In brief, I was diagnosed last week with a reading of 15. gp is treating it as type 2 cos of my age, mid 40, but thinks I will need insulin soon as it is probably an autoimmune cause not diet or familial. (i had colitis and thyroid probs as well.) Started me on metformin 500 3x a day. Went back 6 days later as losing weight (already under 10 stone) cos awful nausea and cramps. Bm that day 3 hrs post a v small breakfast was 17 so he reduced metformin to 1gm Sr and added in gliclazide 80mg twice a day. Told by diabetic nurse to only test once a day and waiting for more strips on prescription so limited anyway. My bm yesterday pre lunch was 12 which is better than the 17 it was the day before at the surgery but I did check it 2 hrs after evening meal and it was 17 again. Does it take a while for the tabs to start having a positive effect. Am worried that gp seems v keen to get me on insulin and don't know how long is realistic to give the tabs time to work. My diet was already low sugar and low fat and with being v slim already, I cant make many more diet changes that may help. Waiting to go on a 3 hr course with a diabetic specialist nurse but by then, worried the gp will have upped tabs, decided they don't work and got me on insulin. Is there a diabetic med algorithm which indicates how long something should be tried for. All v confusing and worrying.
how long before medication should start to work?
- Thread starter geoffry
- Start Date
Hi Geofry and welcome to the forum. I am sure you are feeling quite shocked at this diagnosis and the changes this will bring to your life, we all know how you feel, and I was in similar shoes a couple of years ago. Metformin is a good drug but its not going to bring your levels down lots or super quickly, some of that is in your hands. What a lot of us have found on this forum is that reducing carbohydrates in your diet has a more profound effect on your blood sugar. What this means is cut back on (or in my case out) bread, rice, pasta and potatoes. It sounds life changing and it is but I have got used to this new way of eating and really enjoy it. So for family meals I will serve the family pasta or rice but will replace my portion with broccoli or cauliflower. A couple of nights ago I made a curry and for my portion I stirred in a generous helping of green beans.
The thing to get your head around is the fact that your body converts all carbs to sugar and the whiter the carbs the quicker your body does this, so it might be that toast for brekkie might be a no - no. The best way to tell is to test. Test before you eat and then 2 hours after - your reading after should be around 7.8 - 8.0. If bread makes you spike - which many of us find, its best to reduce or remove this from your diet.
I'm sure it feels daunting but there is so much info on this forum - I only joined in July but since then I have got my BG and my BMI down to levels I am really happy with. Have a read about people who use insulin also, it may be that you will need this so information will really help you to cope with this.
Good luck
The thing to get your head around is the fact that your body converts all carbs to sugar and the whiter the carbs the quicker your body does this, so it might be that toast for brekkie might be a no - no. The best way to tell is to test. Test before you eat and then 2 hours after - your reading after should be around 7.8 - 8.0. If bread makes you spike - which many of us find, its best to reduce or remove this from your diet.
I'm sure it feels daunting but there is so much info on this forum - I only joined in July but since then I have got my BG and my BMI down to levels I am really happy with. Have a read about people who use insulin also, it may be that you will need this so information will really help you to cope with this.
Good luck
borofergie
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I agree with everything that Fraddy said, it is all about the carbs (and especially refined carbohydrates like sugar and flour).
The problem that you're going to have to deal with is that you can't simultaneously be "low-carb" and "low-fat" without losing weight, which you can't afford to do. This means that you're going to have let go of "low-fat" and concentrate of "low-carb", which can seem like a huge step after all the years of false anti-fat propaganda that the Government and NHS have subjected us to over the last 30 years.
When you are ready, I'd suggest reading this:
http://www.nytimes.com/2002/07/07/magaz ... all&src=pm
The problem that you're going to have to deal with is that you can't simultaneously be "low-carb" and "low-fat" without losing weight, which you can't afford to do. This means that you're going to have let go of "low-fat" and concentrate of "low-carb", which can seem like a huge step after all the years of false anti-fat propaganda that the Government and NHS have subjected us to over the last 30 years.
