Blood glucose 23.8 type 2 diabetes

That reading seems very high: is it an anomaly, or have you had similar before?
In the short term, maybe you need to get in touch with your doctor ASAP-

Don't understand why he would hold back on metformin. I've been on 1000mg twice a day since diagnosis years ago. And even when I've been referred on a few times the metformin has always stayed the same. However even if you were on a higher dosage I don't think metformin alone could reduce a 23 reading.
And stopping test strips is even stranger.
There must be some reason I would of thought.
My own non professional suggestion would be that if you think the Dr is giving the wrong advise then you can try phoning your local diabetic clinic and also see if you can self refer to local hospital diabetic clinic. It may sound odd to suggest that but it gets the ball rolling. I did it myself a few years ago when my diabetic nurse at drs changed to one who seemed to know nothing. I called the drs without saying who I was and asked for info on which clinic they send diabetics to for treatment outside the drs surgery.
Are you eating the correct food? And avoiding the bad food. It can be hard.
Without knowing lots more it's hard to give advise and not sure how far advise can go on here .
For now though if your very worried and cannot get an appointment your options are limited. You could try a walk in at the local A&E when your suger is 25+ but if it's anything like my local hospital you could be sitting there for many hours by which time readings may of decreased.
The best solution for now is the same advice I received last week when my readings were thru the roof. And that's cut the carbs. If you can go one week with zero carbs and monitor your glucose readings (if the Dr will not give you test strips you may have to buy or borrow them. Any diabetic friends who have spares?).
If you go no carbs for a week you will then see if you get normal readings. And if you do its a clear sign you need to alter your diet.

Hi. Yes, that reading is high. I would have expected the GP to have put you on max dose (2000mg) Metformin. Its a good safe drug and the SR version is the kindest. It isn't a miracle cure but max dose like I was on would make sense to me. You almost certainly need to look at your diet but don't rush to see a dietician as many in the NHS to be blunt haven't a clue about diet for diabetes. This website has loads of good diet advice and to start with you need to keep the carbs down; perhaps to below 150gm per day. Many in the NHS would advise the opposite so be aware of that. Have enough protein and fat to keep you feeling full; have good unsaturated fats where you can. A low carb diet will help both blood sugar and weight reduction. BTW having a hypo when on Metformin is very unusual but not unknown. It's possible you have one of the less common variants of diabetes so it would be good if you can be seen by the hospital diabetes clinic if the blood sugar doesn't go down. Most GPs won't provide test strips for T2s due to cost so I'm afraid you will need to self-fund these or try to get the clinic to do that if your sugar remains high. Buying thru the web can be cheaper than the high street.

Hi @David.wellings

You sound like you'd prefer to be back on the metformin strength which did work for you. Asking for the same strength shouldn't cause your gp a problem, til you see your specialist.
When are you seeing your specialist?

I agree with other posters, if you're ill go to walk-in centre or call 111.
I'd like to think a short time of higher bgs wouldnt cause too much upset in your body. The verdict about that isnt out on that one!
If this reading is unusual for you you can change your diet to bring it under 10. With addition meds under 7.8mmol/l which is noted as the danger zone.
You can decide for yourself to increase your med if you have some spare but monitor heavily.
Search these forums as there is numerous posts about self monitoring and test strips. Many buy a codefree monitor and strips when gp refuses them.
Don't panic unless this result is on-going and getting higher. Call 111 if it rises, I would.
Ultimately its your call.
What do you want to happen? Wait til specialist if they are not increasing and you have far lower results? Or call 111 and tell them you're unwell with unusual high bgs.
Watch what your eating, go reduced carbs til you know more? Diet can make a huge difference.

David.wellings said:

I really hope someone on here can give me some useful information

Click to expand...

Hi. Welcome to the forum. I think @daisy1 will post you some helpful information shortly.

Meanwhile it is important to understand that our diet has the most direct and immediate impact to our glucose/insulin control. Knowing the type of food that spikes our post meal glucose reading is the first step to better glucose control.

Most of us found success with reducing our carbs intake significantly.

Reading between the lines and you mentioned a hypo, the GP would likely have thought that your endocrine system could be intolerant to the metformin.
It was the first thing my GP did, when she discovered I was having hypos! She took me off it straight away.
I may be wrong but your post is similar to having too much insulin and having as well as insulin resistance and high blood glucose levels.
You should reduce your carbs and sugars to reduce insulin response.
Talk to your GP and when you get to see your specialist, tell him everything, even if you think it's not related as symptoms can get your specialist some idea that something other than your diabetes is going on!

@David.wellings - welcome Yes, that reading is very high. You say you were diagnosed in May 2015, did that diagnosis include all the tests to check what type of diabetes you have? Eg. you should've had hbA1c test which shows your average blood sugar for past 60 days, then you should've had the GAD test which shows whether or not you have anti-bodies which if you do indicates you have auto-immune attack of your pancreas, and finally you should've had the c-peptide test which will show whether or not you still produce sufficient insulin. Whatever the outcome of your tests, it will show what type of diabetes you have and what treatment you should be on. Eg. for me I'm type 2, but I need to be on insulin because my c-peptide test showed I don't produce the insulin I need (although this wasn't the case for me when first diagnosed as I did have my own insulin then).

There are a few variables that could be happening with you and I hope you are able to get help sooner than later. If you have your own insulin then it would be a case of revisiting your diet and cutting back the carb intake. Also docs may decide you need a higher dose of metformin, or even other meds added to the mix.

I wish you the best.

You can see that within days of carbs reduction, my glucose level drops from 20+ mmols to < 10 mmols. And it has remain so ever since...

