Type 2 A Mystery

[ImChris]

Hello everyone, Currently at my wits end with a current condition that doctors do not have an answer too,
I'm 56 5'9 and weigh 11 stone
I'm taking Metformin 500mg 2 in the morning and 2 at night I have also been given sitagliptin 100mg 1 a day
all was going okay until about a year ago 2020, My skin started to itch started in my left lower leg and found a gentle scratch of the affected area wasnt enough to relieve the itch and had to scratch harder enough to make it bleed and then felt such relief from the itching sensation the wound would heal and then the itch would return so again had to scratch harder to break the skin and over time my whole body is a complete mess of scratch wounds and a constant feeling of skin itching,
I stopped taking the metformin and it reduced the skin irritation I advised the diabetic nurse of my condition and was told to keep taking metformin but to see my doctor which i have and was given a weeks supply of antibiotics which done little help
My blood sugar levels have always been high in the 12 -18 range i not a big eater just little but often of fresh wholesome foods very rare i have any fast food I do not drink or smoke
I done some self diagnosis by not having metformin or sitagliptin which seemed to improve the constant itching but because my blood sugar levels went through the roof i started taking my medicine again and the itching came back with vengeance
So the other day i decided not to have any breakfast or lunch and my blood sugar levels dropped down to 6 lowest it has been for ages and the itching feeling calmed down until i had my evening meal and the itching came back and my sugar levels went upto 12, The diabetic nurse asked me to come in she took one look at my body and gasped wow at all the wounds from scratching the doctor took a look and was at a loss as to the problem and suggested a simple diet change which i started but of no change
Im just wondering if anyone else has or had the same problem with the itching and if there is a solution because at the moment it is driving me up the wall
Many thanks for any replies
Ps I used to enjoy my fruits Grapes plums Tangerines but they just shoot my blood sugar levels to the 20 - 25 range

 

[EllieM]

Welcome to the forums @ImChris

My blood sugar levels have always been high in the 12 -18 range i not a big eater just little but often of fresh wholesome foods very rare i have any fast food I do not drink or smoke

How long have you been diabetic? Those levels are too high to have as a long term level and I would have hoped that your doctors would have done more to help you get them down.

Interestingly, my 90yo T2 dad has the itching problem on his lower legs/feet. His GP gives him a steroid cream to calm it down, but he can't use it long term because it would damage the skin.

I would be interested in the nature of the simple diet change suggested, though I'll subject you to the standard low carb diet used by many T2s on here anyway.

So, assuming that you are T2(more about this later) fresh wholesome foods are not necessarily as wholesome as you might think. In particular, most T2s start out as insulin resistant. Their diet contains more carbohydrate than their bodies can cope with and they start having to produce more and more insulin in order to cope with it. Unfortunately high circulating insulin levels plus high blood sugars tend to result in weight gain, hence T2s are often overweight, and the more overweight they get the more their insulin resistance increases, leading to an unpleasant vicious circle of increasing weight, insulin and blood sugars.

Cutting the carbs for T2s can have a similar effect as someone who is gluten intolerant cutting gluten. Buying a glucose meter allows people to work out whether the carbs in a particular meal spike their bloods too much (general ball park is you want to keep the rise less than 2mmol/L 2 hours after first bite of a meal). But grains (including oats), rice, pasta, potatoes and most fruit (not berries) tend to have quite a lot of carbs, and you may need to cut out or reduce all or some of them. (And fruit juice has very high fructose content, so drink with extreme care!).

But my suggestion, if you want to try the lower carb route, is to sit down and write down everything you eat over a few days. Then calculate the carbohydrate content (or post on here and folk will make suggestions). If there's scope to make a big carb reduction then I'd suggest trying it. Keeping blood sugars of 12-18 is pretty unhealthy, and may well be contributing to the itching, even if it isn't a direct cause.

One more question, as you aren't at all overweight, (though some T2s aren't). How confident are you that you are T2 rather than T1/LADA (slow onset T1)? Lots of doctors see your blood sugars and your age and assume T2, while in fact maybe 10% of initially diagnosed T2s are actually misdiagnosed T1s. A cpeptide test and GAD antibody test would help sort that out, if they haven't already been done.

Anyway, good luck. I hope you find out a solution soon, and would be interested to hear it for the sake of my dad, who is also driven up the wall by the itching.

 

[luceeloo]

If my sugars run high for an extended amount of time I get itchy lower legs, and like you, I would scratch until they bleed. It is a common side effect of uncontrolled diabetes.

 

[TeddyTottie]

As others have said, it is possible that your continuous high BG is contributing to, or causing the itching, You have found yourself that it eases if your BG is below 6. This is a figure that many of us would consider to be towards an upper limit of an acceptable management of T2. High BG levels also inhibits wound healing so you are caught in a vicious cycle of worsening skin quality and laying yourself open to persistent infections, which you would be less able to shake off because of your poorly controlled diabetes.

I would suggest that you consider a low-carb diet and see if you can bring those BG figures way down. In the meantime you might find a good quality moisturiser is helpful on your legs.

