Increased meds/insulin.

[Gilsy s]

Help!! Started out on Metformin x2 daily that was increased to x4 daily then gliclazide x2 added which soon increased to x4 daily so this was the full quota of treatment with pills. Had to beg to be started on Insulin. Was started on Humalin which has now increased to 20 units am, 26 units pm. Still on maximum dose of Metformin and Gliclazide. Now, after getting blood sugars down reasonably, They are shooting up to 11-13 am and 17-21 pm, Started on Insulin 6 months ago. What should I do now ? This is really getting me down, I'm trying so hard.

 

[pleinster]

Help!! Started out on Metformin x2 daily that was increased to x4 daily then gliclazide x2 added which soon increased to x4 daily so this was the full quota of treatment with pills. Had to beg to be started on Insulin. Was started on Humalin which has now increased to 20 units am, 26 units pm. Still on maximum dose of Metformin and Gliclazide. Now, after getting blood sugars down reasonably, They are shooting up to 11-13 am and 17-21 pm, Started on Insulin 6 months ago. What should I do now ? This is really getting me down, I'm trying so hard.

Hi. Can you explain why you were so desperate to get on insulin? I would always rather avoid insulin and meds if possible. You don't mention your diet at all. Can I ask what you are eating? You talk about "getting blood sugars down reasonably"...do you mean purely though the action of the meds? I personally found the meds did very little. I only got my levels down through recording my levels and the foods I was eating very regularly, and by cutting carbohydrates right down. I may be telling you what you know already, but..have you cut carbs? If not, check out the forums on this approach. Good luck.

 

[Gilsy s]

Hi. Can you explain why you were so desperate to get on insulin? I would always rather avoid insulin and meds if possible. You don't mention your diet at all. Can I ask what you are eating? You talk about "getting blood sugars down reasonably"...do you mean purely though the action of the meds? I personally found the meds did very little. I only got my levels down through recording my levels and the foods I was eating very regularly, and by cutting carbohydrates right down. I may be telling you what you know already, but..have you cut carbs? If not, check out the forums on this approach. Good luck.

Hi. Pleinster. Thank you for your reply and advice. I wanted to go on Insulin because pills were not working. I'm really dissapointed that I was kept on Metformin and Gliclazide too. It was, after all, my objective to have one type of medication. My Diet is normally, cereal or porridge oats. no sugar for breakfast. Banana or satsuma for mid morning snack. Lunch is usually a Turkey breast sandwich. Multiseeded bread. Fat and sugar free yogurt. Dinner Salmon with rice and roasted tomato's / chicken curry & Rice./ Poast lean meats, chicken, Beef, turkey breast and rarely, pork or lamb with plenty of veg and a roast potato.. I also have a baked eating apple, fat and sugar free yogurt or a piece of fruit. I have semi-skimmed milk in my tea, I've never taken sugar. The only cheat I've had is a slither of my Sons Birthday cake. I used 1/2 sugar and low fat spread. to make the cake. I drink plenty of water, don't like squashes. I probably could do more.

 

[Daibell]

Hi. Your diet is not ideal i.e. too many carbs. Can you let us know whether you are overweight and what your BMI is? If you have insulin resistance then this can cause various problems with insulin aids such as Gliclazide and insulin itself. If you have excess weight then reducing the carbs should help with that. The job for Gliclazide is to increase your insulin output. Excess weight and hence insulin resistance can mean you already have too much. If you are not overweight and have been losing weight then there is always the possibility of being T1 not T2 i.e. being a LADA. In this case insulin is the right way forward and you might need to go onto the Basal/Bolus regime and hence no longer need the Gliclazide as they do the same job. Do discuss all of this with the DN to try to confirm the correct diagnosis and hence treatment. For all of us, however, a low-carb diet is often a good approach anyway and don't worry too much about fat but bananas are a no-no and so are most cereals. Sugar is just another carb and the latter needs control.

 

[Bluetit1802]

Hi and welcome,

Goodness me, you do eat a lot of carbs. Did you know that all carbs of any sort will convert to glucose once inside the system? Eating cereal, oats, banana, satsuma, bread (even multi-seeded), rice and potatoes is what is causing your high levels. It isn't just sugar that does it. You also seem to be eating low fat. Many low fat products contain extra sugar to make them taste better. Good fats do not raise blood sugar levels, in fact they actually help keep them a bit lower.

Please have a good read round the forum and take note of the role of carbohydrates, especially the starchy ones like bread, rice, potatoes, cereals and pasta. Ask as many questions as you like, but if you decide to go low carb you must have a word with your nurse first as she may wish to change your meds.

 

[chalup]

Oats, cereal, bananas, oranges, bread, rice, potatoes. Almost everything you are eating is very high carb and pushing your blood sugars up. Carbohydrates turn into pure sugar once eaten and whether you realize it or not you are eating a very high sugar diet. If you are type 2 then continuing to eat this way and adding insulin will just cause weight gain and more insulin resistance. I am tagging @daisy1 to send you information that is a must read. You can get this under control but the key will be diet, meds can only do so much. As @Daibell has said, if you are slim it may be worth having a c-peptide and antibody test done to confirm what type of diabetes you have but I know if I ate like that my bloods would be in orbit. This is not a criticism of you, I can see that you are following what has been pushed as a healthy diet and that you are doing your best but that advice is not good for a diabetic. At the bottom of Daisy's post will be a link to the low carb program and I highly recommend you check it out. Good luck and take care.

