Hi,
I have not posted here for many years mainly due to having accepted my fate with type 2 as my GP's tend to be of very little help. But I would like peoples opinion or possible experiences with what I am about to write.
This may be quite long.
Quick previous history: I was on a HBA1c of around 60 in 2018 after being put on Simvastatin and no number of conversations with GP's has ever resolved this. During Covid my HBA1c had gone up to as high as 107, I was put on a maximum Metformin dose of 2000mg and then 10mg of Dapagliflozin which brought it down to 70/80 this would flipflop between the two, 80 in April, 70 in November. So to break this cycle I was put on 1 X Gliclazide 40mg. This helped and got me into the mid to low 60's a second Gliclazide tablet did not appear to improve things by much apart from consistently getting me in to the lower 60's.
In early 2024 I had some chest discomfort and and after some irregular ECG results I was given an echo and a CT scan. Nothing was found apart from finding out what my plaque build up was, which I was told was what was expected for someone living in this part of the world and my age. In fact I was told that for someone with some high blood pressure and type 2 diabetes the results were excellent. I am taking that with a pinch of salt but it reassured me a bit. Somehow we got on to the discussion of Simvastatin and high HBA1c, the consultant decided to switch me from Simvastatin to Ezetimibe 1 X 10mg, this was around January 2025. In April 2025 I had my cholesterol and HBA1c blood tests and the results that came back showed HBA1c at 59 which was a 4mmol improvement and had not been in this range for over 6 years, I was expecting a bigger drop, but still an improvement. However, my cholesterol results had all gone in to the abnormal range except for the good cholesterol, and the triglycerides (my nemesis) was about the same, having only gone up .1. We decided to stay on the Ezetimibe until I could speak to the heart consultant who is very good as he will take emails from his patients even after they have been discharged! At this point though I think he may have forgotten why he had taken me off Simvastatin as he recommended Pravastatin which from my research is guaranteed to raise glucose levels, I may be wrong. During this period I had been referred to a Diabetes Dietician (I can't remember why) and in our first face to face meeting I was discharged as my HBA1c was 59. She did however say that Ezetimibe can take a while to kick in and advised me to keep taking it, this I did. Around June I was enrolled into a Semaglutide (rebelsus tablets) drugs trial for Type 2 Diabetes and heart attack strokes etc. This involves a 12 week run-in as they call it with the tablets definitely having the active ingredient of 3mg, apparently not enough to affect HBA1c results. I completed the first 4 weeks and was 6 days into the second vial of tablets at 7mg when I had another cholesterol/HBA1c blood test. Well, the HBA1c had gone down to 57 and I suspect this could still be the weaning off of Simvastatin as it was too early for the Semaglutide to kick in but strangely, my cholesterol levels had returned almost to the levels they were at when taking Simvastatin and amazingly! my triglycerides had gone from 3.0 to 1.6 a 45% plus reduction. I have never had levels that low ever. The lowest I have ever seen are 2.2 and that was rare. So the question now is, is it the Ezetimibe that has now kicked in or is it (I think most likely) the Semaglutide? I have had a look and the oral semaglutide tablets apparently can affect cholesterol especially triglycerides. My surgery is refusing to try any rejigging of medication or any extra blood tests to try and find out which tablet is doing the work (I understand costs etc.) but in reality they are not interested even though I said we may have stumbled across 1 tablet that may be capable of doing most of the work. They can't even tell me, assuming the Ezetimibe is doing the work how long it would take for the effect to wear off if I stopped taking it. To complicate things in six weeks time the first part of the semaglutide trial finishes and I may end up on a Placebo or another increase to 14mg for 5 years.
My thinking is that I will have to try and go privately for tests or buy one of those meters that can test cholesterol including triglycerides and test myself. I don't know if anyone has ever tried those and how accurate they may be. Anyway, thanks for reading apologies for the length and hope to hear something back.
