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Changing meds

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Ellen

Active Member
Messages
25
Location
United Kingdom
Hi, I am new here. I have type 2 diabetes which I have had for about 9 years. I don't watch my diet enough and haven't managed to lose any weight. I asked to stop taking Pioglitazone as I read a really bad report on it. Now my sugar is 8 and I must either take Pioglitazone again or change to insulin. I am not asking you to decide for me but if anyone has a different view on Pioglitazone I would be interested to hear it. It also made me gain 14lbs of which I have slowly lost 9lbs. I have a terrible sweet tooth but I think it is also an emotional issue and perhaps I need CBT (Cognitive Behavioural Therapy). In between tests at doctors I happily forget all about the diabetes and am generally a happy person. I do not really want to inject (who would?!!) but I probably will have to eventually anyway. Sorry to sound completely self-centred! Look forward to sharing info with you.
 
Hi Ellen and welcome.

There are lots of alternatives to glitazone treatment, for example one of the sulphonylurea drugs (Amaryl (glimepride) or glicazide).
There's also metformin, which you are probably already on as it would be unusual to prescribe a glitazone to someone who is not already on metformin.

Then there's repaglinide (used to be called Novanorm) which has similar results to glitazones, although faster acting, but with less side-effects.

Then there's all the newer drugs that have come onto the market in the last 6 months (and are all approved by NICE), like pramlintide, januvia (sitagliptin) and byetta (exenatide).

Slapping a patient straight onto insulin without investigating alternatives is simply a cop-out.
 
Thanks for the reply. I'll ask my GP about those other drugs. At present I am taking 6 Metformin and 3 Glibenclamide. These are the maximum doses apparently. The surgery is very good about diabetics having all the tests which are recommended. We are all asked to take aspirin and Simvastatin and we are offered diabetic photography. I mentioned to the doctor about the report I read about Pioglitazone and he was dismissive. Most reports when they are critising a medicine will say something like "it happens to 1 in a 1,000 people" The report I read was a lot worse than that. The research was carried out at a university. I will let you know what the doctor says as it may be of interest to others.
 
Hi Ellen,

When I complained to my GP about all the side effects I was getting on rosiglitazone he dismissed it with "but that only happens in less than 1 in 1000 cases". The reason GPs all take the same line is that is the misinformation that the manufacturers put in the patient advice leaflet that comes with the medicine. I asked to be referred to a consultant, who immediately took me off the glicazide and agreed that the side effects are far more common than the manufacturers will admit to.

If you are already on metformin and glibenclamide (which is a sulphonylurea) then the pioglitazone is a third-level treatment, which does limit the options that are left if it isn't working for you.
 
Hi, so in that case would the other meds you mentioned not be suitable? We have a nice, new, young doctor so I was going to go and see her! I can't decide if the Pioglitazone would be better or worse than injecting insulin. The nurse has put me down for going on a course at the hospital to learn all about how to use insulin. My blood sugar is 8 at the moment. I don't feel ill but I can tell it is up. I don't really understand why it has gone up as my diet is the same (not good but no recent changes).
 
Hi Ellen,

The ones I mentioned are by no means a complete list. I don't know what strength of metformin you are on, but it might be possible to move up to a higher strength, and/or to a stronger sulphonylurea, perhaps Amaryl.

Sounds like your GP does know what she is doing (unlike many who just don't understand diabetes at all) and is trying to do her best for you, but you don't seem to be doing much to help her!

You mentioned that you don't watch your diet, but that is the biggest thing that you can do to reduce your blood sugars. You can make a huge difference to your BS readings simply by reducing the anount of carbs you eat. This doesn't have to be drastic - for example if you have cereal for breakfast (typically 35+ carbs) then occasionally have a boiled egg with a slice of wholemeal toast (around 15 carbs) or a bowl of porridge (25 carbs). If you have a sandwich for lunch, then have a salad instead. If you like pasta for a main meal then use a low-carb variety instead (Dreamfields is currently the only one available in the UK). You mentioned you have a sweet tooth - whatever you do, don't try diabetic sweets. They don't contain sugar but the substitutes they use have exactly the same carbohydrates as sugar! Just cut down even if you feel you can't give them up.

You also mentioned weight. If you are overweight then did you know that a 10% reduction in your body weight will reduce your HBA1C by a whole percentage point. You can bring your 8 level down to 7 without needing any additional medication to do it.

I agree nobody wants to have to inject, but you are in a position to ensure you don't have to. There's so much that you can do to help yourself, but you have to take the initiative. You said insulin injections will be inevitable - but only because you are making it so. And that is the start of a downward spiral - insulin encourages weight gain - weight gain increases insulin resistance - more insulin resistance needs more insulin - more insulin means more weight gain - and so on.

Your future is entirely in your own hands and its not too late for you to stop the spiral before it starts.
 
You are quite right about helping yourself. I don't understand why weight is a problem with some diabetics when famous ones - Halle Berry, Jasper Carrott- are thin! I walk 30 mins a day and sometimes more. Today I walked my normal 30 mins plus 40 mins.I park out of the city centre so I have to walk 15 mins each way. The way back is uphill. When I returned after Xmas (I had a week off) I could feel my legs getting used to the walk again). I am trying to cut down on the things I shouldn't eat but I only started that yesterday. I have a very addictive personality which is why I think I might benefit from hypnosis or CBT. I will ask the doctor about that at the same time. I am seeing him on Monday (I don't always see the same doctor).
 
There you go - you're taking the first steps already.
 
Update. I have seen the doctor today and I am going to restart Pioglitazone rather than go on insulin. I also asked for a slimming pill, and got it. I will start that in a month's time as the doctor said it isn't a good idea to start two new medicines at the same time. I am also joining the weight loss group at the surgery. I will have a blood test in a month's time to see if the Pioglitazone is working. I have already started eating more healthily (not perfect but an improvement). On Friday my husband gave me a box of chocolates which he had bought me for Xmas but forgot to give me. I handed them back and said sorry, I can't eat those. I would never have done that two weeks ago!! So thanks for the shove in the right direction.
 
Wow - now that's what I call single minded determination.
Good for you.
 
Well, I have been taking the Reductil for 5 days now and have stopped taking it today. I felt quite ill while taking it and was having hypos all over the place. On Friday after lunch (2.30)my blood sugar was 13. I went out and tested when I got back at about 5.30 and it was 4.5 so I ate something. I had a normal tea and measured again at 12.30 and it was 3.3! I have even had to get up in the night (most nights)and eat something as I was having a hypo. I am very disappointed as I hoped to take Reductil and lose my excesss weight. I am seeing the doctor tomorrow but I doubt if there is any way I can continue with it.I will just have to try on my own. Oddly my feet are a bit less fat!
 
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