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Help needed... what after metformin

J

jones01942

Member
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5
Hi all, new here but not new to diabetes.
Im 34, ive been type 2 for over 10 years... only went onto metformin 2 years ago, diet controlled before that where i lost approx 5 stone.
Im 6ft tall, 18stone 10lbs hb1ac of 10 and bloods sugars all over the place.
I survived on 4 metformin (500`s) for 2 years, fine b/s of 5-10mmols, in the last 6 months its been creeping to nearer 15mmols
went onto gliclozides as well as 2000mg a day of metformin about 1 glic in am, 1 at tea time. bloods went as low as 5 at first, then slowly increased to 10-15 but i put on approx 6lbs in weight and began eating more, including chocolate, it gave me a sweet tooth.

told doc, hes took me off and put me on glimepride 2mg in am and slow release metformin 2000mg a day. my bloods have gone up to 18... and keytones!!!!!
just tried the old metformin, not slow release at tea time, and im 9mmols now.

has anyone any advice, and i dont want to hear that im type 1... not interested!!!!!

GARETH
 
Hi Gareth and welcome to the forum :) Here is some information that might help you to stabilise your levels. Ask as many questions as you need to as there is always someone here to help.

BASIC INFORMATION FOR NEW MEMBERS


Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
-------------------------------------------------------------------------------------------------------------------------------------------------------

Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.
Click to expand...
 
You don't go from type 2 to type one - it doesn't work like that. First thing to guess at (or eliminate, whichever way you look at it), how is your diet? I see that you have lost weight before, have you tried cutting your carb levels to see if that makes any difference to your bg's?
 
Ive recently cut out white bread, and substituted it with wholemeal... but maybe sneaked back onto white bread this past week. todays meals were as follows, and this is a typical day.

Porridge, 2 sachets - semi skimmed milk. - 2 slices white toast

dinner - subway 6" bmt sub with light mayo ( i usually have 4 slices of brown bread with either ham/turkey)

tea - burritos - 2 0f... nothing else...

about 4 cups of coffee
 
Hi again Gareth

Frist thing that strikes me looking at that is there is some seriously high carby foods which might be contributing to your high levels. I'm not what is known as a low carber (that's a whole complicated subject!) but do realise that carbs turn to glucose and put your levels up.

Unfortunately brown bread is a culprit too, a lot of us here eat Burgen Bread or you could try wholegrain. Porridge is another thing that sets a lot of people off on high levels..there are other alternatives!

Daisy has given you good advice, we also have some others here who can tell you what has worked for them. Do you have a meter to test your own levels? Very important so you can find out what foods affect you and what you can get away with!
 
I LOVE BREAD....... Oh God dont take it away...
I gave up smoking on new years eve, and I havent really drunk alcohol much in the last 6 months.... dont take away my bread too....
Serious.. I need some advice on food.. I thought wholemeal and porridge was a good idea.....
I realise that the carbs dont help, but ive been focussing on removing all sugar from my diet, I constantly trawl through the ingredients before i buy anything... they think im mental in Asda...
 
That's an awful lot of carbs bud. Porridge, bread, burritos- most of us would have sky high BGs with that diet. I'd suggest you need a big change- try going to the low carb diet forum on this site and have a look. Maybe a start point is to go to 50% of guideline carb levels for a male, 150 grams of carbs a day and see how it goes. All carbs turn to glucose in the blood. Do you count your carbs?
 
Hi again!
Here's some info you may find useful:-
. In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tenId to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!
 
jones01942 said:
Ive recently cut out white bread, and substituted it with wholemeal... but maybe sneaked back onto white bread this past week. todays meals were as follows, and this is a typical day.

Porridge, 2 sachets - semi skimmed milk. - 2 slices white toast OUCH!

dinner - subway 6" bmt sub with light mayo ( i usually have 4 slices of brown bread with either ham/turkey) - OUCH!

tea - burritos - 2 0f... nothing else... - OUCH

about 4 cups of coffee - Ok.
Click to expand...

Your days menu is incredibly high carb. The bread, porridge, burritos, and you would be better off with full fat mayo.

I know I seem to be a harbinger of bad news, but if you cut the porridge and substituted for bacon and eggs, or a two egg omelette or 'berry's' with Greek yogurt or cold meats and cheese or scrambled egg with a splash of cream for breakfast.

Lunch a salad with any kind of meat, or fish or meat with veg, or any kind of combination. You can again have cold meats, boiled eggs, feta cheese, Philly cheese, anything low carb.

Dinner, the list is to huge, but if you look on the low carb food forum, there are dozens and dozens of meal idea's as well as snack suggestions.

You do really need to cut the carbs, and then watch the BG figures drop. You will be pleasantly surprised at what getting shot of carbs can do.
 
Hi. Yes, try to get your diet right; carbs are the enemy. If necessary sitagliptin could be added to your meds as it reduces spikes, has no effect on weight and has few sins overall if a little expensive
 
jones01942 said:
I LOVE BREAD....... Oh God dont take it away...
I gave up smoking on new years eve, and I havent really drunk alcohol much in the last 6 months.... dont take away my bread too....
Serious.. I need some advice on food.. I thought wholemeal and porridge was a good idea.....
I realise that the carbs dont help, but ive been focussing on removing all sugar from my diet, I constantly trawl through the ingredients before i buy anything... they think im mental in Asda...
Click to expand...

Just got to say congrats on giving up the ciggies, been there and know how hard it is. bet you want some good news..well, you have had lots of diet info to help you along and I'm fairly sure that alcohol isn't a no-no with diabetes?
So a glass of wine won't hurt..not that I ever indulge of course. Ahem. :angel:
 
thanks for the info guys....

a lot to think about there for me. I do have a testing kit and i get free strips from my mum who is type 1

ive just done a test now, not eaten anything since tea, 13.1.... ill let you all know over the coming days how im going on, im going to stick to the 150g of carbs for a week adn see what happens.

thanks
 
Good man. Good plan too! Takes a while for the BG levels to start to drop, so give it a hit longer and you'll start to see the improvements.
 
Hey jones01942. Grazer knows best. I was diagnosed just last December and now have really low sugar levels and have lost 3 stone in weight. Just been to see my nurse this week and she says I'm doing great. I started out with an HbA1c of 11.3 and just had a new one done 4 months down the line and its 5.3. That's what the people on this forum can do if you're willing to listen to them.

Afraid a load of that bread is going to have to go. If that's put the fear of God in you it did me too but like me you gave up smoking and it's not really any different. After a while you just don't miss the stuff and find out from the people on the forum there are far nicer things to eat instead. With the bread a load of the rice, pasta, cereals and potatoes needs to go the same way. Think of it this way. If each time you ate more than a safe amount of something you went blind for half an hour you'd soon stop wouldn't you? Just because you can't immediately see things are hurting you doesn't mean they aren't. Give yourself a chance and listen to the sheep!

Keep asking questions we all did to start with.

Here's a link to a Swedish doctors diet. They use hers as the basis of one of the diets they recommend over there. It's similar to what I've been doing, what Grazer is saying and what a number of other forum members try and do.

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in
 
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