Advice on medication

[dayr]

I was diagnosed 6 years ago with type 2 diabetes. Initially I was on diet for about 4 years then when needed medication I was given metformin to try again - previously attempted to use for the control of polycystic ovaries. Unfortunately Metformin disagrees badly with my stomach and I was unable to take on both occasions. The doctor prescribed the slow release version but after a couple of weeks this resulted in the same bad stomach. This same doctor then told me not to take anything which resulted in high sugars. Eventually with the aid of a different doctor I was put on Glucophage sachets (powdered form of Metformin) which worked as long as I took it in the drink with my main meal. Last December when I went to renew my prescription I was informed that the Pharmaceutical companies have stopped producing this and the liquid form. After much discussions with the diabetic nurse I was given Gliclazide tablets. One tablet wasn't working so I had to increase this slowly as well as taking a Pioglitazone. However once I got to 3 tablets I began to get hypos so have had to reduce the tablets.
The problem I'm having is that when I eat my sugars are going really high - despite a well controlled diet, but this is only lasting about 2 hours then crashing down to hypo level. I'm having to eat every 2 hours and not just a snacks / fruit as these don't bring sugars back up long enough so have started putting weight back on which I had lost.
A friend recommended Glimerapide as an alternative but doctor & nurse don't recommend. Any suggestions / advice, Thanks?

 

[AndBreathe]

I was diagnosed 6 years ago with type 2 diabetes. Initially I was on diet for about 4 years then when needed medication I was given metformin to try again - previously attempted to use for the control of polycystic ovaries. Unfortunately Metformin disagrees badly with my stomach and I was unable to take on both occasions. The doctor prescribed the slow release version but after a couple of weeks this resulted in the same bad stomach. This same doctor then told me not to take anything which resulted in high sugars. Eventually with the aid of a different doctor I was put on Glucophage sachets (powdered form of Metformin) which worked as long as I took it in the drink with my main meal. Last December when I went to renew my prescription I was informed that the Pharmaceutical companies have stopped producing this and the liquid form. After much discussions with the diabetic nurse I was given Gliclazide tablets. One tablet wasn't working so I had to increase this slowly as well as taking a Pioglitazone. However once I got to 3 tablets I began to get hypos so have had to reduce the tablets.
The problem I'm having is that when I eat my sugars are going really high - despite a well controlled diet, but this is only lasting about 2 hours then crashing down to hypo level. I'm having to eat every 2 hours and not just a snacks / fruit as these don't bring sugars back up long enough so have started putting weight back on which I had lost.
A friend recommended Glimerapide as an alternative but doctor & nurse don't recommend. Any suggestions / advice, Thanks?

Sounds like a real roller-coaster to me!

I have never taken medication, so wouldn't want to enter into any discussion on those, but it's probably also worthwhile reviewing your diet and results to see if there's anything can be done to soften the peaks and troughs you are describing.

What's a typical days menu for you? Do you subscribe to the NHS guidelines and have lots of "healthy" carbs, or reduced carb, or something else?
You talk about your blood scores shooting up, then dropping to hypo. What are those actual scores?
What was your last HbA1c, and when was it taken?
And finally, what's your usual fasting blood score, first thing in the morning?

Sorry for the Spanish Inquisition, but if these peaks and troughs can be smoothed, even a bit, it gives the medication less to struggle against.

 

[dayr]

Hi, thanks for the reply. I try to stick to NHS guidelines given to me by the dietician during the 4 years on diet as well as using the slimming world diet which I found to be very good for diabetes and I lost 2 stone on it. I do limit my carbs as well. I accept that when I eat something that makes my sugars high that, that is my own fault.
Although not as high as some may experience, I can go up into the 16's and since taking the gliclazide am dropping to 3's within 2 & half / 3 hours, even with reducing the dose back down. Struggling with tiredness when high and headaches, blurry vision & shakes when low.
I am tested every 3 months regularly, last one in Dec was 47.6. Review tomorrow so will see what has happened since then. My norm over the years has been between 45 and that 47.6 but the doctor is happy with that as it within the range. Doesn't help on the day to day differences and feeling ****.
My mornings are usually in the normal range 4-7. Strange thing I'm finding is that the same food is giving different results. I can test at 7am on 2 different days and be 6.6 then eat a bowl of identical porridge and have a result of 7.9 and 15.6. This is taking the same medication at the same time also. Diabetic nurse doesn't know why as porridge is slow release
Would love to smooth them out as affecting my ability to look after kids, house as well as cope with my part time job and finish the 4th year of my degree.

 

[AndBreathe]

Hi, thanks for the reply. I try to stick to NHS guidelines given to me by the dietician during the 4 years on diet as well as using the slimming world diet which I found to be very good for diabetes and I lost 2 stone on it. I do limit my carbs as well. I accept that when I eat something that makes my sugars high that, that is my own fault.
Although not as high as some may experience, I can go up into the 16's and since taking the gliclazide am dropping to 3's within 2 & half / 3 hours, even with reducing the dose back down. Struggling with tiredness when high and headaches, blurry vision & shakes when low.
I am tested every 3 months regularly, last one in Dec was 47.6. Review tomorrow so will see what has happened since then. My norm over the years has been between 45 and that 47.6 but the doctor is happy with that as it within the range. Doesn't help on the day to day differences and feeling ****.
My mornings are usually in the normal range 4-7. Strange thing I'm finding is that the same food is giving different results. I can test at 7am on 2 different days and be 6.6 then eat a bowl of identical porridge and have a result of 7.9 and 15.6. This is taking the same medication at the same time also. Diabetic nurse doesn't know why as porridge is slow release
Would love to smooth them out as affecting my ability to look after kids, house as well as cope with my part time job and finish the 4th year of my degree.

Could you give us a sample days meals and snacks?

I'd me inclined to really grasp the diet, and for me, that would mean looking closely at the carbs; whether the baddies, or the supposedly bad ones. Personally, I can eat a bit of porridge (although I haven't for a while), but many find it tricky. That it's considered a "good" carb is only helpful if it doesn't affect YOUR blood score.

Whatever we eat, out bloods will ebb and flow, but if we eat something we can't handle the peaks, then troughs will be steeper and deeper. By moderating those "difficult" foods, our bodies and meds have less of a challenge, but you may probably already know this.

So, I'd say to go back to absolutely scratch with food and blood diaries and a really conscious eating regime. That your last HbA1c was (just) in the prediabetic range means something has changed. At this point, obviously we don't know if it's your body or your diet.

I'm sure the constant threat of a hypo is unnerving, at least, and may be making you carb up a bit, subconsciously. But, I have read that the steeper the climb, the steeper the following fall will be in that case. I try to go for a blood graph that looks a bit like a smooth wave, rather than a mountain range, which sounds like your results.