The next step - medications

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
I finally got n appointment for next February for my 'annual' diabetes review. It's highly possible I may have to start diabetes medication.

Given I can't take Metformin, any ideas on what is likely to be offered?

I would like chance to do some research before meeting my DN as she is abrasive, and I may not be able to think on my feet and make snap decisions when in her office.

My last hba1c was 54 and I expect this one to be worse due to covid related higher readings.

I may also have to research BP meds. I reacted badly to two types of ACE ones, so need to look at alternatives. My BP is around the 155/85 mark most of the time now, so meds are probably needed.

I am not asking for medical advice, but where to look for reliable information, and anecdata please.
 

Antje77

Oracle
Retired Moderator
Messages
19,392
Type of diabetes
LADA
Treatment type
Insulin
Given I can't take Metformin, any ideas on what is likely to be offered?
Depends. Until a very short time ago, the first option after metformin was gliclazide (sulfonylurea), but I think nowadays some prefer to try flozins or gliptins first, of which I know hardly anything because I was already on insulin when they became very popular.
https://www.diabetes.org.uk/guide-t...lets-and-medication/dpp-4-inhibitors-gliptins
https://www.diabetes.org.uk/guide-t...betes/tablets-and-medication/sglt2-inhibitors
 

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
When I turned 50 I got diagnosed with type 2 diabetes and another condition. I just turned 60 this week and feel like I am falling apart health wise. I am waiting for a scan to see how bad my liver is now too. And my liver consultant wants me to have bariatric surgery. I want a body transplant!!

I am feeling scared at how fast my body is ageing. Asthma was diagnosed 2 years ago. I expected another decade before I got this bad with so much happening medically at the same time.

I suspect there are many on here who feel the same, who have to juggle various conditions, and each ones treatment impacts on the next.

I may not be in imminent danger of death, but my quality of life and lifespan is affected a lot more than a couple of years ago. I haven't felt well since I got covid, then long covid.

Thanks for letting me offload here. As a carer, I have to keep my negative feelings and fears in at home and be the strong one. Xxx
 

Antje77

Oracle
Retired Moderator
Messages
19,392
Type of diabetes
LADA
Treatment type
Insulin
Thanks for letting me offload here. As a carer, I have to keep my negative feelings and fears in at home and be the strong one. Xxx
Keep offloading here please! A forum is a good way to share the burden with lots of people and thus keep the few at home a bit out of the winds (might be a Dutch expression, not sure if it's a thing in English but the meaning is still clear ;))
I want a body transplant!!
Now there's a thought!
Can we choose the body we'd like? I mean, apart from a working pancreas I have some other wishes if we get to choose...
 

Lamont D

Oracle
Messages
15,905
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
As I'm sure you know @lucylocket61. I've been through an awful lot since the turn of the century.......
When I turned 50 I got diagnosed with type 2 diabetes and another condition. I just turned 60 this week and feel like I am falling apart health wise. I am waiting for a scan to see how bad my liver is now too. And my liver consultant wants me to have bariatric surgery. I want a body transplant!!

I am feeling scared at how fast my body is ageing. Asthma was diagnosed 2 years ago. I expected another decade before I got this bad with so much happening medically at the same time.

I suspect there are many on here who feel the same, who have to juggle various conditions, and each ones treatment impacts on the next.

I may not be in imminent danger of death, but my quality of life and lifespan is affected a lot more than a couple of years ago. I haven't felt well since I got covid, then long covid.

