What is the next stage in treatment Type 2

[MaggieAnne]

Good morning. Off to the diabetic nurse at lunch time and a little confused about what the next stage of my treatment should be. Have been on Metformin SR 500 mgs twice a day. Did try the Glic...zide - (sorry cannot remember how to spell that one) but it made me very hungry and faint so stopped that within a couple of days.

Have been low carbing - not what the nurse ordered and blood sugars came down lovely. However, of late they have started remaining high after eating. I am probably starting the same route my mum did when she started with diabetes and she is now on insulin. I think it is an hereditory aspect that the insulin cells are starting to pack in - so whatever I do diet wise will not be sufficient over time, but obviously helps.

So if I go today and she says my blood sugars are raised over the last 3 months what is the next stage? I have read with interest the Byetta discussion - would it be realistic to ask to try that - assuming we have a discussion on insulin?

Any advice gratefully received.

Many thanks

Maggie Anne

 

[cugila]

Hi MaggieAnne.

You ask about Byetta. Who would use it?
People with type 2 diabetes who are not well controlled on diet and oral agents i.e. those not achieving target HbA1c levels on sulphonylureas, metformin or thiazolidenediones. It is particularly suitable in obese people as an alternative to insulin treatment.

The PCT's usually have strict criteria about it's use because of the high cost compared to Insulin. These involve BMI and other factors. You would have to check to see if you are a qualifying patient.

There is a thread on here entitled 'Anyone use Byetta' where there is much information about it.

There is also a similar drug called VICTOZA (liraglutide) which we too have a thread about here. There are at present only 4 or so members on it. So, the information is not full. It is being added to all the time though.

Ken.

 

[MaggieAnne]

Thanks Ken, it was reading the Byetta thread that gave me the idea that was for me. But I do not know if I will fit the criteria.

What alternatives might she offer me? Any ideas would give me chance to prepare by checking the forum for pros and against.

Thanks

 

[cugila]

Hi MaggieAnne.

If it was me deciding I would suggest going back on the Gliclazide ! You are also only on half the max dose of Metformin SR, so there is another option ?

Gliclazide does not have a side effect of making you hungry, what it does do is lower your Bg levels. If at the time you were on it your Bg level was already low because your carb intake was very low then you could well have been getting Hypo symptoms, one of which is feeling hungry . The faintness goes hand in hand with insufficient food consumption.

Maybe Glic and/or Metformin dose increase plus closer attention to the diet and portion sizes might be an alternative, rather than a leap to something much stronger.

Ken.

 

[edwin]

I agree with Ken, I was on 3 X Metformin 500SR and needed a little more control so the Doc added Gliclazide it made me feel a little strange at first but my BG levels came down and I have not needed to change my medication for 2 years now. I would give the Gliclazide a chance, there is always more options later if it does not work.

Ed