Disappointed in advice - Newly DX

[JoKalsbeek]

Hi there, well, as the title of the post says I'm feeling pretty gutted today. I went for a 50 year old birthday check up at the GP's practice and it came back with Fatty Liver and Diabetes t2 112 and my finger-prick test was 12.8 today, I had eaten porridge at that point. I also have a long standing Hiatus Hernia which I take 20mg of Omeprazole for and I said several times to the Diabetes Clinic Nurse that I really wanted go on a lower carb diet (I've already lost 5 stone on a 130mg carb a day) and try that before medication (I hate being on Omeprazole as it is!) and she said no, and today has put me on 2 x 80mg of Gliclazide per day (told to buy some jelly babys just in case of hypo's) along with Metaformin (working up to twice a day) and I'm honesty feeling so sad that I don't know what to do. I feel like I haven't even been given a chance to try and bring my levels down. Did anyone else have levels this high and bring it down without medication successfully? I'm willing to try anything but meds at this point.

Hi @leatrix ,

I'm sure you've gathered by now that yes, it is absolutely possible to go the diet-only route, and that yes, low carbing and gliclazide are a dangerous combo. I know what I'd do. Well, I know what I did: Low carb, high fat, and no medication for the T2 whatsoever. No risk of hypo's when your kids need you or when on the road, excellent blood sugar control AND it will also tackle your fatty liver disease, as it did mine. It is a lot of reading to do, yeah.... I have a little condensed quick-start guide to get you off to a flying start, https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html but what you really want is Dr. Jason Fung's The Diabetes Code. Excellent book, and a lifesaver. Dietdoctor.com's good too, as well as this forum's website diabetes.co.uk (not .org!). You might get some resistance from the nurse, but remember, this is your body, your health, your choice. Also, if you get a meter (they should've given you one, what with the Glic), you can prove at the next appointment that you can and have gotten your blood glucose down. Because I am absolutely positive you're going to do just that!

Good luck!
Jo

 

[VashtiB]

Hi @leatrix

I'm another who is on metformin but no other meds and my 2 HbA1cs after diagnosis have been in the normal range. My doctor tried to prescribe me states and I said no- I said I would only worry about cholesterol levels after I have stopped losing weight. I guess my point is that she could have prescribed it but didn't as I told her that I wasn't willing to take it. I'm sure her notes have a record of my refusal to protect her from any clam may have- but frank;y she didn't expect em to get into the normal range for blood sugar levels and I have so I'm happy to back myself.

Testing is really key. It is the way that you know how your body is going.

Good luck and welcome- you have already received great responses- stick around and let us know how you are going

Welcome.

 

[leatrix]

Thanks for replying! Yes I agree and I definitely felt like I was being dictated too rather than advised too.

I have not yet started the Glic, so am ready to speak to the Diabetic nurse and ask for a grace period, and if she sees the numbers coming down, I want to use that as a bases for her to reconsider. I'm not so obstinate that I won't agree to go on them if I can't control with diet, but just want the chance to have a try, rather than being dosed up to the nines. Here's to having a go anyway *lol*

 

[leatrix]

Just a word of warning Leatrix, not all Health professionals are on board with low carb as a way to put blood sugar levels back into the normal range, so you might get some resistance. May be print out this paper for them to peruse after you’ve informed them that that is the route you are taking:
https://www.practicaldiabetes.com/w...etes-experience-from-one-general-practice.pdf
A compromise may be to accept the Metformin but not the Gliclazide. Metformin will not risk hypos. Some people get side effects but some like myself don’t.

Yes, I got the feeling my DN didn't agree with low carbing, she was very much the medication is the route forward so you don't have to worry about diet, but I've already done so well with 130g of carbs, so I can see the proof. I'm on the Omeprazole for the hernia, but have realised that just getting down to 12 stone from 17 stone, has already meant that I'm feeling better on that score as there's less pressure on the hernia. Thanks for the paper, I've just printed it out and hoping a compromise may be the way forward! Thanks for your message!

 

[leatrix]

I'm surprised you don't like the omeprazole, for me it was a miracle in a capsule, still YMMV. Don't stop the omeprazole at the same time you start metformin, because you'll get a reinforced gastric disturbance effect you won't enjoy. Oh, and make sure the metformin is the slow release form, it should be automatic since you already have gastric problems, but it's worth checking.