Regards
Lou
I have not posted here for many years mainly due to having accepted my fate with type 2 as my GP's tend to be of very little help. But I would like peoples opinion or possible experiences with what I am about to write.
This may be quite long.
Quick previous history: I was on a HBA1c of around 60 in 2018 after being put on Simvastatin and no number of conversations with GP's has ever resolved this. During Covid my HBA1c had gone up to as high as 107, I was put on a maximum Metformin dose of 2000mg and then 10mg of Dapagliflozin which brought it down to 70/80 this would flipflop between the two, 80 in April, 70 in November. So to break this cycle I was put on 1 X Gliclazide 40mg. This helped and got me into the mid to low 60's a second Gliclazide tablet did not appear to improve things by much apart from consistently getting me in to the lower 60's.
In early 2024 I had some chest discomfort and and after some irregular ECG results I was given an echo and a CT scan. Nothing was found apart from finding out what my plaque build up was, which I was told was what was expected for someone living in this part of the world and my age. In fact I was told that for someone with some high blood pressure and type 2 diabetes the results were excellent. I am taking that with a pinch of salt but it reassured me a bit. Somehow we got on to the discussion of Simvastatin and high HBA1c, the consultant decided to switch me from Simvastatin to Ezetimibe 1 X 10mg, this was around January 2025. In April 2025 I had my cholesterol and HBA1c blood tests and the results that came back showed HBA1c at 59 which was a 4mmol improvement and had not been in this range for over 6 years, I was expecting a bigger drop, but still an improvement. However, my cholesterol results had all gone in to the abnormal range except for the good cholesterol, and the triglycerides (my nemesis) was about the same, having only gone up .1. We decided to stay on the Ezetimibe until I could speak to the heart consultant who is very good as he will take emails from his patients even after they have been discharged! At this point though I think he may have forgotten why he had taken me off Simvastatin as he recommended Pravastatin which from my research is guaranteed to raise glucose levels, I may be wrong. During this period I had been referred to a Diabetes Dietician (I can't remember why) and in our first face to face meeting I was discharged as my HBA1c was 59. She did however say that Ezetimibe can take a while to kick in and advised me to keep taking it, this I did. Around June I was enrolled into a Semaglutide (rebelsus tablets) drugs trial for Type 2 Diabetes and heart attack strokes etc. This involves a 12 week run-in as they call it with the tablets definitely having the active ingredient of 3mg, apparently not enough to affect HBA1c results. I completed the first 4 weeks and was 6 days into the second vial of tablets at 7mg when I had another cholesterol/HBA1c blood test. Well, the HBA1c had gone down to 57 and I suspect this could still be the weaning off of Simvastatin as it was too early for the Semaglutide to kick in but strangely, my cholesterol levels had returned almost to the levels they were at when taking Simvastatin and amazingly! my triglycerides had gone from 3.0 to 1.6 a 45% plus reduction. I have never had levels that low ever. The lowest I have ever seen are 2.2 and that was rare. So the question now is, is it the Ezetimibe that has now kicked in or is it (I think most likely) the Semaglutide? I have had a look and the oral semaglutide tablets apparently can affect cholesterol especially triglycerides. My surgery is refusing to try any rejigging of medication or any extra blood tests to try and find out which tablet is doing the work (I understand costs etc.) but in reality they are not interested even though I said we may have stumbled across 1 tablet that may be capable of doing most of the work. They can't even tell me, assuming the Ezetimibe is doing the work how long it would take for the effect to wear off if I stopped taking it. To complicate things in six weeks time the first part of the semaglutide trial finishes and I may end up on a Placebo or another increase to 14mg for 5 years.
My thinking is that I will have to try and go privately for tests or buy one of those meters that can test cholesterol including triglycerides and test myself. I don't know if anyone has ever tried those and how accurate they may be. Anyway, thanks for reading apologies for the length and hope to hear something back.
Regards
Lou
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