 

[Daibell]

Hi. As Metformin and even Sitagliptin don't have a dramatic effect on BS I certainly wouldn't take an antibiotic to combat any itching caused by the two drugs. I would be inclined to agree with the nurse that you stop either or both tablets. You mention 'wholesome' foods and as others have said that could mean foods which for us aren't wholesome. You need to keep the carbs well down but don't worry about fats or proteins. Avoid tropical fruit. There is a possibility that you are a late onset T1 and not T2. This is more likely if you are slim and have lost weight recently. If this is the case do ask for the two tests for T1 i.e. GAD and C-Peptide. BTW there are some other diabetes drugs which may help but not cause itching. BTW is the Metformin the standard variety or Slow Release (SR) version which may be kinder?

 

[ImChris]

Hi. As Metformin and even Sitagliptin don't have a dramatic effect on BS I certainly wouldn't take an antibiotic to combat any itching caused by the two drugs. I would be inclined to agree with the nurse that you stop either or both tablets. You mention 'wholesome' foods and as others have said that could mean foods which for us aren't wholesome. You need to keep the carbs well down but don't worry about fats or proteins. Avoid tropical fruit. There is a possibility that you are a late onset T1 and not T2. This is more likely if you are slim and have lost weight recently. If this is the case do ask for the two tests for T1 i.e. GAD and C-Peptide. BTW there are some other diabetes drugs which may help but not cause itching. BTW is the Metformin the standard variety or Slow Release (SR) version which may be kinder?

Hi hello many thanks for the reply, I have the standard Metformin which to be honest does not seem to be doing anything to lower BS I was hoping the nurse may change my medication but seems okay with what I am taking at the moment and dismisses my skin condition as a reaction to the tablets or links to diabetis she is the professional and left it to her expertise

 

[ImChris]

As others have said, it is possible that your continuous high BG is contributing to, or causing the itching, You have found yourself that it eases if your BG is below 6. This is a figure that many of us would consider to be towards an upper limit of an acceptable management of T2. High BG levels also inhibits wound healing so you are caught in a vicious cycle of worsening skin quality and laying yourself open to persistent infections, which you would be less able to shake off because of your poorly controlled diabetes.

I would suggest that you consider a low-carb diet and see if you can bring those BG figures way down. In the meantime you might find a good quality moisturiser is helpful on your legs.

Many thanks for your reply, Although the itching calms down some when BS drops to around 6 or lower in myself I feel quite dizzy light headed and I feel so hungry and start to shake and sweat so I have to eat something sweet or I'm just going to pass out, When my BS is at about 10 I feel in myself to be very happy good focus and feel fine then the itching starts

 

[ImChris]

If my sugars run high for an extended amount of time I get itchy lower legs, and like you, I would scratch until they bleed. It is a common side effect of uncontrolled diabetes.

Unsure how to control BS any better as I have the 2 Metformins in the Morning along with the Sitagliptin then 2 Metformins in the Evening and the nurse is telling me to carry on as I am, Whilst my whole body which started with one leg is now resembling a join the dots exercise, I'm sure there must be another type of medication I could try??

 

[EllieM]

When my BS is at about 10 I feel in myself to be very happy good focus and feel fine then the itching starts

There is a condition called false hypoglycemia where you feel bad when you reduce your blood sugar to normal from high levels. 10 is too high, but your body is used to higher so sends you false "I am too low" messages when your levels go below this. This condition will pass as soon as you get used to the lower levels.

You need to lower your levels. The complications from long term levels persistently above 10 are horrendous. (I could list them, starting with ED, but I don't want to lecture).

I'm sure there must be another type of medication I could try??

The long term medication is insulin, but if you are T2 still producing excess insulin this is just encouraging your insulin resistance. (Though may be necessary if your insulin producing cells have been worn out). If however you aren't T2, then you should get tested (cpeptide and GAD) and insulin will be your best friend.

A c-peptide test would be very very informative, whether T1 or T2.

As a healthy T1 after 51 years on insulin then I can say it is an awesome drug that has saved my life.

Good luck.

 

[Lamont D]

I suffer from itching, and I use an antihistamine to relieve the itch, but sometimes it is not enough, only an icepack will calm it. Sometimes it feels if my bones are itching rather than the skin.

As others have said, it is the rapid fluctuations of your blood glucose levels that is probably the cause. Getting your levels stabilised and down towards normal levels, will help with everything that you are experiencing.

Low carb works.

 

[lucylocket61]

Many thanks for your reply, Although the itching calms down some when BS drops to around 6 or lower in myself I feel quite dizzy light headed and I feel so hungry and start to shake and sweat so I have to eat something sweet or I'm just going to pass out, When my BS is at about 10 I feel in myself to be very happy good focus and feel fine then the itching starts

What were the results of your most recent liver function test (part of your regular blood tests)? When my liver function wasnt working well I got itching.

 

[lucylocket61]

Unsure how to control BS any better as I have the 2 Metformins in the Morning along with the Sitagliptin then 2 Metformins in the Evening and the nurse is telling me to carry on as I am, Whilst my whole body which started with one leg is now resembling a join the dots exercise, I'm sure there must be another type of medication I could try??

do you control your carbs intake in your diet?

