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I really need advice please help a Type2.

P

Pink_Blossom

Member
Messages
11
Type of diabetes
Type 2
Hi Everyone
I would be really grateful if someone could advise me.
I was diagnosed with Type 2 about 14 months ago, I was having bg of around 9 to 11 in the morning and 11 to 12 at nightI was given Metformin 500mg 3 x daily.
My last HbAc1 was on 4/1/16 the result was 59. My next HbAc1 is due in late April.
Around the beginning of Feb 2016 I noticed the visits to the loo were a lot more frequent and I had a raging thirst that I couldn't quench, I did my bg was 26.9, I went to my GP who prescribed Gliclazide 160mg x 2 Day but still my bg was between 20 up to 32.9, I informed my GP who then topped my meds up with Linagliptin 5mg 1 x Day, so I now take:
Metformin 500mg 3 x Day
Gliclazide 160mg 2 x Day
Linagliptin 5mg 1 x Day
There has been no change in my bg levels, I test before breakfast then 2 hours after breakfast, same with dinner time.
My bg range between 19 (never had one lower) up to HI
I saw my practice nurse who checked my urine and she said there was just a trace of Ketones but she said she wasn't too worried about this.
My right hand is constantly tingling and my wrist is very painful.
I have been referred to see a Diabetic Nurse for next week, I have to take my meter and diary with me, I had a very brief conversation with the Diabetic Nurse on the phone, she said she was only interested in my morning bg and finds it odd that in January my HbAc1 was 59!
I am 49 probably a stone overweight.
My diet isn't perfect, I do avoid Carbs, I only drink Water and Tea.
All I keep getting told is they don't understand why my bgs have gone so high.
I almost feel they don't believe me.
What other meds can they give me?
Am I doing something wrong here or maybe I just don't understand how Diabetes works.
I would be grateful for any advice.
Thank you for reading my post.
 
Have they given you a GAD test? With bloods like that and no change with extra meds it may be that you are actually LADA coming out of honeymoon. Please discuss this option with you nurse.

Alternatively have you had any major changes in your life recently that could be increasing stress levels or do you have an infection?
 
Hi @Pink_Blossom :)

Yes, your readings do seem high so I can understand why you're concerned. Let me tag @daisy1 for you as she has some basic info.

I too think LADA should be considered. Do push for tests for this. If the diabetes nurse isn't helpful, could you ask to see a consultant?
 
Hi,
I like you have had difficulty with BG levels being high on most oral agents and since 2008 my HbA1c was always around the 120 mark. As such I was placed on various combinations of oral medication (Metformin, Gliclazide, sitagliptin) and then moved onto non insulin injectable all with same level of HbA1c. However in the summer of 2015 I was taken off most of the combination orals and injectable and placed on Metformin and Dapagliflozin, after a week on this regime my morning BG level was 25 at which point I seeked medical help and insisted on being placed on Insulin. Within 2 months of being on a combination of Humulin M3, Metformin and Dapagliflozin by HbA1c had reduced to 95, my next was 72, and my last which was 1 month ago was 61. So they are going in the right direction.
I feel that it would be advisable for you to get a referral to your Community Diabetic Nurse Specialist to discuss the options (wish I had sooner) as had always been seen by GP practice. Having read the previous comments above I have looked into the information re LADA which does seem very fitting to both of our diabetes history and you should definitely get it looked into as I will be doing during my next review.
Wish you luck in getting the BG under control but please don't leave it until you get to the point where your BG is dangerously high
 
Andrew Colvin said:
Have they given you a GAD test? With bloods like that and no change with extra meds it may be that you are actually LADA coming out of honeymoon. Please discuss this option with you nurse.

Alternatively have you had any major changes in your life recently that could be increasing stress levels or do you have an infection?
Click to expand...
Hi
Thank you for your reply, there's been no changes in my life.
Sorry you must think I'm dumb but what's a GAD test and what does LADA mean please.
Thank you
 
Pink_Blossom said:
Hi
Thank you for your reply, there's been no changes in my life.
Sorry you must think I'm dumb but what's a GAD test and what does LADA mean please.
Thank you
Click to expand...
Why is that dumb we don't all know everything? Sounds like even your doctor didn't consider it!

It is a test the sees if you have an auto immune system response killing your beta cells

edit: just to add also request a c-peptide test to see how well your pancreas is working
 
@Pink_Blossom

Hello and welcome to the forum :) Here is the information we give to new members. Ask more questions 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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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.
 
