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Diet controlled type2 - Finally had to go to Metformin (not good.......)

Discussion in 'Metformin/Biguanides' started by Robo42, Sep 14, 2015.

  1. Robo42

    Robo42 Type 2 · Well-Known Member

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    I have been diet controlled about 13 years with type2, but last few GP long term blood sugar counts have gone up. Not happy but started 500mg of metformin 3 weeks ago, 1 week of 1 a day and now had 2 weeks of 2 a day. Gone down hill with some discomfort of stomach pains at first increasing to feeling sick and stomach pains and keeping me awake at night and being tied. Contacted my GP today and will try me on a slow release drug so hopefully I will start to feel a bit better soon. It does seem the cheap version which is commonly known to cause major discomfort is always tried first!
     
    #1 Robo42, Sep 14, 2015 at 1:07 PM
    Last edited by a moderator: Oct 7, 2015
  2. Daibell

    Daibell LADA · Master

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    Hi. Yes, Metformin SR should helpa lot. False economy by the NHS giving people a drug known to cause stomach upset and then incurring the cost of a repeat visit for the SR version. Blame NICE for that one.
     
  3. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Hi and welcome to the forum. I will tag @daisy1 who has some newbie info she can post. Reducing your carbs can reduce your blood sugars more than metformin can. Sorry you have had side effects and I hope the SR works out. If it causes problems try to keep taking it for a couple of weeks if not too bad because sometimes it resolves. But if it doesn't then with your doctor's agreement stop taking it.

    Not everyone gets these side effects, I am on the cheap version and have never has side effects. So that is why they try it first, as most people will be able to keep taking it. What they should do however is tell people at the start that if they get side effects they can try SR sooner rather than later, to avoid suffering.
     
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  4. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Overall is still saves money because most people do fine on the first one. They should forewarn people and have a script ready for SR if needed so they dont have to have another appointment.
     
  5. Robo42

    Robo42 Type 2 · Well-Known Member

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    I saw a diabetic nurse who arranged for my prescription of metformin, she did mention that there can be some side effects but no mention of timings or follow up & what to do. Contacting my GP she said after 3 weeks of increasing stomach pains and feeling sick a switch to SR drug was suggested. So I do not have an idea of a settling down time?
     
  6. Daibell

    Daibell LADA · Master

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    You are right to some extent. As you may know there are a high number of problem reports on the forum for the plain version. Yes, for many it settles after a few weeks but the first weeks can be very bad and some can never cope with it. Yes, it would be good if DNs and GPs told people to come back after 2-3 weeks if it doesn't settle and perhaps say SR is available but costs the NHS more. The current approach where patients walk away with no idea what is going to happen or what to do is bad medicine.
     
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  7. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I totally agree. I've read medical training/guidance documents that tell doctors they must discuss benefits and risks before seeking the agreement of the patient to take a drug. Many of them don't do this enough or at all, then they wonder why patients don't trust them. I've learned the hard way to make sure I understand the key info about a drug before I leave the office. I also look online at home as well.
     
  8. daisy1

    daisy1 Type 2 · Legend
    Retired Moderator

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    @Robo42

    Hello Robo42 and welcome to the forum :) Here is the information (mentioned above) we give to new members and I hope you will find it helpful. It should help your blood sugars and maybe you will have less need for Metformin. Ask more questions and someone will 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 over 150,000 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

    Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
    http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

    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

    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 bloodglucose 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.
     
  9. zand

    zand Type 2 · Expert

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    When I took metformin I only had problems with it twice. Both times I had consumed high carb things that day. Once was potatoes and once I had a pint of beer. When I kept my carb count low I was fine.
     
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  10. Robo42

    Robo42 Type 2 · Well-Known Member

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    Well I now have the SR 500mg to take 2 a day, so starting from 17th Sep. Hope a better experience than last 3 weeks on standard Metformin. I was diet controlled until my hba1c went from 43 to 48 to 54 on 6 monthly checks with me increasing exercise & being even better than usual with diet.
     
  11. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    Good luck, I hope it goes well. What sort of foods do you typically eat in a day?
     
  12. Robo42

    Robo42 Type 2 · Well-Known Member

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    When I was first diagnosed(10 plus years ago) I tested my sugar levels pre meals & after 2 hours for some weeks making a note of things I ate to get an idea of what foods were OK and what gave a high sugar reading. I found Carbs were bad for me for breakfast, so it’s no bread and a good typical breakfast is a combination of mushrooms, eggs, smoked sausage, smoked salmon. Porridge oats and an oat flake cereal are not too bad on the sugars, no other cereals are low enough in sugar or high enough in oats.