Welcome to the community, and sorry you have joined us.

Thanks for the welcome! Yes, when I was first dx I was given Cimetidine which I really got along with, but Omeprazole has caused me all sorts of problems, but can't seem to get off it as every time I've tried I get gerd three times worse than I had originally. I did mention this and was told they can now wean me off it, so that's my next port of call. Unfortunately, I really struggle taking meds, my twin sister said to me yesterday, 'well how many ibuprofen do you take a day?' and I said 'about 1 a month!' *lol*.

 

[mariefrance]

Hi Leatrix

On diagnosis my hba1c was 106 and at my first post-diagnosis my hba1c was 35. Like others, I went low carb, reducing carbs to 20g carbs a day. That was in 2017 and my hba1cs have remained in the normal range ever since.

On diagnosis I was told I'd be prescribed Metformin but had to wait 2 weeks for an appointment with the practice nurse for this. During that 2 weeks I got myself a meter, went low carb and by the time of the appointment I could see from self-testing that my numbers had started to come down a bit so decided not to take the Metformin and try by diet alone first. It worked, It also sorted out my fatty liver and lots of my health markers have improved.

I understand about being gutted but as people have said there really is a way to manage this - and quite likely you can end up feeling healthier than you have in a long time. That's certainly what happened to me.

It's great that you have found the forum. I never posted on here when I was first diagnosed, but read the kind of advice people are giving you now. Not only then, but at every step of my journey the advice on here has been invaluable.

 

[leatrix]

106 here. Just metformin and I think it helped but quite probably as it has reduced my appetite.

Low carb was definitely the main reason I have dropped, with lots of help from my BG meter.

I'm so hoping this will be my case too; I'm happy to go onto any medication if my trial run of bringing down my bs with diet only doesn't work, but after reading these posts and researching how to use the BG meter effectively, I'd rather go down that route first, and actually feeling quite upbeat now, as yesterday I have to say, I was in bits! Thank you for replying

 

[leatrix]

I can't give advice (not allowed on the forum) but if I were in your shoes, I wouldn't take the glicazide. I have complications with an Auto Immune condition and needed steroids. Steroids shoot up your glucose, so they gave me glicazide, it did nothing to control the sterioid rise, but I had to promise to eat a wholemeal sandwich at bedtime. I still got overnight hypos and kicked it into touch pretty quickly. I jumped up and down at the surgery until they gave me another option.

I 100% agree! I've rang the practice and waiting on a call back (either today or tomorrow I was told, so fingers crossed today, I have told the reception that I haven't started the medication yet, so hopefully that will spur on a call *lol*) I also have PMR and was put on a heavy dosage of Prednislone for it over a few months, until I was weaned off it (I think this is where my hatred of medication has come directly from as it changed me completely!) I'm very worried about having hypos when I only have my boys here (hubby is a fairground showman, so has to travel) and I know they wouldn't cope if the hypo was severe. Having no real experience of the drug, I'm worried what it's effects will be on me and my pancreas too! What a worrier I am! *lol* Thanks so much for responding!

 

[leatrix]

Well, if they give you gliclazide they have to give you a blood testing meter. (Or maybe they've given you one already?) This is possibly the most important aid after the low carb approach because it'll show you how your diet is affecting your levels.

Some other thoughts - were you on 130g a day when you had the hba1c of 113. That is already moderately low carb and if your hba1c is so high while on it you may need to consider
1) going on much less carbs to achieve lower levels of blood sugar.
2) it's not impossible for you to be t1/lada rather than T2 - in which case your problem would be lack of insulin rather than carb intolerance and insulin over production and you'd need a different treatment regime, though going low carb can't hurt. Though honestly this is pretty unlikely if they've already identified you as nafld.

Nothing to stop you delaying the gliclazide for a week while you see what much lower carb does.....

Note that if you're on gliclazide and you're at risk of hypos you're supposed to do a blood test before driving - if your result is less than 5 you need to take sugar, because if you go hypo (less than 4) you become unsafe at the wheel. Now the at risk of hypos is a bit vague, some people don't get them on gliclazide, but when you're newly taking it you should be very careful, because you don't yet know how much it's going to pull your levels down....

Good luck.