When you are ready, I'd suggest reading this:
http://www.nytimes.com/2002/07/07/magaz ... all&src=pm
xyzzy
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Hi Geoffry
There are tests the doctor can ask for to show if you are T1 or T2. Ask him to organize a c-peptide and GAD test. It is simply not good enough for him to just guess you are going to need insulin "soon" that's totally outrageous and out of order in my opinion. The bottom line is you do not sound as if you meet a lot of the T2 criteria, yes you are mid 40's but you are not overweight and are currently losing weight which is a classic symptom of late onset T1. Did your GP test for ketones in your urine as that would also be an indicator. If you are losing weight AND you are an undiagnosed late onset T1 then the disease is damaging you and needs to be dealt with as swiftly as possible.
All of us who use Metformin see that it will reduce levels by at most 1 or 2 points. Glicazide acts by stimulating your pancreas to produce more insulin. If it is having little effect then it would imply you are not producing a lot of insulin. In the initial stages of T2 insulin production is normally not the major issue and the pancreas is producing insulin but the body fails to use it effectively. Consequently by taking Glicazide the pancreas is told to produce more insulin which compensates somewhat for the bodies inability to use the insulin its producing correctly.
As Fraddycat has said you can help yourself by reducing your carbohydrate intake BUT effectively this will only work if you are really T2 and producing some insulin. Trying to control late onset T1 by diet is not an option. You need to get the doc to resolve what kind of diabetic you are first in my opinion. If it turns out you are bog standard T2 then a low carb regime is undoubtedly the best option in mine and many other members opinion as it allows us to control our T2 condition with minimal medication.
If your doc doesn't seem to want to take the issue seriously then ask to be referred to a consultant at your local hospital.
Good luck, keep asking questions and let us know how you are getting on.
There are tests the doctor can ask for to show if you are T1 or T2. Ask him to organize a c-peptide and GAD test. It is simply not good enough for him to just guess you are going to need insulin "soon" that's totally outrageous and out of order in my opinion. The bottom line is you do not sound as if you meet a lot of the T2 criteria, yes you are mid 40's but you are not overweight and are currently losing weight which is a classic symptom of late onset T1. Did your GP test for ketones in your urine as that would also be an indicator. If you are losing weight AND you are an undiagnosed late onset T1 then the disease is damaging you and needs to be dealt with as swiftly as possible.
All of us who use Metformin see that it will reduce levels by at most 1 or 2 points. Glicazide acts by stimulating your pancreas to produce more insulin. If it is having little effect then it would imply you are not producing a lot of insulin. In the initial stages of T2 insulin production is normally not the major issue and the pancreas is producing insulin but the body fails to use it effectively. Consequently by taking Glicazide the pancreas is told to produce more insulin which compensates somewhat for the bodies inability to use the insulin its producing correctly.
As Fraddycat has said you can help yourself by reducing your carbohydrate intake BUT effectively this will only work if you are really T2 and producing some insulin. Trying to control late onset T1 by diet is not an option. You need to get the doc to resolve what kind of diabetic you are first in my opinion. If it turns out you are bog standard T2 then a low carb regime is undoubtedly the best option in mine and many other members opinion as it allows us to control our T2 condition with minimal medication.
If your doc doesn't seem to want to take the issue seriously then ask to be referred to a consultant at your local hospital.
Good luck, keep asking questions and let us know how you are getting on.
Grazer
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borofergie said:
I agree 100%. And with fraddycat's comments on food types. I happily ate all the foods that said no or little sugar without realising it was the carbs getting me up into the teerns with my blood sugar levels. Flour based products were worse for me than sugar! ou do need to check your diabetes type as well though as xyzzy says; you can't tackle it properly without knowing.
You also need to get more strips and test more often. If you can't get enough on prescription, buy the SDcodefree meter on amazon, strips for it are only £7 for 50. The meter itself is cheap as chips too.
borofergie
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And as the others have said - you need to keep a very close eye on it, because if you really do have T1 then you'll get very poorly without insulin (no matter how few carbs you eat).
Although I don't have any personal experience, it seems to me that insulin isn't such a bad thing, especially for someone with a very low BMI.
Although I don't have any personal experience, it seems to me that insulin isn't such a bad thing, especially for someone with a very low BMI.