@David.wellings

Hello David and welcome to the forum To add to all the excellent advice you have received from members, here is the basic information we give to new members and I hope you will find it useful. Ask more questions when you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 220,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Many of us here are self-funding our meters and strips, and many of us use the Codefree because it has the cheapest strips, and you will need a lot of strips. If you end up self funding, try here for the Codefree meter

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips
http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

Pharmacies don't sell them. There are discount codes if you buy in bulk and don’t forget to check the box that you have diabetes so you can buy VAT free.

5 packs 264086
10 packs 975833

That reading is very high - I had to promise the doc that if my reading reached 25 - I would admit myself to the hospital.

I was put on 4x metformin and 160 g of Gliclazide when I was diagnosed with similar readings to yours.

Do you test regularly - what are your daily readings. Above all - don't give up trying - just look at my results since being diagnosed 8 months ago.

Would it be possible to see another GP at your practice?

Your doctor cannot deny the test strips as you are also supposed to test before you drive any distance. If the metformin is not doing it then its time to look at starting insulin. The advice about the carbs is good cut out bread , potatoes , rice and pasta for a week and then start adding them to your diet at 25 grams per meal test after each meal to see what your body can tolerate. I have one slice of bread and one small potatoe a day in all 175 grams. If it works then you have you carb tolerance. I've been diadetic for 18 years now and on metformin and insulin and I'm 73. Get a different doctor!!!!

Hi David,
I was diagnosed in October this year and have always been under the hospital. I don't know where you live but I would fully recommend Queen Elizabeth's in Woolwich, since diagnosis I've seen my dietician twice, nurse twice n doctor twice... in three months. I am type 1, but I can't see how which type you are would affect the help you get. Hope you get help soon.
By the sounds of it you deffo need to be seen somewhere else

Dutchman said:

Your doctor cannot deny the test strips as you are also supposed to test before you drive any distance. If the metformin is not doing it then its time to look at starting insulin. The advice about the carbs is good cut out bread , potatoes , rice and pasta for a week and then start adding them to your diet at 25 grams per meal test after each meal to see what your body can tolerate. I have one slice of bread and one small potatoe a day in all 175 grams. If it works then you have you carb tolerance. I've been diadetic for 18 years now and on metformin and insulin and I'm 73. Get a different doctor!!!!

Click to expand...

Hi and welcome,

While your suggestions are completely appropriate to your situation, I am afraid that nowadays most newly diagnosed type 2 diabetics are not routinely issued with repeat prescriptions of test strips for their meter (if they get a meter at all). Usually only people on medications like Gliclazide and insulin get those.

Also, the advice on testing before driving only applies to people on those meds. For those of us without meds or on the 'gentler' ones like Metformin, the DVLA driving requirements on testing do not apply.

The NHS has a list of drugs, starting with Metformin, and going through a series of drug escalations, including Gliclazide and others, before it prescribes insulin to type 2s. The general intention seems to be to delay the use of insulin for as along as possible, only using it when the other drug regimes have failed.

Dutchman said:

Your doctor cannot deny the test strips as you are also supposed to test before you drive any distance. If the metformin is not doing it then its time to look at starting insulin. The advice about the carbs is good cut out bread , potatoes , rice and pasta for a week and then start adding them to your diet at 25 grams per meal test after each meal to see what your body can tolerate. I have one slice of bread and one small potatoe a day in all 175 grams. If it works then you have you carb tolerance. I've been diadetic for 18 years now and on metformin and insulin and I'm 73. Get a different doctor!!!!

Click to expand...

@Dutchman It's probably a typo but can you clarify your "175grams" there? A slice of bread and a small potato would be much less than that if you're talking about grams of carb.

Brunneria said:

The general intention seems to be to delay the use of insulin for as along as possible, only using it when the other drug regimes have failed.

Click to expand...

That was certainly my experience.... and I was only put on insulin after they did another GAD and c-peptide test. So I managed my diabetes for 7 years with diet alone, the next 5 years on oral meds, then I've been on insulin for past 7 years.

David.wellings said:

I've been on metformin since May 2015 500mg twice daily. Recently started having the odd hypo.

My doctor changed metformin to 500 mg once daily I've been on the stove now for about three months in which time I have gained nearly 2 stone in weight and watched my blood glucose increase slowly over this time.

I spoke with my GP yesterday to ask if I could go back to 500 milligrams twice daily and was told the best he could do was to put me on 500 milligram slow-release once daily. Until I see the specialist in January.

I've really had a bad night sleep got up this morning to do my blood glucose thinking that this may be the issue and I got a reading of 23.8 this is the highest it's ever been

I am new to diabetes I don't know what I need to do in order to reduce my blood glucose level

I was diagnosed in May 2015 and at that time I was promised an appointment to go and see a dietitian despite several requests I am still waiting also for some reason my doctor has stopped issuing the test strips for me to test blood glucose I am at my wits end don't know what to do .

Sorry for such a long post, I really hope someone on here can give me some useful information

Click to expand...

Don't let these people fob you off. With a reading like that you need to test frequently.

If you are getting those levels of blood glucose you might be best phoning 111 or your doctor's surgery if they have emergency cover - at least it will alert people to your predicament.
I was told that the 17.1 level I was at was very bad, along with glycated Hg of 91, but I have lowered the blood glucose to under 7 by avoiding carbs - I have a salad and a few low carb veges each day, as a rule. I have tried to eat higher carb foods and they either spike BG or stop me losing weight. If you don't get help from the doctor then eating low carb might save your sight and your toes.