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Erratic BG Levels! Advice please

IZ THE LEG END

IZ THE LEG END

Well-Known Member
Messages
169
Location
East Yorkshire
Type of diabetes
LADA
Treatment type
Insulin
Dislikes
Diabetes!!!
Good morning,

I am just wondering if anyone has some advice...

I was diagnosed with LADA in May 15.

I was originally prescribed Metformin, to which I have sensitivity to both normal and SR. The specialist has moved me to Januvia (Sitagliptin).

I have made some huge changes in my lifestyle, both physically and nutritionally and whilst on the Metformin I was able to maintain a BG level of between 5 and 6.6 (Fasting). And my HB1AC was 41 so within target range.

However since being on the Januvia my bloods have been erratic, I've had nothing below 6.8 and peaked at 13.3 (Fasting). I've not had a HB1AC since being on the Januvia.

I have noticed that I am feeling shaky and sweaty if I've not eaten regularly enough more often than ever before. However my biggest concern is that I went for my first diabetic eye screen and the found that I had traces of retinopathy already. And I don't want high BG levels to effect this further...

I understand that the Januvia works in a completely different way to the Metformin.

I work along the lines of 5.5 as my ideal level and try to achieve this but recently I'm nowhere near I'm very rarely going below 7.5.

Has anyone had similar results or concerns?

I'm reluctant to go back to the GP as I think he would just push for insulin.

Any advice would be greatly appreciated.

Thanks izzy
 
IZ THE LEG END said:
Good morning,

I am just wondering if anyone has some advice...

I was diagnosed with LADA in May 15.

I was originally prescribed Metformin, to which I have sensitivity to both normal and SR. The specialist has moved me to Januvia (Sitagliptin).

I have made some huge changes in my lifestyle, both physically and nutritionally and whilst on the Metformin I was able to maintain a BG level of between 5 and 6.6 (Fasting). And my HB1AC was 41 so within target range.

However since being on the Januvia my bloods have been erratic, I've had nothing below 6.8 and peaked at 13.3 (Fasting). I've not had a HB1AC since being on the Januvia.

I have noticed that I am feeling shaky and sweaty if I've not eaten regularly enough more often than ever before. However my biggest concern is that I went for my first diabetic eye screen and the found that I had traces of retinopathy already. And I don't want high BG levels to effect this further...

I understand that the Januvia works in a completely different way to the Metformin.

I work along the lines of 5.5 as my ideal level and try to achieve this but recently I'm nowhere near I'm very rarely going below 7.5.

Has anyone had similar results or concerns?

I'm reluctant to go back to the GP as I think he would just push for insulin.

Any advice would be greatly appreciated.

Thanks izzy
Click to expand...
I think your GP would want you to let him know about this, and hopefully he would have a discussion about the range of options and not just push for one of them. It's meant to be a partnership where he tells you the pros and cons, and you decide.
 
Maybe you need to go back to the specialist urgently. He fixed something that wasn't broke and he should know it. But believe me insulin treatment is better than retinopathy, whatever the outcome of seeing either doctor.
 
@CatLadyNZ @RuthW I have an appointment at 2:15 but only with a GP as my specialist is off, so here goes explaining the whole LADA thing again to another doctor lol fingers crossed thanks for all your help on this
 
Seen the doctor this afternoon...

I am continuing on my Januvia 100mg daily and now taking gliclazide 80mg daily to attempt to stabilise my blood sugars... Let's see how the next few weeks go.

Thanks for all your advice
 
Why don't you come and join our Regular Moderate Exercise Log. That'll help you to delay the onset of the D, or help to control it if it does develop?
 
I used to be on januvia years back and it didn't help me at all. It apparently works on brain receptors. That could be why you're getting erratic sugar levels.. I'm glad your doc introduced another drug into the mix. With LADA you'll probably be placed on insulin soon. I've been on insuin for past 5 years and I've had better diabetic management than I did on oral meds. Oral meds won't work on me anymore anyhow because I hardly produce any insulin.
 