I agree with the others that you may well have LADA (late onset T1). Your GP is wrong in saying you are T2 but it's auto-immune. Auto-immune diabetes is a T1; late though it may be. You can initially partially control it by a low-carb diet but if you are a T1 you will have to increasingly reduce your carb intake with corresponding weight loss. If Gliclazide doesn't help much then that's an indicator; my Gliclazide has little effect for example although I'm not a confirmed LADA. Sitagliptin may be better in the short-term than Gliclazide as it extends the time the pancreas does produce any insulin after meals rather than prodding non-existent cells. Interesting how GPs vary. Mine refused to give me insulin last year saying it was a 'last resort' and added Sitagliptin which has helped a bit. So, do consider going through Sitagliptin first before insulin (see the current NICE guidelines) unless your Hba1c continues to go high.
Thank you for all your replies and support. I have read all about low carbs etc so trying to do that. However, it would still be helpful to know if when others used metformin and gliclazide whether it worked in a few days or a few weeks etc. I don't want to rush back too soon to gp incase he changes things too quickly; I also know my partner is going to try and contact a diabetic specialist nurse, rather than waiting to be contacted. Do these 2 drugs always work as soon as you start them or is it normal for it to take a little time?
Metformin has the same effect in both type I and type II diabetics.. it works by increasing insulin sensitivity and decreasing the amount of glucose that the liver releases throughout the day. Gliclazide works by stimulating the pancreas to produce more insulin.. this will work for a time in a newly diagnosed type I however at some point due to the body attacking the pancreas it will lose so much function that the glicazide will no longer be effective.
Your best bet is to get correctly diagnosed as soon as possible.. if you are type I then you will need to go on insulin straight away.
Your best bet is to get correctly diagnosed as soon as possible.. if you are type I then you will need to go on insulin straight away.
Hi. Perhaps to answer your question on length of time to act. Opinions vary but I would expect Metformin to work within a few weeks if you are an insulin resistant T2 and perhaps a bit sooner if you are relying on the reduction of glucose output by the liver. I would expect Gliclazide to work within a few days as it works directly on the pancreas. These are just my opinion but GPs views also vary a lot. My GP said it would take up to 6 months for Sitagliptin to work but it had an effect within 2 days......
Just to give you an update and ask for more advice (sorry). After not tolerating metformin 3x a day, nausea ++, and bs still 17 2 hrs post v small breakfast, gp put me on metformin 1gm Sr and glaclazide 80 twice a day. Bs then spiked to 26 a few days later (pre bed. Fasting bs that day had been 11, high but low for me). Had to see out of hrs gp to check for ketones. Saw normal gp next day who spoke to cons endocrinologist who advised the gads and c peptide bloods and doubling the meds. Not got blood results yet. But bs still all over the place. Was told to check levels twice a day but today have done it more to get an idea.
Fasting vs 9 (had v small bowl ofmalt wheats, no sugar etc)
Pre lunch, was 13.7. (had home made fish pie, v small amount mashed sweet pot and lots of green veg)
2 hrs post lunch it was 4.4! (did have half he walk pre taking it)
Just before tea it was 4.8 (had 2 pieces home made wholemeal seeded bread, homemade lentil and sweet potato spread, homemade unsweetened yog and a small homemade muffin which was a diabetic recipe.
Bs 2 hrs after upto 14.
Generally my bs trend today has been lower than other days which is encouraging but still peaks but not always post food. V confused. I need some carbs, I can't lose more weight, but trying to ensure I have a lot less, they are low gi and homemade as much as poss. Will the gp want to put me on insulin or is there another med that can be added in?
Sorry for the long post. Frustrated and worried.
Fasting vs 9 (had v small bowl ofmalt wheats, no sugar etc)
Pre lunch, was 13.7. (had home made fish pie, v small amount mashed sweet pot and lots of green veg)
2 hrs post lunch it was 4.4! (did have half he walk pre taking it)
Just before tea it was 4.8 (had 2 pieces home made wholemeal seeded bread, homemade lentil and sweet potato spread, homemade unsweetened yog and a small homemade muffin which was a diabetic recipe.
Bs 2 hrs after upto 14.
Generally my bs trend today has been lower than other days which is encouraging but still peaks but not always post food. V confused. I need some carbs, I can't lose more weight, but trying to ensure I have a lot less, they are low gi and homemade as much as poss. Will the gp want to put me on insulin or is there another med that can be added in?
Sorry for the long post. Frustrated and worried.
