What Say Do I Have in my Medication?

pmtbrew

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Diet only
Hello all,

I've been diagnosed for close to 12 months and have dropped by A1C to around the 34-40 mark (2g of metformin and 40mg glic a day) but cannot maintain my body composition (cannot get above 85kg and body fat is falling from 25% to around 17%).

Whenever I speak to a nurse I am told I should not take the glic as my control is too tight but am thinking that it would be better to be on insulin as I believe this would give me more freedom to eat more carbs (currently less than 100g per day) but know the answer would be no. I can go 24hr without glic before the sugars start to rise too high so beleive I woudl need very little insulin.

Can I request that I be given insulin? Is this a good idea or have I missed something out which would make this silly/dangerous.

I use the Freestyle Libre so monitor so hypos are not an issue.

Any thoughts/feedback would be appreciated.

Paul
 

Lamont D

Oracle
Messages
15,796
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Reactive hypoglycemia
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I do not have diabetes
It is your choice, but......

The idea of low carbing is to come off the meds, all meds, if at all possible.
You only need insulin if you need it because your endocrine system doesn't produce enough.
 

AndBreathe

Master
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If your A1c is 34-40, I can't grasp why your doctor would still prescribe Gliclazide. You are running at non-diabetic levels.

What makes you feel you should be taking insulin?

I have never taken medication diabetes, and would like to remain that way. Wouldn't you rather be reducing meds, rather than effectively increasing them?
 
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pmtbrew

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Diet only
I've argued that as I am 38 I need to have tight control in order to reduce risks over the next 50 years

If the glic is removed the A1C will jump to 50 (based on testing), so thought insulin would be more suitable to provide insulin only when needed.
 

Lamont D

Oracle
Messages
15,796
Type of diabetes
Reactive hypoglycemia
Treatment type
I do not have diabetes
Glicizide works differently than insulin!

I don't think you have an insulin problem.
Is your diet, carb reduced enough to help you with control?
 

pmtbrew

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Diet only
At the moment I can control blood sugars but what I am doing is unsustainable and will have no eat more carbs at some point in the future in order to remain a healthy weight (all parties tell me I need to ingest around 450g carbs a day to be healthy on a 3000 calorie diet - which is what I need to maintain my weight)
 

Daibell

Master
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12,642
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I wonder why you are trying to maintain such a high weight? 450 gm of carb a day is far too high for anyone let alone a diabetic. I think you need to define a sensible level of carbs as a diabetic such as less than 200 gm/day. See how your blood sugar goes. Anything near to 42 mmol HBa1C is very good. You shouldn't need to consider insulin unless max dose of Gliclazide no longer works. I was on 320gm/day with no effect after 5 years so insulin was obviously needed. My stupid diabetes GP refused as I was listed as T2 but actually LADA. 1 year later she offered me insulin as my blood sugar had shot up and it has been a salvation. I think you are many years away from needing it; tablets are easier.
 

4ratbags

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3,334
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It sounds a bit like you really cant give up the carbs, for a lot of us here even 100gr carbs is too much and you are talking about ingesting 450gr carbs per day. I think it is time for you to stop making excuses and to really sit down and rethink your diabetes goals. To plan the rest of your life based around medication is madness. Have you ever had a really good look into the LCHF way of eating. If done properly it is possible to lower your BS and if need be lose, maintain or gain weight depending on what ratio of carbs, protein and fat you are consuming.
 
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Patricia21

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I would only think of insulin as a very last resort.
Your BG is lower than mine Im 44 and pleased with that as it was 58 last year.
I have had worries maintaining my weight with low carbs,but I am static now.
I do eat carbs but just cut down,and eat lots of everything else,I have found it easy.
 

AndBreathe

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I've argued that as I am 38 I need to have tight control in order to reduce risks over the next 50 years

If the glic is removed the A1C will jump to 50 (based on testing), so thought insulin would be more suitable to provide insulin only when needed.

I would suggest going to insulin could be a using a hammer to crack a nut, at best, and a disaster at worst.

Most T2s produce plenty insulin, but for various reasons we can't use it very well. If we carry any weight, particularly around our mid-sections, the chances of us having insulin resistance (the ability to use our natural insulin) go up, quite a bit.

In your shoes, my approach would be to be happy I have reduced my blood scores to non-diabetic levels, and to concentrate on getting rid of any spare poundage I was carrying - particularly around my middle. Getting to, and staying at a very trim place.

My personal experience is based on my desire to control my bloods, with weight-loss being very much a secondary consideration. As my numbers moderated, I dropped some weight, due to carb reduction. Periodically, my blood numbers would plateau, then notch down a bit. This aligned with my trimming up.

My HbA1c scores, since diagnosis are in my signature. My current daily range is pretty low, and I remain meds free. I have never taken any diabetic medication.

I can categorically state that the two things that made a difference to my health, blood readings, and potential future well-being have been two-fold:
- Everything I eat, or don't eat
- Trimming away excess fat; in particular around my mid section

In November I was removed from the Diabetic Register. I don't state I am cured or anything flashy like that, but I am certainly in a decent diabetic place.