Mep said:
I used to be on januvia years back and it didn't help me at all. It apparently works on brain receptors. That could be why you're getting erratic sugar levels.. I'm glad your doc introduced another drug into the mix. With LADA you'll probably be placed on insulin soon. I've been on insuin for past 5 years and I've had better diabetic management than I did on oral meds. Oral meds won't work on me anymore anyhow because I hardly produce any insulin.
Click to expand...

Thanks for your time, I am continuing on my Januvia 100mg daily and now taking gliclazide 80mg daily to attempt to stabilise my blood sugars... Let's see how the next few weeks go unfortunately my specialist is off all week so I only got to see a GP but she was very helpful and very accommodating which was good especially as with most GP they don't know very much WRT LADA.
 
Hi . Iv just been taken of gliclazide as my hba1c was to low at 33 . Just change to sitagliptin 100 mg with 2 x 500 metformin .. I will let you know how I get on and keep on eye out to see how you are doing. .
Hope it works for you
Clive
 
Good luck hopefully all works well for you...

Since this my BG has rocketed my fasting BG IS AROUND 14-15 and anywhere upto 26. I went back to the docs and they have doubled my gliclazide to 160mg daily and I have the option to double again to 320mg daily but they also given me insulin now to carry as a precaution due to my work taking me around the world at short notice.

I have been on the 160mg daily for a week tomorrow still with high BG so if still high by Wednesday I will double to 320mg daily as my GP recommended hopefully don't need to use the insulin... Interesting times
 
IZ THE LEG END said:
Good luck hopefully all works well for you...

Since this my BG has rocketed my fasting BG IS AROUND 14-15 and anywhere upto 26. I went back to the docs and they have doubled my gliclazide to 160mg daily and I have the option to double again to 320mg daily but they also given me insulin now to carry as a precaution due to my work taking me around the world at short notice.

I have been on the 160mg daily for a week tomorrow still with high BG so if still high by Wednesday I will double to 320mg daily as my GP recommended hopefully don't need to use the insulin... Interesting times
Click to expand...

Sorry to hear your BGLs are skyrocketing. :( Have you had the GAD & c-peptide tests done recently? If not, it may be worth asking that they be done again as it just may be you no longer have sufficient insulin at all (the c-peptide test result will be in the red if that is the case). If you do not have sufficient insulin yourself, oral meds will not work as they're designed for diabetics who produce their own insulin. I came to the point myself early 2010 and I'm on full time insulin therapy since then. I'm glad you've been given insulin as a precaution. Is this a basal insulin only? or a mix of basal & bolus? You will need basal & bolus if you no longer have sufficient insulin yourself. If you are producing sufficient insulin, then just the one type should be ok. I noticed you mention your advice is from your GP, I'm not sure if your GP can request the diagnostic tests I mentioned above? I know that they can't here, my endocrinologist requests these tests. I hope you are able to get some answers and get control soon. Wishing you the best.
 
Mep said:
Sorry to hear your BGLs are skyrocketing. :( Have you had the GAD & c-peptide tests done recently? If not, it may be worth asking that they be done again as it just may be you no longer have sufficient insulin at all (the c-peptide test result will be in the red if that is the case). If you do not have sufficient insulin yourself, oral meds will not work as they're designed for diabetics who produce their own insulin. I came to the point myself early 2010 and I'm on full time insulin therapy since then. I'm glad you've been given insulin as a precaution. Is this a basal insulin only? or a mix of basal & bolus? You will need basal & bolus if you no longer have sufficient insulin yourself. If you are producing sufficient insulin, then just the one type should be ok. I noticed you mention your advice is from your GP, I'm not sure if your GP can request the diagnostic tests I mentioned above? I know that they can't here, my endocrinologist requests these tests. I hope you are able to get some answers and get control soon. Wishing you the best.
Click to expand...

Thanks @Mep much appreciated.

