Type 2 Advise on treatment needed please!

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I was diagnosed with Type 2 diabetes in 1997 when I was having trouble seeing. Perhaps it wasn't a shock as I have always had weight problems. Started with diet, then added Metformin then more Metformin then other oral mediation added as time has gone by.

I have always tried to watch my blood sugars and always attend my reviews and eye tests but 2 years ago I was told that I had background retinopathy. I have managed over these two years to lose weight by using the 5:2 diet and my BMI is 36 which has been reduced from 42.

This has meant that my blood sugar came down as well but unfortunately I saw a new diabetic nurse at the surgery about 18 months ago who congratulated me on how well I had done and said she would see me again in 9 months. I went away reasonably happy on Metformin ER (2 x 1000mg) per day + my Actos (Pioglitazone). I then got a phone call from the pharmacy saying there was a new prescription for me and to collect it. The prescription was for Januvia (Sitagliptin). No discussion just a change so I took it. I had so many upper respiratory tract infections last year that I started to wonder what was happening and a bit late I checked the side effects of Januvia and realised that that that could be the reason.

I was 18 months before I was reminded about a review and my HbA1c was high. I had a chest infection and iron deficiency and felt dreadful.

My doctor has now prescribed Invokana (canagliflion) with the Metformin. I have been taking this for 2 months now and feel thirsty, nauseous, bloated, have thrush all the time and discomfort in my back.

I have an appointment with my doctor next week and after reading lots about these new drugs I want to go to my doctor with a proposal of what I want to do:

As I see it I have 3 options:

1. Return to something I have already tried.

2. Byetta injection added to Metformin.

3. Insulin.

I am in a position now to be able to control my food intake and I definitely do not want too lose my sight, get bladder cancer or loose my kidney function! I am now also monitoring my blood sugar again as they removed my prescription for test strips stating that there was need for them!

If anyone can make any suggestions - I want to go armed with some idea of what I want this time rather than the 'oh well there are some new drugs - this one will help you lose weight as well' prescription!

 

[Daibell]

Hi. As you probably realise the optimum solution for you is to ensure your diet is low in carbs so that both weight and blood sugar come down. Metformin is a good safe drug and at it's best reducing insulin resistance when overweight. The glitazones can be effective but there have been safety issues raised so do discuss these with the GP; there are some side effects. It looks like these have been stopped anyway. Sitagliptin can help a bit with few side effects. Canagliglizon is very new and may well be a good treatment but if you look at the manufacturers website or leaflet there are side effects and it may be some of these are what you are experiencing. I would certainly discuss the option of weekly injectables such as Byetta with the GP. Insulin is not ideal when you have excess weight unless you know your natural insulin is low as you would be adding insulin when there is already too much? In summary do give priority to a reduced carb diet and insist on a meter and test strips as you do need them.

 

[4ratbags]

Its great to see you are starting to take control of your health. Just make sure to note down everything you want to discuss with your Dr and make a point to ask for more test strips as you have a good argument for needing them.