Hi there and thanks for the advice; much appreciated. Yes, I was given a testing meter yesterday and this morning tested at 9.4 so my diet already seems to slowly but surely bringing the numbers down (started at 80mg of carbs yesterday from my normal 130mg of carbs, a bit of a shock to the system but going from the carbs I used to eat when I was much larger, it's definitely doable over time) and hoping to drop to 40mg (I did try between 20mg to 30mg when I first started losing weight and had really bad diarrhoea from it (sorry tmi), so had to up it a little more).

I don't drive at the moment, so this isn't a problem, but it's the thought that taking a medication that could make life that risky (I can drive, just not got a car presently) that worries me. So I'm waiting on the GP's practice to get back to me, keeping everything crossed that I can hold off meds until proving my worth and getting those levels down.

 

[leatrix]

Please don't take the Gliclazide and drive if you do not know your blood glucose level - it is essential that you test to be legal, as far as I can tell.
I'd think that you have a good argument against taking the Gliclazide, though - if you are determined to try lowering your blood glucose levels eating low carb.
My personal level of carbs is under 40 gm per day, as I am very sensitive to carbs - I think I was undiagnosed for a long time. Low carb is usually very effective, so if you find that your blood glucose levels are not normalizing it might well be that you are not a standard type two.

I'm thinking the same as you, that I was undiagnosed for a long time and it's built up to epic proportions in my blood. I asked the nurse if the GP practice had done a full blood count and she told me they don't really take a blood test for diabetes as they only test if they think the patient could be diabetic and as they were delighted with my weight loss and overall health (she originally said she'd never seen such a healthy looking person with such high numbers), they never really bothered checking, until I mentioned a story about a GP years ago thinking I was an alcoholic and my then BF saying 'she doesn't even drink'...so that must have alerted the GP to get the test done, as they said fatty liver and diabetes can be connected.

I've tried 20-30mg of carbs and unfortunately had a rotton time of it with runny tummy, so will probably try and find a good place between 40mg-50mg. If that works I'll be over the moon, as I know I won't be on meds then. I'm hoping with the BS Machine and diet, I'll confidently crack this. #thetheoryanyway Thanks for your reply!

 

[xfieldok]

I am on prednisolone currently being weaned off. This could well be where your high numbers came from. I was eventually given insulin to control the rise they caused but only after having been left for several months in the high teens and 20s. I am also on 40mg omeprazole, not noticed any effect on bs, but I have so much going on. Prednisolone also raises cholesterol ldl. It takes me over an hour to sort out my doses for the week.

 

[xfieldok]

@leatrix be aware that there are cases of steroid induced diabetes, depends what level you were on and for how long. It may have no bearing on your situation but just keep the information in your back pocket.

 

[leatrix]

Hi @leatrix ,

I'm sure you've gathered by now that yes, it is absolutely possible to go the diet-only route, and that yes, low carbing and gliclazide are a dangerous combo. I know what I'd do. Well, I know what I did: Low carb, high fat, and no medication for the T2 whatsoever. No risk of hypo's when your kids need you or when on the road, excellent blood sugar control AND it will also tackle your fatty liver disease, as it did mine. It is a lot of reading to do, yeah.... I have a little condensed quick-start guide to get you off to a flying start, https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html but what you really want is Dr. Jason Fung's The Diabetes Code. Excellent book, and a lifesaver. Dietdoctor.com's good too, as well as this forum's website diabetes.co.uk (not .org!). You might get some resistance from the nurse, but remember, this is your body, your health, your choice. Also, if you get a meter (they should've given you one, what with the Glic), you can prove at the next appointment that you can and have gotten your blood glucose down. Because I am absolutely positive you're going to do just that!

Good luck!
Jo

This is fabulous and just what I needed to read today. I'm still waiting on the D/N to get back to me via phone today, and haven't taken any meds yet, and really don't want to esp with the kids being ASD as I'm their main go to person. I want to be fighting fit so I can be there long term for them, so know how important getting healthy is (hence why I lost the weight in the first place), but just don't think cramming myself with chemicals will do that. I'm delighted it helped your fatty liver too, as I'm was going to ask for a dietician meeting as I wasn't sure if the LCHF way of life would be harmful to the liver, but clearly for yours anyway, it wasn't. I've already been reading Dietdoctor, it is good and thanks for the nutritional blog link, i'll read that this afternoon. Yes, I have the meter, so already keenly reading up on how to put it to good use! Thank You

 

[leatrix]

Hi @leatrix

I'm another who is on metformin but no other meds and my 2 HbA1cs after diagnosis have been in the normal range. My doctor tried to prescribe me states and I said no- I said I would only worry about cholesterol levels after I have stopped losing weight. I guess my point is that she could have prescribed it but didn't as I told her that I wasn't willing to take it. I'm sure her notes have a record of my refusal to protect her from any clam may have- but frank;y she didn't expect em to get into the normal range for blood sugar levels and I have so I'm happy to back myself.