    Lunch ideally is salad with fish but not always available, so pitta bread or a soy/linseed bread with tuna, ham or sausage. On a not so good day pork pie with coleslaw (today) or bacon, perhaps just soup some days. I have a light lunch with a bigger evening meal.

    One thing we look for on food ingredients is try to keep to food with 4% sugar or less also low carb and not too much wheat. I am allergic to dairy (cow’s milk) so use soy milk, sunflower spread and goat cheese is ok.

    Basics for evening meals are basmati rice, whole wheat pasta and sweet potatoes rather than normal potatoes, green veggies often as possible. I like fish, salmon, tuna, sea bass, pasta is often with tuna & a tomato based sauce. I could eat chicken all the time and love a steak usually have with baked sweet potato and coleslaw.

    There are a range of ready meals which are really good for me: The Kirsty’s range of healthy and nutritious gluten-free, dairy-free and wheat-free chilled ready meals. http://www.kirstys.co.uk/

    The odd treats are some ice cream made with coconut milk & not often dark chocolate. Some fruit, not more than 1 per day, apples, pears, peaches, strawberries. I drink decaff tea and coffee.

    I am pretty good at keeping to all the best things for me, so hopefully when I stray or its not so easy when out or away from home it does not affect too much. Rob
     
  13. carol43

    carol43 Type 2 (in remission!) · Well-Known Member

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    I'm afraid that the pork pie, rice and pasta might not be the best things for you to eat. There are far too many carbs in those
    Kirstys meals.
     
  14. Robo42

    Robo42 Type 2 · Well-Known Member

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    You think? I look at the % of carbs and these Kirsty meals are between 9 & 13% carb with 1 and 3 % sugar. I think of these as low, but happy to be guided................................ I only the odd one a week.
     
  15. Brunneria

    Brunneria Other · Moderator
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    Hi,

    I am really impressed that you have managed for so long on so much carb.
    That isn't to say that your diet is high carb - it is probably lowish, compared to normal people, but I couldn't eat all that bread and pasta.

    You are probably at a decision point, and it is entirely up to you which way to jump. Clamp down on the carbs and stay low or no meds, or carry on eating as you are, and gradually increase the meds.

    Those Kirsty's meals look delicious, and (for preprepared somewhat processed foods) they look healthy, but 13% carb in a 400g meal is over 50 g carbs, at once. I have less than that all day. (sorry the 400g is a guess because I couldn't quickly find the nutritional listings, but that is the equivalent weight of a tin of tomatoes, so it is a nice round, meal sized amount)
     
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  16. Keeth

    Keeth Type 2 · Member

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    Ask to Try Dapagliflozin
     
  17. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    I don't think that will be necessary, as low carbing can get BGs down without needing a drug that has considerable side effects and risks:
    http://www.phlaunt.com/diabetes/36474059.php
     
  18. Keeth

    Keeth Type 2 · Member

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    Yes it does have some bad side effects some side effects are Dry mouth urine infection skin peeling I have had it all but this guy gets a bad belly and the drug I am talking about will take the sugar from his urine not bowl
     
  19. ButtterflyLady

    ButtterflyLady Type 2 · Well-Known Member

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    If you read the article I linked above you will see there are also risks of serious illness. I don't think the GI side effects of metformin warrant going to this drug at this stage. Metformin SR is still being tried, and as I said, he has yet to see the effect of low carbing on his BGs. I would wait at least 3 months to see what low carbing does before considering any other drugs, especially this one, given its risks of serious harm.
     
  20. Robo42

    Robo42 Type 2 · Well-Known Member

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    ################
    Interesting what people think is low/high carbs, I have never really had much guidance in all the years. The dietician I first saw was not much use, generalisms of what not to have & what is better. If I had followed their advice I would have had fruit juice & toast for breakfast and all sorts. It was only doing regular testing that I found what hit me & was OK. Our key guide has been 4% sugar a max and sort of no more than third carb. I would be interested what you do to keep as low as 50g carb a day. Main thing has been lower GI choices, sweet pots not potatoes, brown basmati rice instead of white rice, whole wheat pasta.
     
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