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That's interesting about doing the blood test and adjusting the dosing interval based on that. Agree, there are sometimes problems with the B12 assay, but I believe that they are rare. Always worth doing the blood test for coeliac disease cos more common in diabetic people, easy to do, but...

Apparently alcohol increases risk of hypos for up to 24 hours. best wishes

I am not allowed to give specific treatment advice, but there is a really good article from New Zealand on the topic. Basically the metformin probably stops the end of the small bowel from absorbing B12 adequately; sometimes one can overcome this by giving a lot of B12 orally, although one USA...

I would also just check that no one was kindly buying doubles for you instead of singles. But I would tend to agree with NicoleC1971 about lightweight drinkers. But a lesson for all of us. Best wishes

Hi Your GPs must be fairly flexible to allow 2 monthly B12; in our area, a lot of elderly have B12 deficiency (the cells lining the stomach that make intrinsic factor to help absorb the B12 shrivel up with age)m and the GPs are not exstatic about the number possibly needing injections. Hence...

One is not allowedd to suggest treatment here, but studies show that the weight gain associated with insulin is a bit less if taking metformin at same time, and much less if taking a GLP-1 RA injection such as liraglutide at same time. One study suggested that weight gain was less on bedtime...

Agree about getting appointments with nurse, so I do the jabs myself - initially used upper arms, but a bit fiddly and I was using probably the same spot, so now use anterolateral thigh - bigger area to hit. May I ask how you knew that 3 monthly wasn't working? I have seen a few folk who feel...

Hi, it is unusual to measure the creatinine level in the urine, but it is common to measure the albumin or protein leak from the kidneys by comparing these levels to the level of creatinine in the urine'; the other way to measure albumin and protein in the urine is to collect the urine for 24...

Yes - lots of uncertainty here. But recent analysis is interesting:- https://jamanetwork.com/journals/jama/article-abstract/2728487 Each half an egg eaten per day increased risk of cardiovascular disease 6%, each 300 mg cholesterol eaten per day was associated with a 17% increase in CVD. The...

Yes - lots of uncertainty here. But recent analysis is interesting:- https://jamanetwork.com/journals/jama/article-abstract/2728487 Each half an egg per day increased risk of cardiovascular disease 6%, each 300 mg cholesterol per day was associated with a 17% increase in CVD. The effect of...

Him sorry to hear of your troubles. I'm not much into guidelines, but the NICE guidance is here , and it is useful for you IMHO:- https://www.nice.org.uk/guidance/cg182/chapter/1-Recommendations#classification-of-chronic-kidney-disease-2 If your e GFR was 70 last year and it is now 42, then...

Metformin SR was introduced by Merck to address the gastro-intestinal side effects of plain metformin, not necessarily to make it a once per day drug. The datasheet states that if control deteriorates on once per day Metformin SR, one should go back to the Metformin SR several times per day. Do...

I have split the dose in the past, half morning and half evening and it made no difference. If one takes prednisolone in evening, it is said to interfere with sleep I used to find that the steroids had a slight effect morning and lunchtime but really put the glucose levels up teatime and...

Totally agree with above about foot clinic re ulcers. And I would hope that you are seeing someone who is helping about the neuropathic pain. Being somewhat pessimistic, sorry, but foot amputation might leave you with the pain (phantom) still. There are other agents to consider such as...

As above, your doctors cannot dictate that you should take something. You have given the simva and atorva a trial and had side effects both times - that is clear - ie you have a totally valid reason not to take the statin, Have your doctors considered ezetimibe which is not a statin and has far...

I've seen younger folk get up and go back to work within a few hours of a fit from idiopathic epilepsy but as one ages, time for full recovery seems longer eg octogenarians might not be right for 5-7 days. I would have thought that an 80 year old would have been back to normal within 7 days. So...

One of my patients was an ambulance driver on basal bolus. We kept a log of his shifts initially to show that he managed the job OK (which he did) and no hypos and then he just got on with it. The only special trick was to inject after rather than before food cos of the risk of injecting and...

That is the same Matt Hancock who said that he could not promise that there wouldn't be deaths from lack of medicines, and the same Matt Hancock who told us not to worry cos he was stockpiling body bags! Totally agree that the present governement (and most of the opposition) are totally...

Levemir might not be quite as strong as other insulins eg julio rosenstock showed in a glargine levemir comparison that one needed 50% more levemir that glargine. Probably need to touch base with your specialist about how far to uptitrate. Best wishes

Hi, sorry that you are having a rough time; as others have said, one is not allowed to give diagnoses here, and I would be reluctant to criticise a HCP cos we might not have the full story. Diagnosis of diabetes is made on fasting glucose 7.0 mmol/L or more, or random glucose 11.1 mmol/L or...