 

[daisy1]

@Gilsy s

Hello and welcome to the forum In addition to the advice you have received above, here is the basic information we give to new members and I hope you will find it useful. In particular it contains the link to the Low Carb Program which was mentioned above and which you could try. Ask as many questions as you like 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 well over 220,000 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 free 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.

 

[Gilsy s]

Hi. Your diet is not ideal i.e. too many carbs. Can you let us know whether you are overweight and what your BMI is? If you have insulin resistance then this can cause various problems with insulin aids such as Gliclazide and insulin itself. If you have excess weight then reducing the carbs should help with that. The job for Gliclazide is to increase your insulin output. Excess weight and hence insulin resistance can mean you already have too much. If you are not overweight and have been losing weight then there is always the possibility of being T1 not T2 i.e. being a LADA. In this case insulin is the right way forward and you might need to go onto the Basal/Bolus regime and hence no longer need the Gliclazide as they do the same job. Do discuss all of this with the DN to try to confirm the correct diagnosis and hence treatment. For all of us, however, a low-carb diet is often a good approach anyway and don't worry too much about fat but bananas are a no-no and so are most cereals. Sugar is just another carb and the latter needs control.

Thanks for all your help and useful information. I can see that I have a lòt to learn. Ī am very overweight. So I have a long road to travel

 

[Gilsy s]

Thanks for all your help and useful information. I can see that I have a lòt to learn. Ī am very overweight. So I have a long road to travel.Thank you all for your replies. I get confused when poting replies. lol. I wouldn't like to miss everyone. So please bear with me.

l

 

[pleinster]

There's a lot of good advice above. Research low carb diets. Low carbs are pretty much those with 10g of carbohydrate or less per 100g of product. Get used to looking at carbohydrate content on labels as much as at sugar (more even). I suggest you record your meter readings before and 2.5 hours after food...also record the food and the time, as well as any meds you take. You will soon see what's working and what isn't. It was only when I started this that I realised which foods and which meds were causing a clear spike (and that, for me, Gliclazide wasn't really doing much at all). I stopped my Gliclazide and presented my doctor with my findings to support my decision to control my diabetes with diet alone. Since my readings had dropped very nicely, I had no problem convincing him. It's not all about avoiding certain foods; it is also about finding foods that are good for you which you like eating. In brief - I avoid bread, cereal, spuds and obvious stuff. I eat beef, pork, lamb, bacon, black pudding,chicken, oily fish (avoiding batter), mushrooms, eggs, some peppers, cauliflower, broccoli, leafy salad, avocados (very very good for you), a few strawberries, certain nuts and a lot more. I'm never hungry really. As a result of good steady levels, I now allow myself the odd half pizza...maybe even a croissant. I found breakfast the hardest...but found that dried bacon slices, smoked cheese slices or an omelette do just fine. Most important thing then...keep a record and learn from it. Good luck.

 

[Brunneria]

Also, please be aware that as you reduce your carb intake, your blood glucose will drop and your meds (particularly insulin) will need adjusting and reducing.

If you aren't comfortable making those adjustments yourself, then please get advice from your health team! You don't want to go hypo from too much insulin.

Hope that helps.

 

[Gilsy s]

There's a lot of good advice above. Research low carb diets. Low carbs are pretty much those with 10g of carbohydrate or less per 100g of product. Get used to looking at carbohydrate content on labels as much as at sugar (more even). I suggest you record your meter readings before and 2.5 hours after food...also record the food and the time, as well as any meds you take. You will soon see what's working and what isn't. It was only when I started this that I realised which foods and which meds were causing a clear spike (and that, for me, Gliclazide wasn't really doing much at all). I stopped my Gliclazide and presented my doctor with my findings to support my decision to control my diabetes with diet alone. Since my readings had dropped very nicely, I had no problem convincing him. It's not all about avoiding certain foods; it is also about finding foods that are good for you which you like eating. In brief - I avoid bread, cereal, spuds and obvious stuff. I eat beef, pork, lamb, bacon, black pudding,chicken, oily fish (avoiding batter), mushrooms, eggs, some peppers, cauliflower, broccoli, leafy salad, avocados (very very good for you), a few strawberries, certain nuts and a lot more. I'm never hungry really. As a result of good steady levels, I now allow myself the odd half pizza...maybe even a croissant. I found breakfast the hardest...but found that dried bacon slices, smoked cheese slices or an omelette do just fine. Most important thing then...keep a record and learn from it. Good luck.

Thank You. Pleinster. You have certainly given me food for thought (pardon the pun) I found the 10g of carbs per 100g rule on any foodstuffs was a particularly good tip.I do look at food values but only the sugar values. I can see now that I must be more vigilant. I think that avoiding bread, even if it's multi seeded granary, and spuds is going to be the hardest for me. I'm willing to give it a go, I can't not try. I will gather some Info, a plan of action.Especially the Menu !. Once again Many Thanks

 

[Gilsy s]

Also, please be aware that as you reduce your carb intake, your blood glucose will drop and your meds (particularly insulin) will need adjusting and reducing.

If you aren't comfortable making those adjustments yourself, then please get advice from your health team! You don't want to go hypo from too much insulin.

Hope that helps.

Thank you Brunneria for that bit of advice regarding Meds. Last thing I need is an Hypo. So used to being sky high in the Glucose department, I know that I can contact my gp and He will respond quickly.The links, I will have a look them too.