 

[TeddyTottie]

Hi hello many thanks for the reply, I have the standard Metformin which to be honest does not seem to be doing anything to lower BS I was hoping the nurse may change my medication but seems okay with what I am taking at the moment and dismisses my skin condition as a reaction to the tablets or links to diabetis she is the professional and left it to her expertise

I understand the temptation to accept what the healthcare professionals say as gospel, but in my opinion any nurse or doctor who is content to allow your BG to tank along between 12 and 18 all the time is being negligent in their duty of care. For comparison, my preprandial BG at diagnosis was around 17 and my GP was most concerned to get it down asap.

Please, for your own long-term health, do a little research on your own behalf. And do pursue the possibility that you might be something other than a simple T2.

 

[Brunneria]

Unsure how to control BS any better as I have the 2 Metformins in the Morning along with the Sitagliptin then 2 Metformins in the Evening and the nurse is telling me to carry on as I am

Good gracious!
Your nurse is definitely not offering you all the options available, and seems content to leave you itching and scratching in what must be constant misery.
Can you see another nurse, in future?

as for what you can do... there is an extensive list.
- reducing carb intake is probably the quickest, easiest and most effective. Diet and lifestyle changes are far more effective for T2s than most of the medications.
- test your blood glucose (self funded tests, if necessary) before and 2 hours after food. If your blood glucose has risen by more than 2mmol/l then you ate more carbs than your body could cope with. Simply eat less next time, and watch your blood glucose stop peaking so high. Replace the carbs with more veg, protein and low carb foods to prevent hunger.
- when/if you feel wobbly, test your blood glucose. If it is high, then no need to eat carbs. If it is below 4 then follow the guidance for T1s on treating a hypo. If it is above 4 but lower than usual, then you may be experiencing a false hypo. These do not require treatment. If you wish, you could eat something, but keep track of the carbs and try to keep them low. Using sweets and carbs to push blood glucose back up during a false hypo just prevents your body from re-learning what it feels like to have healthy levels.
- you may continue to need some medication, but there are many more Than the 2 you are currently on, and your nurse is, in my view, not acting in your best interests, if they don’t research different medications and med combos to find the best ones for you.

As your blood glucose starts to lower towards normal levels (approx 4-8mmol/l) you may need to check with your doc to discuss lowering your medications. No point in over medicating and causing hypos when diet changes may be able to achieve normal blood glucose without them.

There are many, many success stories (here on the forum) of people doing exactly that.

 

[Resurgam]

It is only an unprofessional opinion, but I'd put money on you not actually passing out when you start to get normal blood glucose.
A quiet sit down with a warm drink and you'd probably feel fine in a few minutes.
It is just that your brain is used to a nice warm sugary environment, and it is throwing a real wobbly.
Something nutritious but low carb would most likely make you feel a lot more cheerful in a few minutes.
Your reaction to fruit is entirely normal, by the way.
Throwing any bit of cold meat you might have in the fridge into a blender, then adding some veges, either cooked fresh or even frozen after defrosting in warm water, then tipping it into a pan with any stock or a stock cube, maybe a small amount of an aromatic curry powder or a pinch of herbs and a few minutes gentle simmer should give you all you need, rather than something sugary.
The itching could be down to Metformin - if you did not eat then you might well not have taken the tablet, and I would think it is far better to rely on eating less carbohydrate than taking tablets, just for your mental wellbeing, even if they are not the cause of the itching.

 

[MrsA2]

When I first started low carbing I had itching and flaky skin, and light-headedness and many other odd symptoms too BUT they did pass. I envisage it as the sugar fleeing my body and trying to get out any way it can. But the body is like a spoilt toddler, it wants to hold onto sugar even though its bad for it so it throws tantrum by giving cravings.

Its up to you to decide how much you want to get through those first couple of weeks while your body tantrums and gets rid of the sugar. A bit like going cold turkey from other addictions.

As many of us find there is no easy medication route to get diabetes under control, but luckily low carbing does become a way of life that is sustainable . You just have to have the determination to overcome cravings and a few other short lived side effects. When you've managed to control your bg better you could probably ditch the drugs that seem to be causing this skin irritation.

Well be here to support you

 

[VashtiB]

Hi @ImChris ,

I hope you are feeling a bit better. I echo everyone else. I would really try lowering your carbs before resorting to more mediation. Having said that your levels are really high and as others have said you are likely to get false hypos. This is one of the real value of testing.

As someone with type 2 diabetes you are likely to be insulin resistant and unless you lower your arb intake you are likely become more resistant and need more and more insulin.

Let us know what you plan to do and how you are going.

Take care.

 

[Circuspony]

Itching was one of my signs of undiagnosed diabetes - I was convinced I was allergic to washing powder. My BG just read Hi on the monitor. It's damage to blood vessels that's causing it.

You must, must get those levels down. You might feel woozy below 10 but that's just because your body has got used to a lot of sugar.