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cazj2det

Member
I have an underactive thyroid and high blood pressure (both controlled by medication) and was diagnosed with T2 diabetes last year following an HBA1C test of 68.
I was put on 500mg of Sukkarto (metformin) once a day, increasing to twice a day after a month. I changed my diet - no sugar, low carb etc and the results of my next two HBA1C tests over the next six months were good (54 then 44). I lost weight and felt great!
However, since then, things have gone downhill. The next HBA1C was 78 and my GP upped the Sukkarto to two tablets in the morning and one in the evening. I started waking up with an awful taste in my mouth and feeling as if I had a permanent hangover (despite avoiding alcohol). My GP told me to start taking two tablets in the evening as well as in the morning. Next HBA1C was 79! Life is very stressing both at home and work and worrying about my diabetes doesn't help. Could stress be counteracting the medication? Last week, the GP put me on 100mg Sitagliptin in addition to the Sukkarto and initially, I felt better as no hangover feelings! However, four days in, I now have eggy burps, acid reflux and diarrhoea. Is this a side effect of the Sitagliptin? Has anyone else experienced these sort of symptoms or am I a medical mystery? Any suggestions anyone?
 
Hello and welcome to the forum. Tagging @daisy1 for the info pack offered to all newcomers.

I am sorry I can't help with info on the sitagliptin but I wonder if there is something we can help you with regarding dietary approaches. Your initial successes seem to have been good but the last A1c is a bit of a mystery to me.

It is late so you may not get many replies tonight but have a wander around the forum and ask as many questions as you like.
 
I have an underactive thyroid and high blood pressure (both controlled by medication) and was diagnosed with T2 diabetes last year following an HBA1C test of 68.
I was put on 500mg of Sukkarto (metformin) once a day, increasing to twice a day after a month. I changed my diet - no sugar, low carb etc and the results of my next two HBA1C tests over the next six months were good (54 then 44). I lost weight and felt great!
However, since then, things have gone downhill. The next HBA1C was 78 and my GP upped the Sukkarto to two tablets in the morning and one in the evening. I started waking up with an awful taste in my mouth and feeling as if I had a permanent hangover (despite avoiding alcohol). My GP told me to start taking two tablets in the evening as well as in the morning. Next HBA1C was 79! Life is very stressing both at home and work and worrying about my diabetes doesn't help. Could stress be counteracting the medication? Last week, the GP put me on 100mg Sitagliptin in addition to the Sukkarto and initially, I felt better as no hangover feelings! However, four days in, I now have eggy burps, acid reflux and diarrhoea. Is this a side effect of the Sitagliptin? Has anyone else experienced these sort of symptoms or am I a medical mystery? Any suggestions anyone?
From what I gather the Sitagliptin could get such responses when combined with metformin, though it's supposedly rare. (But rare usually isn't as rare as you'd expect rare to be.). Stress can certainly cause an increase in bloodsugars, and if your thyroidhormones are off, that could affect your bloodsugars as well, so you might want to get your levels checked, especially if there's been a change in weight. (I had to change my dosage from 175 micrograms to 132,5 micrograms, and that can make a world of difference.)

You might want to look into your diet further, maybe reduce carbs more so you can, hopefully, reduce the meds that are causing you discomfort. What do your daily meals look like? Maybe we can help you tweak them? For me personally, I don't go over 20 grams of carbs a day, which means a gradual weight-loss and a HbA1c of 34. (And still eating meals I enjoy). Can't advise you on alternative meds because I don't take any these days, and I only ever used metformin and gliclazide. Sorry.
Good luck, and let us know if we can assist in any way!
Jo
 
Thank you. Following the "getting higher" blood sugar tests, my thyroxine dose was reduced from 150mcg to 125mcg and as from this week, 100mcg. However, I am getting very mixed messages - my GP contradicted what the diabetic clinic specialist nurse said. For example, the nurse said that baked beans were OK for diabetics as studies had shown that if sugar is combined with high fibre it metabolizes in a different way and doesn't cause sugar spikes. She also said that 100% peanut butter was a good energy boost as it is has a low GI. My GP said these were banned substances and that basically I should just eat meat, poultry, fish and vegetables and avoid everything else. I think what has got me down is that despite following a low carb diet, avoiding alcohol and taking the meds, I am getting worse, not better and no-one can work out why.
 
@Buddyboy1

Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask all the questions you like and someone will 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 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
They do like their little joke about sugars (or starches)being OK if you only .......
Whatever.
The only way to be sure is to test and see what your BG levels is after eating various foods which do have varying effects on different people, but I found that the advice I was given about beans was pure fantasy - but I digest legumes very well and get a good high spike from the carbs they contain. Low or high GI or GL seems pretty irrelevant too.
 