Thanks for letting me offload here. As a carer, I have to keep my negative feelings and fears in at home and be the strong one. Xxx

...And I was only 45, like you it was just one thing after another culminating in RH in 2012. Having my life completely destroyed by events out of my control and the mental illness that entirely altered my personality and my outlook on life, as a carer for my disabled wife and the father in law, always needing help. And having to sacrifice your time and energy for no rewards other than knowing without you, how would you feel otherwise? I admire your resilience and fortitude, but who else would do it right?
I really understand the falling apart bit, I am trying to remember the right words to say and long words or names, can be hard when typing. And trying to stay positive and getting knocked back by more health issues not just for you but others around you.
Have you noticed that the older you get, the number of people you know, are no longer with us, and as I reach my seventies in a couple of years time, it is not getting any better. My head and heart still believe I am no more than 35 years old, even though all my grown up kids are older than that. My overriding goal is to see my great grandkids.
But as soon as my brain function tells me to get things done, it's either myself, my wife, pops! Or one of the kids or grandkids, family or friends something has happened. And you have to get through this, death, disease and more is always hovering.
When you find yourself, trying to get better, battling the odds of age and disease, to have the ability to understand why and do something about it is not only brave, but so precious and valuable with your lot.
And after that, my list of symptoms and conditions grow again, New diagnosis of Essential Tremor syndrome and then following on behind as a result of my mental health, Restless Legs syndrome. Again as I'm typing my legs are swinging and rubbing, feet twirling and so comical. And typically, no known cure.

This brief history of both of our dotage, us old codgers, sorry! Young uns, can only do what we can, despite the barriers, we will try our best and if it's not good enough well we will get up tomorrow and try again.
And as always something else will come along, but we have bouncebackability!
And on this forum, we have got people going through hell, panicking, distraught, not knowing what to do, no support asking for advice, asking for help. And like me, you understand that, you help with great advice and knowledge with experience of your diabetes, what it takes to use your time for others and I'm told its a gift!
I don't have the words to thank you enough the advice you have given me, the support, the sympathy, empathy, steering, until the poster and or me gets it!
That is something to be proud of, something to put on your CV. If there is a deity, and needs someone, I think this would just about get you in. But no way, are you a saint!
He knows your past! Like me, you have your failings and your sins!
So, that is it, my brain hurts now and I think my right foot has dropped off!
(Next!)

My prayers are with you, and keep on trucking, as you have done already.
You are a good person!

Then you say that I am as well!(lol)

Merry Christmas.
 
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jonathan183

Well-Known Member
Messages
373
Type of diabetes
Type 1
Treatment type
Insulin
I guess the NICE guidelines apply. Would the slow release metformin be an option or do other conditions medication prevent it? Dr Bernstein lists 4 insulin sensitising agents one being metformin (Glucophage) the other pioglitazone (Actos). The other oral agents he suggests are insulin mimetics.
 

JohnEGreen

Master
Messages
13,229
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Tripe and Onions
I went to the body shop the other day but they were out of stock of young fit bodies so I guess I'm stuck with the one I've got.
I do sympathise as I simply can no longer remember what it felt like to feel well.
I hope that what ever medication you decide on as it is your decision not your DN's helps you feel better and don't forget that this is the place to come to when you feel down and need support without worrying those close to you at home we are here for you when you need us.
 
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Lamont D

Oracle
Messages
15,905
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Oh yeah, meds!
If metformin is a no go, then as others have said, the Gliptin range of meds, May be worth a consideration, and depending on your hormonal response which dpp4 inhibitor, will be best for you.
It helps with initial insulin response because of insulin resistance or poor insulin levels. It helps with decreasing the spike and with a low carb dietary lifestyle choices, should help with Hba1c levels and lower your symptoms and your health improves.

Stay safe.
 

AndBreathe

Master
Retired Moderator
Messages
11,337
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
@lucylocket61 - Sorry you're having a tough time of it still. It's been rather an awful couple of years for you, for sure.

This might e useful to you, in terms of the thinking/referencing your GP might undertake if he/she considers a bit of pharmaceutical support would benefit you: https://www.nice.org.uk/guidance/ng...in-adults-with-type-2-diabetes-pdf-2185604173

I know from reading that your elevated numbers concern you, so perhaps a bit of help to rein them in might help buoy you up all round.

Keep fighting that good fight!
 

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
As I'm sure you know @lucylocket61. I've been through an awful lot since the turn of the century.......


