Medication

[Jessica4999]

This is my first post here and I would appreciate the thoughts of others. When I was originally diagnosed with T2 diabetes, I was put on Metformin with disastrous results - travelling to work on a bus was no joke - stinking farts and explosive diaharrea. My GP then out me on Glipizide as an alternative and all went well for years until very recently when my blood sugars have risen. It was decided to put me on GlucophageSR (metformin) and I was extremely concerned because of my initial experience. Regime was 1 tablet (500mg) in the morning for 10 days, increasing to 1 in morning and 1 in evening for 10 days and so on until I was on 2 morning and 2 evening. 1 went down fine but the trouble started when I reached 2 - the smelly farts, diahorrea, and worse, occasional leakage. Spoke to nurse practitioner who told me to persevere and I have. Then I started to have hypos around lunchtime - a very new experience for me - and heartburn, especially at bedtime. I went to GP and she said I should still continue with meds as prescribed but to increase my breakfast food intake with more carbs and protein (I am trying to lose weight!). She also prescribed omeprazole for my digestive problems. I am now recording lows in the 2s and 3s just before lunch (at least I can tell as I get light headed and shaky) and that is even after a decent breakfast - today 2 bacon butties! I am due a diabetic review soon but the temptation is to reduce the Metformin. However, I have had another thought and this is where I would like an opinion.......
The GP told me metformin was not the problem and I remember my old GP telling me that Glipizide can cause lows. I currently take 2 x 5mg tabs in the morning and now wondering whether I should take 1 in the morning and the other when I take my evening dose of metformin. Any thoughts?

 

[Resurgam]

The glipizide is wringing the insulin out of your pancreas and yes it can cause lows - the logic of telling someone to eat more carbohydrates to counteract the effects of the medication is not really on my scale of rationality.
Has no one ever suggested that it is the carbohydrates from such things as bread you should avoid? Weight gain is a symptom of diabetes and it often goes away when blood glucose is kept under control by a low carb diet.
Having just checked on the loaf of ordinary bread two slices would be 36 gm of carb - that would be my whole day's intake - but I have carbs as salad and low carb veges and berries.
Now you are taking the glipizide eating fewer carbs would not be advisable as you got hypos even after the sandwiches, but I can't see the reason for it.
Taking glipizide in the evening doesn't seem like a good idea - it's effect is to cause insulin to be released, and if you are going low during the night that could be nasty.
I should confess that I threw the Metformin and Atorvastatin in the bin shortly after diagnosis - I just couldn't live with the side effects.

 

[LindsayJane]

This is my first post here and I would appreciate the thoughts of others. When I was originally diagnosed with T2 diabetes, I was put on Metformin with disastrous results - travelling to work on a bus was no joke - stinking farts and explosive diaharrea. My GP then out me on Glipizide as an alternative and all went well for years until very recently when my blood sugars have risen. It was decided to put me on GlucophageSR (metformin) and I was extremely concerned because of my initial experience. Regime was 1 tablet (500mg) in the morning for 10 days, increasing to 1 in morning and 1 in evening for 10 days and so on until I was on 2 morning and 2 evening. 1 went down fine but the trouble started when I reached 2 - the smelly farts, diahorrea, and worse, occasional leakage. Spoke to nurse practitioner who told me to persevere and I have. Then I started to have hypos around lunchtime - a very new experience for me - and heartburn, especially at bedtime. I went to GP and she said I should still continue with meds as prescribed but to increase my breakfast food intake with more carbs and protein (I am trying to lose weight!). She also prescribed omeprazole for my digestive problems. I am now recording lows in the 2s and 3s just before lunch (at least I can tell as I get light headed and shaky) and that is even after a decent breakfast - today 2 bacon butties! I am due a diabetic review soon but the temptation is to reduce the Metformin. However, I have had another thought and this is where I would like an opinion.......
The GP told me metformin was not the problem and I remember my old GP telling me that Glipizide can cause lows. I currently take 2 x 5mg tabs in the morning and now wondering whether I should take 1 in the morning and the other when I take my evening dose of metformin. Any thoughts?

Hello and welcome to the right place for advice and support. I'm tagging @daisy1 who will send you some really useful info. Good luck with your journey (I don't envy you the side effects of Metformin!)

 

[Jessica4999]

Hello and welcome to the right place for advice and support. I'm tagging @daisy1 who will send you some really useful info. Good luck with your journey (I don't envy you the side effects of Metformin!)

Thank you xx

 

[Jessica4999]

The glipizide is wringing the insulin out of your pancreas and yes it can cause lows - the logic of telling someone to eat more carbohydrates to counteract the effects of the medication is not really on my scale of rationality.
Has no one ever suggested that it is the carbohydrates from such things as bread you should avoid? Weight gain is a symptom of diabetes and it often goes away when blood glucose is kept under control by a low carb diet.
Having just checked on the loaf of ordinary bread two slices would be 36 gm of carb - that would be my whole day's intake - but I have carbs as salad and low carb veges and berries.
Now you are taking the glipizide eating fewer carbs would not be advisable as you got hypos even after the sandwiches, but I can't see the reason for it.
Taking glipizide in the evening doesn't seem like a good idea - it's effect is to cause insulin to be released, and if you are going low during the night that could be nasty.
I should confess that I threw the Metformin and Atorvastatin in the bin shortly after diagnosis - I just couldn't live with the side effects.

 

[Jessica4999]

Thank you! what you are saying makes sense and my son, who studied diabetes at uni told me about the role of carbs and reducing carbs was the way I was heading but still trying to consume complex carbs! Given glipizide was my FIRST control med, perhaps the practitioners should have considered what might happen when Metformin was introduced. Incidentally, I take Atorvastatin too with a co-enzyme q10 supplement. Is there a reason why you gave up?

 

[Resurgam]

Rather a lot of reasons - my skin was itchy, my muscles and joints ached, I was incontinent, painfully so - I could not concentrate on anything my memory was going - I sing English and Scottish folk songs but I could not remember them. My hair was falling out every time I brushed it. I went to Tesco and bought all the Christmas food twice. I wandered around the car park looking for the car, and when I found it and opened the back there was a heap of shopping I'd forgotten about.
The most galling thing about the whole experience is that I did not need the tablets anyway.

 

[daisy1]

@Jessica4999
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

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 well over 600,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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 blood glucose 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.