Metformin and Blurred Vision,HbA1c

[Rog32]

Hi everyone!
I am 32yrs old and last month i have been diagnosed with diabetes type 2 in the mid of August last month. My test results showed that my BG level was 27.
The last time i tested for diabetes was in August 2009 and the BG level was 3 back then.
My vision was blurred for 3wks before i was diagnosed.
After 4 days of taking oral medication-1 Dacadis and 1 metformin my vision went back to normal.
The metformin medication had to be increased gradually ie one tablet in wk1,2 in wk2 and 3 in wk 3.
When i increased the metformin dosage to 2 in wk 2 my vision started to get blurry again daily until i was told to reduce the metformin in the 3rd wk to 1 a day.I did reduce it to 1 a day and now my vision is getting back to normal again.

I did a second blood test within 1wk of being diagnosed and the results came back yesterday.The second results that came back had results for my glycated haemoglobin-HbA1c- and that was really high at 16% ie poorly managed as i have never done a haemoglobin test before.
My blood sugar level in the second test showed it had decreased from 27 to 13 within 12dys of takin my meds.Today my fasting BG level stays below 9 every morning for almost 19dys now and my lowest BG so far during the day before dinner was 4.
I noticed that with little meds and exercise that my BG drops during the day before dinner.
The test also showed that my cholesterol level is 4.6 below the normal 5 mark.
My blood pressure is 124/75.

Even though my blood pressure level and cholesterol level is within range i was given simvastatin to reduce my chol level and ramipril to reduce my BP level even further.

My regular GP has now referred me to a diabetes specialist doctor and i am waiting on a retinopathy screening.

As of today my vision is back to normal and i am worried that increasing the glicazide to 2 in the morning instead of 1 i was taking before may cause my vision to go blurry again.

Being use to having a 20/20 vision to being reduced to having blurred vision is quite a scary thing for me.


Questions:
Have anyone experienced blurred vision with metformin?

Isnt it too early for me to be testing for HbA1c at this stage as i have been recently diagnosed and only just started taking meds?

Is statin and ramipril necessary even though my BP level and Cholesterol level are within the normal range?

It would be greatly appreciated if experienced forum posters would answer these questions for me pls.

Thanks.

 

[daisy1]

Hi Rog and welcome to the forum To try to answer your questions, I didn't get and don't get now, blurred vision with metformin. The HbA1c takes the average of your blood levels during the last 8-12 weeks, with the last two weeks being weighted heavier. So since you were diagnosed less than 8-12 weeks ago it won't be any use getting an HbA1c yet. Lots of doctors see benefits in statins regardless of your levels but with the Ramipril you need to check your BP yourself to make sure you are not going low.

Here is some information that you might find interesting and useful - it is routinely given to new members.

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 well over 30,000 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 ... rains.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

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.

 

[Rog32]

Thx for replying daisy1.

 

[pianoman]

Hello and Welcome,

variable Blood Glucose levels can affect vision... one of my earliest symptoms was blurred eyesight. This usually settles as your BGs are managed to more normal levels.

Many Doctors prescribe statins but other Doctors question their efficacy and safety. I'd advise you to read around the topic and make up your own mind.

 

[Daibell]

Hi

Blurred vision tends to be related to quite high BS but obviously everyone is different. You are quite young to be diagnosed with Type 2 so it's always possible you have one of the variants from the typical insulin resistant Type 2. An HbA1C will show up how your average BS is. Anyone with DB should have an HbA1C at least once a year and more frequently if BS isn't under control so you should welcome the test. At your BP level I'm surprised you are on Ramipril. I was put on it when I went up to about 130/90. Also your cholesterol appears OK as it is? If it was me I would discuss both the meds with your GP; it's your choice and both meds have side effects.

 

[witan]

Hello and wellcome Rog32

Diabetes can affect many parts of the body, some parts only after having high glucose levels for many years, but the eyes respond remarkably quickly to glucose level changes, but in a slightly perverse way.

If you have had slowly increasing glucose levels over a long period you will have adapted to the changes in your eyes and never noticed any problems - as soon as you start driving the levels down quickly with medication the changes will affect your vision until it becomes stabilised at the lower levels.

Reducing the metformin will slow the changes down and get your levels and vision back to normal in a controlled manner.

You'll hear the terms Hyper and Hypo used frequently, Hyper means high levels(of glucose in this case) and Hypo means low levels. Of course this usually refers to the 'Normal' range, but when you are first diagnosed (or just out of control) your body has got used to operating in the Hyper mode, so just reducing your levels by a few points may make the body think it's going Hypo!

As anyone who has ever had a Hypo will tell you, after possibly the hunger and shakes, the vision goes wobbly, for me it's spinning shinning discs, for others it's a sort of blurred, sticky, out-of-focus thing.

The small blood vesells in the eyes are easily damaged by high glucose levels and as soon as you have your levels under control I am sure you'll join us all on the yearly or 6 monthly eye check-ups.

So expect some changes and try to keep those levels comming down through diet, exercise and meds, quickly, but not too quickly, and when they are stabilised ensure you get on the diabetic retinopathy screening programme and visit your optician, letting them know you are diabetic.

Unfortunately once diagnosed with diabetes you have to be better than normal on all the other measurements so they expect your cholesterol and BP to be at the lower end of normal ' to avoid complications' but all the meds they give you have side effects, so it's best to be sure you are comfortable taking them or look into other ways of control, i.e diet, exercise, relaxation, meditattion etc.

Best of Luck and let us know how you get on.