Testing is really key. It is the way that you know how your body is going.

Good luck and welcome- you have already received great responses- stick around and let us know how you are going

Welcome.

Hi there and thanks for the reply! I have to say, I was wondering when my nurse was going to mention statins, my Mum wasn't a fan of them at all, and I'm sure that'll be the next thing I have to target. My overall hope is that going on the LCHF diet will balance everything out and get me back to peak health. I know for years I've been eating rubbish food (I have a terrible sweet tooth!) and know that in T2 it's nearly always food related. I put myself in this position and want to at least have a go at getting out of it. I noticed today how important testing was, I tested, had my eggs and restested and the jump was nothing like it was after eating cereal (my usual go to breakfast meal). Clearly Weetabix and Shreddies weren't doing me any favours at all! *sob*

 

[leatrix]

Hi Leatrix

On diagnosis my hba1c was 106 and at my first post-diagnosis my hba1c was 35. Like others, I went low carb, reducing carbs to 20g carbs a day. That was in 2017 and my hba1cs have remained in the normal range ever since.

On diagnosis I was told I'd be prescribed Metformin but had to wait 2 weeks for an appointment with the practice nurse for this. During that 2 weeks I got myself a meter, went low carb and by the time of the appointment I could see from self-testing that my numbers had started to come down a bit so decided not to take the Metformin and try by diet alone first. It worked, It also sorted out my fatty liver and lots of my health markers have improved.

I understand about being gutted but as people have said there really is a way to manage this - and quite likely you can end up feeling healthier than you have in a long time. That's certainly what happened to me.

It's great that you have found the forum. I never posted on here when I was first diagnosed, but read the kind of advice people are giving you now. Not only then, but at every step of my journey the advice on here has been invaluable.

Oh that's great to read! I'm just loving all these positive LCHF posts proving my point, all good evidence, I'm making the right decision for my body and health. I think I'll have to play around and find the right carb allowance for myself as when I went on 20g carbs (in the early years of dieting), I found it gave me terrible runs, but 40-50g was perfect and allowed me to loose a great deal of weight (I didn't know what my BS was then, as I hadn't realised I had DT2), but it will be very interested to see if that does normalise things for me and still allows me good weight loss, I'm currently 12.6 stone and want to be a healthy 11 stone, so not too much weight to lose now.

Yes, my numbers are already starting to drop in such a quick time too, so I'm sure this is the right way forward and again I'm delighted to read you've also sorted the fatty liver out too, as that was also a concern to me, regarding the diet.

I'm loving this forum, I've never had some much good advice and so kind too, I thought everyone would be 'nope, listen to the advice the medical practice has given you', but to see I have options is wonderful, thank you!

 

[leatrix]

@leatrix be aware that there are cases of steroid induced diabetes, depends what level you were on and for how long. It may have no bearing on your situation but just keep the information in your back pocket.

Now that is very interesting, because I assumed I'd probably had this a while and it was undetected, but I moved house 2 years ago, and so moved from the GP Practice to a closer one, and I'm sure the old practice would have detected any diabetes in me (I was with them for over 12 years), but there's no record of having done so. It's only just been detected this last couple of weeks (had to wait 2 weeks from the phone call to get a nurse app) and I can't believe it's just appeared from nowhere. I was on around 40mg for between 3 to 4 months from about May 2017 and then weaned off them very quickly, so probably not long enough to cause diabetes, but when the nurse calls I will definitely ask if this is a possibility. I'm assuming if it is, it's a whole different route to wellness then.

 

[xfieldok]

Anything you fancy, foodwise, google it, just put keto first.

Sweet tooth, google fat bombs. I found I got along better once I learned the lingo. Your tastes will change over time.

