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A little concerned!

frazerl

frazerl

Member
Messages
19
Type of diabetes
Type 2
I was diagnosed Type 2 in March 2011 and GP me put straight on metformin. At the time my hba1c was 11. Since then between me and the GP we have settle on the following medications

Metformin MR 3 x 500mg in evening
Gliclazide 1 x 80mg in evening and 2 x 80mg in the morning
Simvastatin 1 x 40mg in evening.

My last hba1c, in June, was 7.3 which my GP says is ok better but needs to be lower. I don't test daily but to give an example of when I did test 30th June pre evening meal I was 6.5. If I was not careful around lunchtime I could go as low as 3.1.

For no particular reason that I can put my finger on I am not and have not been feeling my normal chipper self. Always thirsty, up all night again going to the toilet and feeling generally tired and a little bit down. I started checking my levels again and was a little surprised......

2hrs after evening meal 20.1
1st thing in the morning 12.5
before lunch 17.9
4 hours after lunch 10
1st thing in morning 13.2

None of these results were on a particularly carby days

I think you get the picture, before dinner yesterday I was 8.6 but this morning i was 11.2 and I had a duck breast with no veg and no carbs at all with my meal.

I have booked an appointment on Monday with my GP which I am sure will result in an icrease in my dosage.

I am just a little worried about what has happend to cause such an increase in my levels and what next should I ask my GP for a change in direction with my treatment.
 
I see that it's over a year and a half since you last posted (Feb 2011)
What have your HbA1cs been doing in the meantime ?

It sounds as if you haven't been eating to your meter. Forget low-carbing. If eating carbs allows you to keep your blood sugar levels low, then good for you. But it's your diabetes, your body, your possible future complications. You need to know what affects your blood sugar.

I recommend an intense period of testing to get on track.
Far better to control what you can with diet, and then consider medication.

Hope you get it sorted.

Geoff
 
Thanks Geoff


My Hba1c has come down slowly to 7.3 over the first year and I have been stuck on 7.3ish for the last six months. I dont really worry too much about carb counting but I only mentioned it as I had such a high reading this morning after such a low carb meal.

As regards to testing my GP does not believe in type 2's testing as she will only look at my HbA1 (even though she prescribes testing strips!!)
 
Hey frazerl!

Firstly, I agree with librarising that you really do need to test to find out what different foods are doing to you. The medical profession is fixated on Type 2s not needing to test, but they are quite simply wrong.

Secondly, your high figures recently could be due to an infection. Maybe you are starting with a cold or something?

Finally, there is a possibility you are not Type 2 but LADA which is a slow onset form of Type 1. Many of us were initially misdiagnosed as Type 2 and told not to test, only to find within a year our BGs were very high. You need to test to establish a pattern of what is going on. If there is any doubt in the Type 2 diagnosis, your doctor needs to do two tests: GAD antibody test to check for the presence of antibodies destroying your pancreatic beta cells and c-peptide test to check how much insulin you are actually producing. The doctor will probably be reluctant to do this due to cost, but looking at your figures, there is a possibility you have been misdiagnosed.

Smidge
 
Hi Frazer

Completely agree with Geoff. Don't think of it as low carbing think of it in terms of getting safe levels. If you can afford it get an SD Codefree meter off eBay or Amazon. It will cost you less than £20 with an initial 50 strips included. Extra strips can be bought for £5 / 50 so a lot cheaper than other meters. Once you get the meter then obviously keep avoiding plain sugary things but go on and make adjustments to the quantities of starchy carbs (rice, pasta, potatoes, bread, cereals and flour based products) until your readings start to respond. In the early days when your readings are high then aim to get a two hour post meal reading roughly the same as one you take just before your eat. You should then see a gradual improvement. You are aiming in the end to get readings under 8 two hours after a meal and to be between 4 and 7 at all other times. If you do that you will easily meet the sub 7.5% hBA1c and be meeting the NICE guidelines on good blood level targets.

It doesn't matter if you do the carb adjustments of your meals by counting carbs or by just reducing portions as both methods will work. The key if you do it with portion size is to recognise the food types that you need to reduce i.e the starchy foods. If you do it by carb counting then you obviously are implicitly recognising its carbs you are reducing as they are the ones you are counting.

Be aware that because you are on quite a high dose of Gliclazide a drastic reduction in carbs may give you really low levels so reduce the starch slowly. As your levels reduce you may need to go back to the doc to talk about reducing the glic.

If reducing carbs seems to be having no effect after say 5 to 10 days then you need to go back to the doc and discuss. It could mean that your pancreas is producing very little insulin despite the glic trying to make it produce more. If that's the case you may need different medication.
 
Thanks for all the advice. I went to GP on Monday and she seemed genuinely concerned about my levels, she found sugar in my urine and has increased my gliclazide to 2 x80mg in the evening and keeping me at 2 in the morning plus my 1500mg metformin. Levels so far today are before breakfast 10.2 and 3hrs after 15.1. Am going for blood test and gp wants me to test several times daily.

I thought that gliclazide was fairly fast acting but I do wonder whether the increase will have any affect bearing in mind my high levels during the day after 160mg of gliclazide!
 
Just a quick update -

I have been on increased dose of gliclazide no for three weeks i'm still drinking like a fish and up all night in the loo. I am going for my HbA1C tmw. I am testing more often than I was and my lowest morning test was today three days ago 8.8 it is normally between 10.1 and 14 I was 12.9 at 6.30 5 hrs after eating today. I somewhere between 14 and 20 after my evening meal!!

Gp said next stem is sitaglipin

hey ho!!
 
Have you been tested for GAD antibodies and c-peptide? Has the doctor also tested you for ketones?

I'm bumping this post and hopefully a type 1.5 can respond for you. This sudden and fast deterioration seems a bit suspicious to me, but I'm definitely no expert.
 
Been a lot in the news lately - statin drugs raise blood sugars, and cause diabetes and peripheral neuropathy. So they may make insulin resistance worse, which is what it sounds like here... And yes, get your insulin and C-Peptide dosn to see where your insulin levels are. If high, lower insulin, if low raise insulin levels and make your body more sensitive to insulin through exercise and diet.
 
Re: A little concerned! - update

Well I had my HbA1C a couple of weeks ago and was a little surprised with the results. The receptionist said "great news 7.1 and the doctor is really pleased". Bearing in mind how I have been feeling for over a month and my test results this was a little surprising. I asked them to double check but they just repeated 7.1.

I have not been feeling any better and still testing over 20 after my evening meal and never below 10 1st thing in the morning so I booked an appointment with a GP for this morning. It turns out my Hba1C is 8.7 and should have been written to. This is not the first time the receptionists have given out wrong info or no info - "the doctor says it is ok" well at least I test daily.

GP has increase Metformin sr to 4 x 500mg and he wants me back early January lets hope 1 extra metformin gets it down!!!!

I am not convinced
 
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