@Pink_Blossom You can look at info about LADA on this forum. It stands for Latent Autoimmune Diabetes in Adults. It's sometimes referred to as Late Onset Type 1. Tests can be done to see if you have this. A GAD test is one of those.

Some people think that Type 1 is a childhood thing, but adults can develop it too - and at any age, even 60+
 
By the way if in between now and seeing your nurse/... you become much worse make sure you get yourself to A&E. Additionally make sure you are drinking lots and lots of water to ensure those BG levels are kept as low as possible.
 
Andrew Colvin said:
Why is that dumb we don't all know everything? Sounds like even your doctor didn't consider it!

It is a test the sees if you have an auto immune system response killing your beta cells

edit: just to add also request a c-peptide test to see how well your pancreas is working
Click to expand...
Thank you for your reply, and yes you would thought my GP would of discussed this test with me.
Sorry may I ask if you would know why the Diabetic Nurse only seems interested in my morning pre breakfast bg?
Thank You
 
daisy1 said:
@Pink_Blossom

Hello and welcome to the forum :) Here is the information we give to new members. Ask more questions 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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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.
Click to expand...
Thank you for taking the time to reply
 
Pink_Blossom said:
Thank you for your reply, and yes you would thought my GP would of discussed this test with me.
Sorry may I ask if you would know why the Diabetic Nurse only seems interested in my morning pre breakfast bg?
Thank You
Click to expand...
possibly because you are not impacting your levels with food so it gives an idea of how your liver and pancreas are communicating. What are your fasting levels at the moment?
 
ijonesrad said:
Hi,
I like you have had difficulty with BG levels being high on most oral agents and since 2008 my HbA1c was always around the 120 mark. As such I was placed on various combinations of oral medication (Metformin, Gliclazide, sitagliptin) and then moved onto non insulin injectable all with same level of HbA1c. However in the summer of 2015 I was taken off most of the combination orals and injectable and placed on Metformin and Dapagliflozin, after a week on this regime my morning BG level was 25 at which point I seeked medical help and insisted on being placed on Insulin. Within 2 months of being on a combination of Humulin M3, Metformin and Dapagliflozin by HbA1c had reduced to 95, my next was 72, and my last which was 1 month ago was 61. So they are going in the right direction.
I feel that it would be advisable for you to get a referral to your Community Diabetic Nurse Specialist to discuss the options (wish I had sooner) as had always been seen by GP practice. Having read the previous comments above I have looked into the information re LADA which does seem very fitting to both of our diabetes history and you should definitely get it looked into as I will be doing during my next review.
Wish you luck in getting the BG under control but please don't leave it until you get to the point where your BG is dangerously high
Click to expand...
Thank you I really appreciate your reply, I even changed meters incase mine was faulty and the readings were false! No such luck, I am just extremely tired, irritable and find I am getting tingling in my hand and pain in my wrist, my skin is also very dry, not sure its all related.
I will definitely take your advice on board.
Thank you again
 
Pink_Blossom said:
Thank you I really appreciate your reply, I even changed meters incase mine was faulty and the readings were false! No such luck, I am just extremely tired, irritable and find I am getting tingling in my hand and pain in my wrist, my skin is also very dry, not sure its all related.
I will definitely take your advice on board.
Thank you again
Click to expand...
Hope you feel better soon as well
 
Andrew Colvin said:
possibly because you are not impacting your levels with food so it gives an idea of how your liver and pancreas are communicating. What are your fasting levels at the moment?
Click to expand...
My fasting levels in the morning are between 21 to 28
I then have porridge re test 2 hours later and again still high, for example Last night at 10pm my bg was 29.5 I went to bed had 2 trips to the loo, finally got up at 5am very thirsty, checked my bg it was 26.9, checked again at 8am before breakfast and it had dropped to 23.2 then took meds, checked again after 2 hours my bg was then 26.4
 
ouch ouch and ouch. Try and avoid the porridge for now and have a cooked breakfast instead.

A
 
@Pink_Blossom
T1 can strike at any age. The owner/mod of one of the other forums was treated as type 2 for many years in her 50's before being diagnosed as T1.
 
you are more than welcome. It was other members who gave me lots of knowledge and still learning things now. Good luck and keep coming back.
 
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