...And I was only 45, like you it was just one thing after another culminating in RH in 2012. Having my life completely destroyed by events out of my control and the mental illness that entirely altered my personality and my outlook on life, as a carer for my disabled wife and the father in law, always needing help. And having to sacrifice your time and energy for no rewards other than knowing without you, how would you feel otherwise? I admire your resilience and fortitude, but who else would do it right?
I really understand the falling apart bit, I am trying to remember the right words to say and long words or names, can be hard when typing. And trying to stay positive and getting knocked back by more health issues not just for you but others around you.
Have you noticed that the older you get, the number of people you know, are no longer with us, and as I reach my seventies in a couple of years time, it is not getting any better. My head and heart still believe I am no more than 35 years old, even though all my grown up kids are older than that. My overriding goal is to see my great grandkids.
But as soon as my brain function tells me to get things done, it's either myself, my wife, pops! Or one of the kids or grandkids, family or friends something has happened. And you have to get through this, death, disease and more is always hovering.
When you find yourself, trying to get better, battling the odds of age and disease, to have the ability to understand why and do something about it is not only brave, but so precious and valuable with your lot.
And after that, my list of symptoms and conditions grow again, New diagnosis of Essential Tremor syndrome and then following on behind as a result of my mental health, Restless Legs syndrome. Again as I'm typing my legs are swinging and rubbing, feet twirling and so comical. And typically, no known cure.

This brief history of both of our dotage, us old codgers, sorry! Young uns, can only do what we can, despite the barriers, we will try our best and if it's not good enough well we will get up tomorrow and try again.
And as always something else will come along, but we have bouncebackability!
And on this forum, we have got people going through hell, panicking, distraught, not knowing what to do, no support asking for advice, asking for help. And like me, you understand that, you help with great advice and knowledge with experience of your diabetes, what it takes to use your time for others and I'm told its a gift!
I don't have the words to thank you enough the advice you have given me, the support, the sympathy, empathy, steering, until the poster and or me gets it!
That is something to be proud of, something to put on your CV. If there is a deity, and needs someone, I think this would just about get you in. But no way, are you a saint!
He knows your past! Like me, you have your failings and your sins!
So, that is it, my brain hurts now and I think my right foot has dropped off!
(Next!)

My prayers are with you, and keep on trucking, as you have done already.
You are a good person!

Then you say that I am as well!(lol)

Merry Christmas.
You are a good person. Thank you for writing all this. I will save it to look at as and when I need reminding. Xxx
 
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TeddyTottie

Well-Known Member
Messages
394
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Remember, you do not have to decide anything during the review itself. Write down any suggestions or recommendations made, and then say you need a couple of weeks to do your research. You can always request a follow up call or F2F appointment to discuss and make any decisions. Yes, I’m sure this will not be a popular option with the healthcare tyrants but really, who cares…

Do what you need to do. Even if you do feel railroaded into making an on the spot choice, you can always delay filling a prescription until you fully understand the implications and then request a follow-up call if you are not happy.
 

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
Remember, you do not have to decide anything during the review itself. Write down any suggestions or recommendations made, and then say you need a couple of weeks to do your research. You can always request a follow up call or F2F appointment to discuss and make any decisions. Yes, I’m sure this will not be a popular option with the healthcare tyrants but really, who cares…

Do what you need to do. Even if you do feel railroaded into making an on the spot choice, you can always delay filling a prescription until you fully understand the implications and then request a follow-up call if you are not happy.
Thats a great idea. My DN wont like it - she is a bit of a tyrant know all, which brings out my worst qualities and temper, but yes, I will try that.
 

EllieM

Moderator
Staff Member
Messages
9,281
Type of diabetes
Type 1
Treatment type
Insulin
Dislikes
forum bugs
@lucylocket61 I am sorry you are having such a difficult time with your health.

Just a thought, and I'm sure you already know this, but if your readings have gone up from covid and/or long covid, even if you do have to go on medication you won't have to necessarily stay on it if your health (and sugar levels) improve as a result of recovery from covid.

I appreciate that you are much more knowledgeable about T2 and your own body than me (and your diabetic nurse) so I just want to encourage you not to be afraid of temporary medication. Though your DN may be convinced that T2 is progressive we all know it doesn't have to be.