Thank you. Following the "getting higher" blood sugar tests, my thyroxine dose was reduced from 150mcg to 125mcg and as from this week, 100mcg. However, I am getting very mixed messages - my GP contradicted what the diabetic clinic specialist nurse said. For example, the nurse said that baked beans were OK for diabetics as studies had shown that if sugar is combined with high fibre it metabolizes in a different way and doesn't cause sugar spikes. She also said that 100% peanut butter was a good energy boost as it is has a low GI. My GP said these were banned substances and that basically I should just eat meat, poultry, fish and vegetables and avoid everything else. I think what has got me down is that despite following a low carb diet, avoiding alcohol and taking the meds, I am getting worse, not better and no-one can work out why.

Oh, wonderful... Everyone's contradicting everyone again, and in the end, it's the patient that suffers: We assume they know what they're talking about... And then they go against each other, leaving us in the middle with a sky-high HbA1c. A carb is a carb is a carb. Glycemic index is a wonderful invention, but rather useless for T2's, usually: Whether it's processed/metbolised slow or not, it will need processing, and we aren't well-equipped to do that as the insulin's not doing what it's supposed to. Baked beans are really, really not a good idea. Low GI is something you can toss out the window right now, really... Not only does it make things overly complicated, it just doesn't do the job in lowering bloodglucose. Any "energyboost" coming from carbs, is one that will spike you. Maybe read Dr. Jason Fung's books, they explain things a whole lot better than I can.

In any case... Your GP had a point with meat, poultry, fish and (above-ground) vegetables. That may not sound like much, but meals could look like this: 3 eggs with cheese, bacon, mushrooms, maybe some cherry tomatoes or high-meat concent sausages. A green salad with a can of tuna (drain the oil, as it gets a bit much), olives, mayo, capers, avocado and olives. Dinner just meat or fish with for instance, cauliflower rice or broccoli rice (both rather versatile), maybe some cheese and bacon tossed in for flavour and to bulk it up some. If you want to snack, have some walnuts, pecans, olives, cheese, extra dark chocolate (Lindt 85% or higher is fine) Avoid potatoes, bread, underground veggies (or starchy legumes for that matter), pasta, rice, oats/cereal, corn and things like that. Forget the whole GI thing and just look at the amount of carbs in your food, it makes life and groceryshopping a whole lot easier and less frustrating.
 
Oh, wonderful... Everyone's contradicting everyone again, and in the end, it's the patient that suffers: We assume they know what they're talking about... And then they go against each other, leaving us in the middle with a sky-high HbA1c. A carb is a carb is a carb. Glycemic index is a wonderful invention, but rather useless for T2's, usually: Whether it's processed/metbolised slow or not, it will need processing, and we aren't well-equipped to do that as the insulin's not doing what it's supposed to. Baked beans are really, really not a good idea. Low GI is something you can toss out the window right now, really... Not only does it make things overly complicated, it just doesn't do the job in lowering bloodglucose. Any "energyboost" coming from carbs, is one that will spike you. Maybe read Dr. Jason Fung's books, they explain things a whole lot better than I can.

In any case... Your GP had a point with meat, poultry, fish and (above-ground) vegetables. That may not sound like much, but meals could look like this: 3 eggs with cheese, bacon, mushrooms, maybe some cherry tomatoes or high-meat concent sausages. A green salad with a can of tuna (drain the oil, as it gets a bit much), olives, mayo, capers, avocado and olives. Dinner just meat or fish with for instance, cauliflower rice or broccoli rice (both rather versatile), maybe some cheese and bacon tossed in for flavour and to bulk it up some. If you want to snack, have some walnuts, pecans, olives, cheese, extra dark chocolate (Lindt 85% or higher is fine) Avoid potatoes, bread, underground veggies (or starchy legumes for that matter), pasta, rice, oats/cereal, corn and things like that. Forget the whole GI thing and just look at the amount of carbs in your food, it makes life and groceryshopping a whole lot easier and less frustrating.
Thank you. Most informative and helpful! And above all easy to remember! I'll cut out the inadvertent bad stuff I was eating and report back in a month!
 
Thank you. Most informative and helpful! And above all easy to remember! I'll cut out the inadvertent bad stuff I was eating and report back in a month!
And here is an update following my three-month blood test last week...
The eggy burps and other issues which I thought might be a side effect of Sitaglyptin, have subsided, my Hb1aC has come down from 79 to 49, I have dropped 16kg but my cholesterol has gone up from 5 to 6.1. I can't control my body temperature - hot and sweating then freezing cold to the point of shivering, and my periods ovaries seem to have reactivated themselves after a 15 month break. The low carb, no sugar diet seems to have paid off but I just seem to have exchanged problems.
 
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