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I don't think my meds are working...

ChilliGal

Member
Messages
9
Location
Nottingham
Type of diabetes
Treatment type
Tablets (oral)
I'm been diagnosed as T2 for just over 2 years now. I was on Metformin for about a year before I realised that it was making me really sick. I got swapped to Gliclazide which frankly doesn't seem to be working. I was put on the max dose (320mg per day) and still the sugar levels were climbing, and I've now had a gliptin added. And my fasting bloods are climbing almost daily - this morning after a (typically) virtually carb free day yesterday they were at 17.2. My most recent HBA1C showed that basically my T2 is out of control but to be honest, I'm not convinced at all that either med is doing a thing. I've become paranoid about it now because I'm about to have a major op and the consultant is concerned (quite rightly!) about my bloods, but I don't know how to express to my GP that I don't think the drugs are doing anything anyway. Any ideas please?
 
I'm been diagnosed as T2 for just over 2 years now. I was on Metformin for about a year before I realised that it was making me really sick. I got swapped to Gliclazide which frankly doesn't seem to be working. I was put on the max dose (320mg per day) and still the sugar levels were climbing, and I've now had a gliptin added. And my fasting bloods are climbing almost daily - this morning after a (typically) virtually carb free day yesterday they were at 17.2. My most recent HBA1C showed that basically my T2 is out of control but to be honest, I'm not convinced at all that either med is doing a thing. I've become paranoid about it now because I'm about to have a major op and the consultant is concerned (quite rightly!) about my bloods, but I don't know how to express to my GP that I don't think the drugs are doing anything anyway. Any ideas please?

I agree that 17.2 is higher than you'd want at any time, never mind just before surgery.

The hard fact is that the diabetic tool each of us has to hand 24/7 is our diet. I must say, when first diagnosed, I was aghast where those nasty little carb-blighters could hide themselves, as my former beliefs in terms of a decent diet were proven to be well off the mark, having crossed the diabetic threshold.

It sounds like you have a handle on carbs, but could you indulge me by giving me an idea of the sorts of things you're eating and drinking on a typical day? Even now, I'm sometimes astonished when I add the carbs how many I've eaten, even just in vegetables, but I do love my veggies!

Regarding your medication, have you ever felt the Gliclazide has worked for you, or has it got worse over time?

And finally........ (Nobody expects the Spanish Inquisition !) - Do you keep daily records of your food and bloods in an app or a diary or something?
 
Hi,

Those blood glucose levels are definitely too high.
If your diet is really low carb, and your blood glucose does not respond, with meds as well, then I would be back to the doc requesting further tests.

A small number of people are diagnosed T2, but it later turns out that they have LADA or MODY or one of the other types of diabetes.

Hope that helps.
 
Hi and welcome. Yes, do bear in mind the possibility that you are Late onset T1 and not T2. I went thru the same meds i.e. Metformin (useless if you are slim), then 320 mg Gliclazide which worked for a year or two, then Sitagliptin added which helped for a couple of years. It is likely you will need to go onto insulin at some point in the future which you may find a great relief as I did as it really works and you can eat more freely. Regarding the operation it may make sense to ask the GP to go onto insulin earlier than expected to help get the HBa1C down and stay down.
 
Thank you for your kind replies! I actually felt so awful that I got an appointment with the practice nurse who checked me out and said (thankfully) no ketones and no infection - take it easy over the weekend, you're pretty stressed out with the op pending and so on. I went home to bed. Saturday morning? 10.3..... I felt palpably better.

I discussed the consideration that the meds weren't working - either the gliclazide or the sitagliptin - but she didn't really respond to the question with anything positive. I suspect that I'll have to wait until my review in December now.... I don't actually feel that they are working, but what does work is the low carbing - I seem remarkably responsive to them and I'm going to have to work harder at being totally ruthless. Not easy when fundamentally I'm a carb addict....

I haven't been keeping a record as such of food/drink but I think that's an excellent idea and I agree that carbs hide under the most innocuous of stones.

Thank you for your support - it's much appreciated
 
@ChilliGal

Hello and welcome to the forum :) I hope this information which we give to new members will help you in addition to other answers you have got and will get from other members. Ask as many questions as you want and someone will be able 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 over 150,000 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-and-whole-grains.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 bloodglucose 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.
 
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