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Can anyone advise me please

Iamamotherof2

Member
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7
Please could some one advise me, have been type 2 for the last 2 years, and finally managing to get my head round what I should be doing. My doctor is really beginning to confuse me, my last 2 hb tests have read 8.2 and he put me on varying doses of metformin till I have reached 2000 mgs per day. Had to see him last week for high blood pressure due to a shock I had recieved which coincided with my test results, the hb was again 8.2 and bp had been going thru several roofs, but was beginning to come back down slowly, prior to the shock, had been testing the bp about once evry 4-6 weeks with excellent readings. He upped my bp medication by double and when I queried this, told me that going up in small doses wouldnt work as it was a diminishing return tablet, so I said ok for now, he also put me on sitagliptin for the blood sugar which I was ok with, having been told I was on the highest dose of metformin and couldnt go any higher. I had a violent adverse reaction to the sitagliptin and was feeling very woolly headed. Spoke to my local chemist who has said my bp 102/65 way too low and she couldnt understand why I hadnt been allowed to increase the metformin dose. So rang dr, who was a bit off, insistent my bp was ok, and now wants to see me to discuss I assume treatment for the blood sugar, I am left feeling very wary by this and dont what to expect or what my options could be, can anyone help, dont mean to sound a pain, but dont know whether I'm coming or going here. Thanks in anticipation :?
 
Hi and welcome to the forum, I dont know who you talked to at the chemists but I'm guessing it was not a pharmacist as the max dose of metformin is 2000mg usually taken as a split dose 1000g am and 1000mg pm also helps fend off possible side effects if taken with food.

As for the blood pressure readings above 90/60 and below 120/80 indicate that the pressure in your arteries is considered normal for most adults. Are you experiencing any dizziness? It might be an idea to talk to your GP about reducing your bp meds slightly if he feels your bp is too low but many people would love to see those numbers.

If I am understanding you correctly your HbA1c or average blood glucose (bg) level is currently 8.2 which is a little high and should be addressed. Are you aware that carbohydrates as well as sugars raise your bg. Many members here find that by cutting down on the carbohydrates we eat we are able to control our bg levels. I'm sure daisy will be along shortly with the usual info for new members which is very good information in deed IMHO. Read the advice she will no doubt give you and if you have any questions then just ask. And try not to get too stressed as stress can push your bg levels up too.
 
Just to add to what Sid has said, blood pressure is very variable, it goes up and down depending on excercise, stress, blood salt level and some medical conditions.

The stress one is what I wanted to mention, just going to the docs. can push your BP way up, they even have a name for it "white coat syndrome). Buy yourself a BP meter (£15 Lloyds Chemist) and do about 20 readings over 2 days. Keep a record of times and sit quietly for 5 mins before you check. Take them to your doc. it will give him/her a far better idea of what is going on.

H
 
Sid Bonkers said:
I'm sure daisy will be along shortly with the usual info for new members which is very good information in deed IMHO. Read the advice she will no doubt give you and if you have any questions then just ask. And try not to get too stressed as stress can push your bg levels up too.

Hi and welcome to the forum :) Here is the information for new members which Sid mentioned. I think you will find it very helpful.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.
 
Thanks so much for your quick responses folk.Just wanted to let you know Sid, it was a pharmacist I spoke to, hence my confusion, but I have found your insight quite relaxing if that doesn't sound daft, and very appreciative of Daisy's post and the other person whose name escapes me right now is so right in telling me not to stress, sometimes easier said than done as am sure we all know, didn't realise it had much effect on the bg, still learning here. I don't suppose anyone has any insight as to what's possible on my agenda next re meds, feeling as I say a little wary due to the violent reaction I had to the sitagliptin.
 
I'm on 2500 mg per day Metformin and GP told me could go up-to 3000mg :roll:
also on Januvia (sitagliptin) had no problems with it worked well to level things out
and Glipizide 240mg Same no problems

Told next move would be byetta

And I found this ref Metformin

The National Institute for Health and Clinical Excellence recommends that the dose of metformin should be stepped up gradually over several weeks to minimize the risk of gastrointestinal adverse effects [NICE, 2008a]:

CKS recommends a starting dose of 500 mg once a day (with breakfast), increasing by 500 mg at intervals of 1–2 weeks according to response. The maximum daily dosage of metformin is 3 g (in divided doses), although in practice, daily dosages above 2 g are rarely exceeded..

Ref
http://www.cks.nhs.uk/diabetes_type...diabetic_drugs/metformin/initiating_metformin
 
Cheers for that Bowell, the speed at which you guys respond is fantastic, I now feel more relaxed and have some kind of info to go on, really do appreciate it, thank you :D
 
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