Freaking out a little...

Postitnote · Apr 10, 2015

So I find myself re-diagnosed as a possible Type 2. And I have stopped my insulin (as instructed by the consultant) and am on metformin (2x500mg a day)..... as a "trial". It has only been two days but my BG is hovering around 14 and 15. I am LCHF (aiming for less than 20g a day). I feel absolutely fine but I am so worried about the long term damage that this "trial" may be causing! My DSN doesn't work Fridays through Mondays. I don't quite know what to do - wait until the metformin kicks in or take some Novorapid?

noblehead · Apr 10, 2015

Ring your clinic up and ask to speak with another DSN.

Postitnote · Apr 10, 2015

I have left a voicemessage. I think this is slightly irresponsible of them. It was sort of along the lines of them: "hmm, you're not taking much insulin and your control is really good"
Me: "thank you. I am on low carb and also try to exercise as often as I can."
Them: "you may be Type 2. Let's re-do your bloods and in the meantime, stop your insulin and take these pills instead. Let's see what happens".
Me: "erm, okay......."
It would be nice to be Type 2 I think... pills are easier than needles.

noblehead · Apr 10, 2015

Well if push comes to shove and your bg levels don't go down or continue to climb then you could go back to using insulin again as you've only just stopped using it, hope they get back to you soon and sort this out.

Daibell · Apr 10, 2015

It sounds like the consultant may have slightyl over-reacted. Common sense would say that as you are low-carbing, then if your insulin usage has not been near zero then you probably need it and why stop it? Metformin only ever has a small effect on blood sugar. Stopping insulin only makes some sense if you are overweight and having too many carbs as a diet change may be enough. I would insist that the insulin is re-started if the bs remains in the teens most of the time. Ask for an HBa1C and the target must be below 6.5%?

donnellysdogs · Apr 10, 2015

I take it that they must be doing C-peptide and GAD tests?

If they prove you are a type 1, (which I suspect you are) would you consider having a pump that would offer you the ability to just give miniscule doses as required by your body?

I know @ElyDave has small amounts pumping through rather than mdi...

donnellysdogs · Apr 10, 2015

agree with noblehead too.. If you remain at raised levels then you could go back to injections.

LucySW · Apr 10, 2015

Daibell said:
It sounds like the consultant may have slightyl over-reacted. Common sense would say that as you are low-carbing, then if your insulin usage has not been near zero then you probably need it and why stop it? Metformin only ever has a small effect on blood sugar. Stopping insulin only makes some sense if you are overweight and having too many carbs as a diet change may be enough. I would insist that the insulin is re-started if the bs remains in the teens most of the time. Ask for an HBa1C and the target must be below 6.5%?

I agree with Daibell, and totally understand your worries. Is this based on a negative GAD test? If youre that high and on 20g a day, no way can you cope on Metformin.

In your shoes I think I'd take the Novorapid and try, try to get it sorted out.

Horrid situation to be in - sorry you are. Good luck !!

Paul59 · Apr 10, 2015

Daibell said:
It sounds like the consultant may have slightyl over-reacted. Common sense would say that as you are low-carbing, then if your insulin usage has not been near zero then you probably need it and why stop it? Metformin only ever has a small effect on blood sugar. Stopping insulin only makes some sense if you are overweight and having too many carbs as a diet change may be enough. I would insist that the insulin is re-started if the bs remains in the teens most of the time. Ask for an HBa1C and the target must be below 6.5%?

Does anyone in the Nhs have common sense or even logic. "I think not".

Daro · Apr 11, 2015

My Dr said Metformin takes several weeks to start taking effect on that basis I would think your current experience is not unexpected but you definitely need more guidance than you are getting

LucySW · Apr 11, 2015

And it's not safe to sit in the teens. It's irresponsible. Make yourself very clear, Postit, that you won't accept that. It's your complications, not theirs.

Postitnote · Apr 13, 2015

Yeah. ****** this for a lark. Most recent HbA1c is 6.8% and I worked (sort of) hard for that! I have re-started detemir (on advice of DSN who responded to the message that I left) as of yesterday afternoon readings are now in (high) single figures. Feeling fine but am a bit grumps. I have written a strongly worded email and it won't come to anything but I feel better for it.

LucySW · Apr 13, 2015

What about bolus then?

Postitnote · Apr 13, 2015

None yet. Daft but, I want to give things a chance..... Am keeping an eye on things. Am back in double figures now.... blast.

noblehead · Apr 13, 2015

Go back to both insulins as before until you get things sorted, being in double figures isn't good.

daddys1 · Apr 13, 2015

Daro said:
My Dr said Metformin takes several weeks to start taking effect on that basis I would think your current experience is not unexpected but you definitely need more guidance than you are getting

Hi @Daro and welcome to the forum, you have certainly come to the right place for help and support and a vast range of information.

Normally when there is a new member we tag @daisy1 who will come along with a long list of very helpful information we give to all new members

I'm on metformin and it may well take a while to start to work but it does very little in controlling your sugars. It is more of a appetite suppressant and will slow down the release of 'Glycogen Stores' from the Liver, but it's overall effect is small, diet is the key by reducing the carbs. That is what will control your blood sugars.

Neil

LucySW · Apr 14, 2015

noblehead said:
Go back to both insulins as before until you get things sorted, being in double figures isn't good.

Yes, that's what I would do. Metformin is a good drug and may form part of your long term regime, so by all means give it three weeks to get working. But it's only a helper. If you need insulin, you need insulin. Honestly, to mess you around like that for the sake of a half-baked idea without even any tests .. If it ain't broke !!!!

Postitnote · Apr 14, 2015

I am back on basal/bolus now. In my panic I have overdone it though and am now hypo (don't worry, I have treated it - my first instinct is not to automatically post on the forum! )

noblehead · Apr 14, 2015

Postitnote said:
I am back on basal/bolus now. In my panic I have overdone it though and am now hypo (don't worry, I have treated it - my first instinct is not to automatically post on the forum! )

Too late Seriously though, you need to take into consideration that your taking metformin now and will likely need to reduce your insulin doses, make sure to test regularly and maybe best that you do some basal testing.

LucySW · Apr 14, 2015

noblehead said:
Too late Seriously though, you need to take into consideration that your taking metformin now and will likely need to reduce your insulin doses, make sure to test regularly and maybe best that you do some basal testing.

Yes, Metformin will make you need less insulin - which is great!

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