Don't beat yourself up if you fall off the wagon. Treat it as part of your education.

 

[jjraak]

Now that is very interesting, because I assumed I'd probably had this a while and it was undetected, but I moved house 2 years ago, and so moved from the GP Practice to a closer one, and I'm sure the old practice would have detected any diabetes in me (I was with them for over 12 years), but there's no record of having done so. It's only just been detected this last couple of weeks (had to wait 2 weeks from the phone call to get a nurse app) and I can't believe it's just appeared from nowhere. I was on around 40mg for between 3 to 4 months from about May 2017 and then weaned off them very quickly, so probably not long enough to cause diabetes, but when the nurse calls I will definitely ask if this is a possibility. I'm assuming if it is, it's a whole different route to wellness then.

I think @JohnEGreen had issues caused by preds..tagged him in case he can offer some insight, as well as @xfieldok input..
never hurts to have more info.

As for being spotted ..i wasn't, though rarely went to docs..did have a health issue back in 2011,
not dx'd as t2, but i think i was well on the way back then..so maybe if you don't present with symptoms i guess it's not on anyones radar..at least not back then

 

[JoKalsbeek]

This is fabulous and just what I needed to read today. I'm still waiting on the D/N to get back to me via phone today, and haven't taken any meds yet, and really don't want to esp with the kids being ASD as I'm their main go to person. I want to be fighting fit so I can be there long term for them, so know how important getting healthy is (hence why I lost the weight in the first place), but just don't think cramming myself with chemicals will do that. I'm delighted it helped your fatty liver too, as I'm was going to ask for a dietician meeting as I wasn't sure if the LCHF way of life would be harmful to the liver, but clearly for yours anyway, it wasn't. I've already been reading Dietdoctor, it is good and thanks for the nutritional blog link, i'll read that this afternoon. Yes, I have the meter, so already keenly reading up on how to put it to good use! Thank You

Well, if you like the liver bit: It was so fatty, that the specialist thought it was one big tumorous mass and I had a few weeks left to live, tops. Once he found it was "an abnormal stacking of fat" he told me there was nothing I nor he could do about it, and he'd see me again when cirrhosis kicked in. Well... If they'd do an ultrasound they'd probably still see some fat in there someplace, but it doesn't show up in the blood work anymore, so... For all intents and purposes, the non alcoholic fatty liver disease is gone. Levels and function are all normal. And a lot of people here have found their liver cheered right up on LCHF too.

So yeah... LCHF is kind of a cure-all. I have a feeling you're going to be perfectly fine.

 

[JohnEGreen]

Now that is very interesting, because I assumed I'd probably had this a while and it was undetected, but I moved house 2 years ago, and so moved from the GP Practice to a closer one, and I'm sure the old practice would have detected any diabetes in me (I was with them for over 12 years), but there's no record of having done so. It's only just been detected this last couple of weeks (had to wait 2 weeks from the phone call to get a nurse app) and I can't believe it's just appeared from nowhere. I was on around 40mg for between 3 to 4 months from about May 2017 and then weaned off them very quickly, so probably not long enough to cause diabetes, but when the nurse calls I will definitely ask if this is a possibility. I'm assuming if it is, it's a whole different route to wellness then.

Thanks for the tag @jjraak

Diabetes is more likely to be induced if you have been on high dose for 3 months or more but it can in some cases say if you had an underlying susceptibility happen in a shorter time depends on the individual I was on 40 and above mg per day for several years.

Once you have stopped taking them normally the diabetes will go away but if you had an underlying susceptibility for instance there are instances when it can become permanent but that does not happen often and if it does you should be able to manage it with diet or some meds so I would not be too scared about it when you come off the preds as you have the effects don't just disappear overnight it may take a while for you to get back to normal if however the preds have just unmasked what was already there then you may have to deal with it.

If your old practice had had no reason to test for diabetes and you were not reporting symptoms then it could easily have been missed.

My old practice even though I was reporting symptoms and my neurologist had informed them of my raised HbA1c refused to acknowledge my diabetes for about two years then my new doctors surgery diagnosed me as soon as I registered with them.

I wish you well and hope your nurse will be able to reassure you that your diabetes is temporary and that it will subside.

Bye the way I am still taking preds and manage low blood sugars even so, so things are not that desperate.