As for insulin I have Levemir... I'm guessing this is basal haha not sure as this were not explained to me by the nurse

I will ask for the tests but I'm back offshore to Saudi on the 28th for 30 days so could be a while before I get them

Thanks for the pointers, I'm going to read up on insulin now too have a good Christmas and new year
 
IZ THE LEG END said:
Good luck hopefully all works well for you...

Since this my BG has rocketed my fasting BG IS AROUND 14-15 and anywhere upto 26. I went back to the docs and they have doubled my gliclazide to 160mg daily and I have the option to double again to 320mg daily but they also given me insulin now to carry as a precaution due to my work taking me around the world at short notice.

I have been on the 160mg daily for a week tomorrow still with high BG so if still high by Wednesday I will double to 320mg daily as my GP recommended hopefully don't need to use the insulin... Interesting times
Click to expand...
Hi as a LADA, insulin may be in your future, I've read some of the ones on the forum and they have said since insulin they havent looked back, they feel much better.
 
IZ THE LEG END said:
Thanks @Mep much appreciated.

As for insulin I have Levemir... I'm guessing this is basal haha not sure as this were not explained to me by the nurse

I will ask for the tests but I'm back offshore to Saudi on the 28th for 30 days so could be a while before I get them

Thanks for the pointers, I'm going to read up on insulin now too have a good Christmas and new year
Click to expand...

Yes, Levemir is a basal insulin. That means it works over a long period to keep your sugar levels lower when you're not eating. What it wouldn't do well is control the peak of your sugar levels when you do eat, you need bolus insulin for that. So depending on whether or not you have your own insulin will depend on what insulin therapy you should be on. I'm on what they call basal-bolus therapy. I have a minimum of 4 injections per day. Hopefully you will get these answers from your medical team when you return from your work. I wished they'd placed me on insulin sooner than they did as they had me on oral meds that weren't working at all for a while before I put my foot down and said look something is very wrong. My gut instinct was right.

Have a merry christmas a new year. :)

ps. excuse me if I'm explaining too much for you... I've spent years training people as part of my work and I like to explain what I've learnt for myself.
 
Thanks again for the info much appreciated, let's see how the next month goes on a plus side in Saudi it's chicken and rice for breakfast dinner and tea hahaha... So not too much to spike on so long as I avoid the rice!!! Whilst typing this and baking mince pies with the kids oops!
 
take it one day at a time mate and you will get there. it's a hell of a shock to the system, how long have you been diagnosed?
 
APril this year I think the whole process started. It took a little getting use too, as I am never needing medical help. Now I have a whole cupboard just for me hahaha... But am good with it and like you say 1 day at a time thanks pal
 
@IZ THE LEG END - LADA is essentially late onset Type 1 diabetes. It is caused by an Autoimmune response. Giving a LADA any kind of insulinogenic drug will speed the destruction of the beta cells due to the way in which the autoimmune system latches on to insulin production to attack them.

You are far better off either going very low carb to reduce insulin production and therefore reduce the autoimmune response or to start taking insulin, which will alleviate your body having to produce insulin, and again protect beta cells. You should only need very small amounts if caught early enough, but you should be given both basal (Levemir) and Bolus (quick acting insulin as described above) to properly protect you.

You should also get yourself to a diabetic clinic with a proper Diabetic Consultant rather than a GP, as a Diabetic Specialist GP is not going to understand how to properly treat LADA.
 
Same thing happened to me. Skyrocketing BS and fastings out of nowhere. They put me on type 2 meds and I was all over the place. I started dropping tons of weight and I didn't have any to lose. I was skin and bones and finally the hospital I ended up in did a GAD and I immediately started on insulin and within 3 days felt like a whole new person. It is not fun but it is much better than the alternative. I also believe the Amaryl killed my pancreas. Eating VLC I am able to keep all insulin doses very low. 2-3 basal and 1 unit Novolog with meals. Managing diabetes with insulin is a challenge in the beginning but once you find a routine it is much easier. I was sent home with a sliding scale and insulin and within a week pitched the scale and followed my gut and meter along with LC.
 
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