welcome to the forum Here is the information we give to new members and I hope this will help you with your levels, in addition to the good advice from members above. Ask more questions and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[Oldvatr]

Yeh, I was just asking questions. I'm not in UK so I don't know your procedures there.

What you asked is sensible, but this is only the second post the OP has made since Dec., and getting a broadside from us old lags may deter them. They are looking for reassurance and gentle guidance. If they cannot get levels down over time then further action may become necessary, but in the meantime there is work they can do simply that could remove their problem.

 

[Mep]

What you asked is sensible, but this is only the second post the OP has made since Dec., and getting a broadside from us old lags may deter them. They are looking for reassurance and gentle guidance. If they cannot get levels down over time then further action may become necessary, but in the meantime there is work they can do simply that could remove their problem.

Yeh ok cool I get what you mean. For me I when I was a newbie to this forum I was not a newbie to diabetes. I don't know the history of newbies unless I can see it written that they were only just diagnosed, etc.. so I just ask questions based on my own experiences to clarify. For example I was placed on metformin 7 years after I was diagnosed. I controlled with diet only prior to that.

Thanks again.