Although I know very little about T2 (apart from ny dad who was on gliclazide for a few years before low carbing) I've been on blood pressure meds for about 30 years. There are a number of different brands and mechanisms for them, so I agree with @TeddyTottie that you should push for some options from your DN, and research before you take them.

Lots of virtual hugs, you can do this.
 
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finzi1966

Well-Known Member
Messages
183
Lucy if they are suggesting bariatric surgery then I’m going to make the assumption that you have quite a lot of weight to lose. So maybe they’ll suggest Ozempic (a once a week injectable)? It works by both reducing appetite/increasing satiety and also by promoting appropriate insulin secretion (more subtly than gliclazide). I’ve had really fantastic results with it so far, both weight loss and BG wise.
 

Daibell

Master
Messages
12,650
Type of diabetes
LADA
Treatment type
Insulin
Hi. Why can't you use Metformin? The SR version works well for most people so if you are worried about bowel problems make sure you try SR
 

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
Hi. Why can't you use Metformin? The SR version works well for most people so if you are worried about bowel problems make sure you try SR
I am not going to go into my other medical issues, but I have tried all forms of Metformin. It's not an option.
 
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lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
Lucy if they are suggesting bariatric surgery then I’m going to make the assumption that you have quite a lot of weight to lose. So maybe they’ll suggest Ozempic (a once a week injectable)? It works by both reducing appetite/increasing satiety and also by promoting appropriate insulin secretion (more subtly than gliclazide). I’ve had really fantastic results with it so far, both weight loss and BG wise.
I already have no appetite and eat around 1200 cals a day max. Making myself eat has been an issue for me since my teens. My weight has remained unchanged for 10 years, despite my low carb and cal intake. I will research Ozempic, thanks. My BMI is under the threshold for bariatric surgery, the consultant is suggesting this due to the combination of conditions I have.
 
Last edited:

lucylocket61

Expert
Messages
6,435
Type of diabetes
Type 2
Treatment type
Diet only
@lucylocket61 I am sorry you are having such a difficult time with your health.

Just a thought, and I'm sure you already know this, but if your readings have gone up from covid and/or long covid, even if you do have to go on medication you won't have to necessarily stay on it if your health (and sugar levels) improve as a result of recovery from covid.

I appreciate that you are much more knowledgeable about T2 and your own body than me (and your diabetic nurse) so I just want to encourage you not to be afraid of temporary medication. Though your DN may be convinced that T2 is progressive we all know it doesn't have to be.

Although I know very little about T2 (apart from ny dad who was on gliclazide for a few years before low carbing) I've been on blood pressure meds for about 30 years. There are a number of different brands and mechanisms for them, so I agree with @TeddyTottie that you should push for some options from your DN, and research before you take them.

Lots of virtual hugs, you can do this.
Thank you for this. I had been thinking that once I get onto the meds ladder, it's a one way trip. I hadn't thought that it could be temporary. This is a cheering point.:)
 

TriciaWs

Well-Known Member
Messages
1,727
Type of diabetes
Type 2
Treatment type
Other
When I turned 50 I got diagnosed with type 2 diabetes and another condition. I just turned 60 this week and feel like I am falling apart health wise. I am waiting for a scan to see how bad my liver is now too. And my liver consultant wants me to have bariatric surgery. I want a body transplant!!

I am feeling scared at how fast my body is ageing. Asthma was diagnosed 2 years ago. I expected another decade before I got this bad with so much happening medically at the same time.

I suspect there are many on here who feel the same, who have to juggle various conditions, and each ones treatment impacts on the next.

Xxx
I hope you can get a suitable medication to lower your BS, and that the long covid resolves soon.

I had one year pre-covid when I was diagnosed with 4 conditions in a single visit to a neurologist. But not the one I was referred for! It is a difficult adjustment getting any long term condition, often likened to the grief process as we lose the person we were.
In my experience, unlike ordinary grief we may cycle over and over as things change.
Let us know if you need any more support.