Have I cut the carbs too much, too soon?

Hi John

I would say you have two options. Glicklazide can and does produce hypos because it is an insulin stimulating drug so simplistically if it makes your pancreas send out more insulin than is needed to be processed a hypo condition can arise so you do need to be careful. It is a bit more complex than that but lets not worry too much about the finer details as avoiding hypos is the serious thing.

In my opinion you should either up your carbs so that the amount "matches" the power of the glicklazide or you could reduce the glicklazide dosage but of course before doing that you should speak with your gp and explain you have been reducing carbs and take his advise.

Really it comes down to your personal preference of the balance you want between diet and meds. You do need to get that balance right however!

Hi signs

What you are suggesting seems to make perfect sense to me but I'm diet only controlled so don't suffer hypos or juggling meds

Mary x

I was neer on glic but was on glimepiride. I had been on it for 3 years , quite a high dose. When I started taking j januvia and low carbing I was told by the hospital I should be avble to cut tthe glimepiride {same sort of thing as glic} gradually.

I had to cut it it very quickly as i was having hypos several times a day. Had I waited to see the nurse in my practice I would have been very ill I think.

When I had my HBAic - the only time a GP will talk to you about diabetes in my practice} they totally agreed with me.

If you are havning hypos after lowcarbing then you are over medicated. Of course noone can officially give you medical advice but I know you will find that they would be more concerned wih your having hypos than lowering the medication.
You may get someone who tells you that you should eat more carbs but you have to ry to avaoid getting into the "meds make you put on weight which raises your levels so you have to have more meds " etc

I would not tell them that you are low carbing because they may not understand what you mean, Just say you are being careful with your diet and reducing starchy carbs.

I dont think it would be a good idea to eat more carbs han you want just o accommodate the medication. It is often difficult to get he dosage righ in the beginning. You may need to increase it again in the future when you have worked ou a sustainable diet for yourself but I doubt if you will get much help with this from the HCPs who are bound by NHS guidelines.

I was told to eat more carbs because of the effects of metformin , This I got into that spiral with other drugs which have caused complicaions.

Changing to tjhe metformin sounds like an excellent idea. That will give you a bit of help should you need it without causing hypos.
Obviously your nurse was just doing what everyone has to dio in the beginning, just try various doses to see how they work.

I have had exercise-induced hypos and found that they were far less unpleasant than the medication induced s You dont want many of those!

The only point of taking the glic is to increase the insulin production so if you dont need it dont take i. That doesnt apply to all medication but seems to make sense in these circumstances.

You are definitely very lucky with your Dn John. That helps so much! I found that the weight just dropped off once i reduced the meds which had caused it. A little extra exercise can kickstart it!

With the meds i was on i too put on loads of weight and coz of the sickness i could move to much either. Since stopping the list of meds in signature bit, i dont feel sick anymore so once sugar levels are stable i will be back out being active.

It might be a case of out of the frying pan and into the fire by going on insulin thiough.

Exactly right. The low carbs could mean you no longer need the gliciazide and part of itthe reason could be that your pancreas has been kickstarted .
Just a word of caution you dont want to throw the baby out with the bathwater and have your levels rising. You have to learn to balance the meds wen you eat and exercise. Not so easy.

I
Thats why I said you needed to find a sustainable level of carbs for you to fit into your lifestyle. I don't nwow what you did when you went out bu tperhaps it involved more waliking han ussual? That would account for your levels going down.
It may be that you will be able to cut the glic down or do without it altogether but if you can't sustain your precsent diet
then you might have to readjust later.Its best to take it all gradually although it is very satisfactory to see a quick result..

It is good that you have a sensible DN because it is hard to advise patients on this class of drugs but she will, I am sure be able to give you the correct advice.

Well done John! You're doing brilliantly!

Signs said:

I won't say I don't miss all the "healthy" foods I ate before but needs must.

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Forget about them. Think of all the "unhealthy" things you can eat in their place (and especially all that cream you can now eat).

Signs said:

I hope to get back to the gym soon so will have to work out how to balance carb intake with exercise. There's so many at the gym who tell me loads of ****!

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Yes. A little bit of knowledge is a dangerous thing, most of what you hear in the gym is absolute rubbish. Having said that, there are some members of the body building community that seem to know more about nutrition than the whole of the NHS put together (which isn't that difficult).

My only advice is not to expect miracles in the first few weeks. When I first started I ran two of my slowest ever 5k times and felt rubbish. Since then I've managed to run faster every week, including (I hope) 4 consecutive PBs, knocking nearly 2 minutes off my time.

In the last 2 weeks I've tried eating a small carby snack (20g of carb) just before I race, to aid recovery, and to try and prevent a huge liver dump. It worked last week, but not this, as my BG was @ 11mmol/l after the race :shock: , although it soon dropped down to 5mmol/l.

You just have to test and see, test and see, test and see.

Got to say signs, I think you're balancing the equation just right. This illness is a choice between meds and diet for a lot of people - sadly not all. There are many that have come off the stronger meds on the back of a good diet and exercise. That's where you're going, so well done.

Well done Signs. At that 60 - 80 you are doing roughly the same as me. I found after a few weeks you don't miss those "healthy" foods at all so hopefully it will be the same for you. Once you get to that point people start to think you're quite strange and do a "does not compute" look when you tell them you don't care about losing them from your diet.