If you are carrying weight, I would make a wager that trimming up, and maintaining a decent diet, would improve your insulin resistance, which can have two impacts. It can further lower your HbA1c and/or allow you to eat more carbs in due course.

Taking insulin isn't a walk in the park, and it's, by all accounts, a bit of a bind. Why would you want to put yourself through that? I just don't get that. My comments aren't meant to be in any way a personal dig at you. I am merely expressing my concern for your thinking processes.
 
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Mike d

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It's your life, but for the life of me, I cannot fathom why you would want to use insulin if you don't have to. I'd rethink your strategy, as to me (and others) it doesn't seem to be a path I'd consider. Heed the advice and ask more questions so you can work thru the issues

Mike :)
 

Totto

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2,831
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I've argued that as I am 38 I need to have tight control in order to reduce risks over the next 50 years

If the glic is removed the A1C will jump to 50 (based on testing), so thought insulin would be more suitable to provide insulin only when needed.

I think you are perfectly right to want to have tight control. Why you choose to eat such staggering amount of carbs is however beyond me. I keep under 30 grams per day and have reduced my HbA1c to a normal level without any medication at all. Not that everyone should do as low carb as me, just giving an example. If you reduced your carb intake a bit I'm sure your control would improve even further.
 
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Bluetit1802

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Tight control is the most important thing, and you have shown you can have this without insulin, possibly without Glic. Maybe even without Metformin. If you are concerned that you can't put a bit of weight on the Metformin won't be helping you. It is an appetite suppressant for one thing.

With low carb most people lose weight. It dropped off me. When I reached goal weight I kept on losing until I found the right balance of fats without increasing my carbs. It was trial and error, hit and miss, for a while, but I did find the right balance for me. I have now been an ideal stable weight for a few months. It can be done.

I am suspecting that the weight isn't your main concern, more wanting to be free to eat carbs and maintain tight BS control by increasing meds. That to me is plain daft.
 
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carty

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3,379
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Have you tried increasing your fat content instead of increasing carbs .That should increase your weight without increasing your BG s
CAROL
 

Ali H

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790
Type of diabetes
Type 2
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Insulin
This thread is like a game of chinese whispers! The OP states they are eating less than 100g of carbs a day but whenever they talk to somebody they are told they SHOULD be eating 450g of carbs a day, ie they are not eating a huge amount of carbs but not in low carb territory as such, and they state their body fat percentage is falling towards 17% so I would suggest they don't have a podgy middle? Unless I am also interpreting the content incorrectly that is!!!!

Ali
 
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NoCrbs4Me

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I would suggest trying to get a consultation with an endocrinologist or at least a doctor specializing in diabetes. Based on the info you have provided it does seem like your blood glucose control issues when going of gliclazide are more due to lack of insulin production than insulin resistance, but I could be wrong.
 

AndBreathe

Master
Retired Moderator
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Hello all,

I've been diagnosed for close to 12 months and have dropped by A1C to around the 34-40 mark (2g of metformin and 40mg glic a day) but cannot maintain my body composition (cannot get above 85kg and body fat is falling from 25% to around 17%).

Whenever I speak to a nurse I am told I should not take the glic as my control is too tight but am thinking that it would be better to be on insulin as I believe this would give me more freedom to eat more carbs (currently less than 100g per day) but know the answer would be no. I can go 24hr without glic before the sugars start to rise too high so beleive I woudl need very little insulin.

Can I request that I be given insulin? Is this a good idea or have I missed something out which would make this silly/dangerous.

I use the Freestyle Libre so monitor so hypos are not an issue.

Any thoughts/feedback would be appreciated.

Paul

When you talk of being off Glic for 24hrs, before your levels go too high; what do they actually go to, and what had you eaten in that 24 hours? Whatever it was, was that your usual diet, lower or increased carbs?
 

Brunneria

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Messages
21,889
Type of diabetes
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At the moment I can control blood sugars but what I am doing is unsustainable and will have no eat more carbs at some point in the future in order to remain a healthy weight (all parties tell me I need to ingest around 450g carbs a day to be healthy on a 3000 calorie diet - which is what I need to maintain my weight)

Who are these 'all parties', advising you to eat so many carbs?

I have no idea your fitness and exercise levels, but there are endurance athletes running 100 miles at a time, who fuel themselves on low carb eating.

Aspiring to eat that many carbs is absurd advice to give to a diabetic, and i would distrust any other advice they offer too. Advice like that is so far out of date it belongs in the last century - and was bad advice then.
 

pmtbrew

Active Member
Messages
44
Type of diabetes
Type 1
Treatment type
Diet only
The fasting level hits 8mmol/l if no glic is taken (my target is less than 6mmol/l)
 

AndBreathe

Master
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Messages
11,321
Type of diabetes
I reversed my Type 2
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The fasting level hits 8mmol/l if no glic is taken (my target is less than 6mmol/l)

What about the other part of my post? What had you eaten? Was it your usual diet, or were you trying out a higher carb eating regime to see how you went without the Glic?