Went to the doctor today to show him the blood test results and as suspected I have diabetes type 2. He prescribed me this medicine called Xigduo (dapagliflozin + metformin). He told me he might put me on insulin but first he wants to see how it goes with this. However I've been thinking and I don't see how this medicine can be helpful in the long term. I mean, yes, it will lower the blood sugar levels by decreasing glucose production by the liver and by increasing glucose excretion through the kidneys BUT since my cells are insulin-resistant and my pancreas is not producing enough insulin doesn't this mean that at the end of the day my cells won't be getting enough glucose as a substrate to produce energy? Doesn't this mean that my cells will still be using fatty acids primarily to get energy and hence ketone bodies will be produced and released into the bloodstream? Isn't that a bad thing? Maybe I'm missing something here. Could anyone please help me out about this, I'm feeling a bit lost here. Thanks.
... BUT since my cells are insulin-resistant and my pancreas is not producing enough insulin doesn't this mean that at the end of the day my cells won't be getting enough glucose as a substrate to produce energy? Doesn't this mean that my cells will still be using fatty acids primarily to get energy and hence ketone bodies will be produced and released into the bloodstream? Isn't that a bad thing? Maybe I'm missing something here. Could anyone please help me out about this, I'm feeling a bit lost here. Thanks.
it will lower the blood sugar levels by decreasing glucose production by the liver and by increasing glucose excretion through the kidneys BUT since my cells are insulin-resistant and my pancreas is not producing enough insulin doesn't this mean that at the end of the day my cells won't be getting enough glucose as a substrate to produce energy?
Doesn't this mean that my cells will still be using fatty acids primarily to get energy and hence ketone bodies will be produced and released into the bloodstream?
May I ask a couple of questions, please? You do not have to answer, the choice is yours.
What was the result of your HbA1c? You should have had two blood draws, the second to confirm diagnosis.
Have you been flagged up for follow up tests such as foot/eye screening? Were you given any advice at all about dietary approaches or weight loss management?
What was lunch?HbA1c (NGSP) - 9.9%
HbA1c (IFCC) - 85 mmol/mol
Yes I am going to have my feet and eyes screened next week and be given more thorough advice about diet and weight loss. I will also see an endocrinologist from time to time according to my doctor.
By the way I had lunch at 12 and my blood sugar was 150 mg/dL at 2pm. Could it be that the medication has already started working? Yesterday I had >250 mg/dL after meals.
What was lunch?
HbA1c (NGSP) - 9.9%
HbA1c (IFCC) - 85 mmol/mol
Yes I am going to have my feet and eyes screened next week and be given more thorough advice about diet and weight loss. I will also see an endocrinologist from time to time according to my doctor.
By the way I had lunch at 12 and my blood sugar was 150 mg/dL at 2pm. Could it be that the medication has already started working? Yesterday I had >250 mg/dL 2h after meals.
Please be aware that the study data showed a relative risk increase, but that actual events were rare or infrequent. Dapagliflozin is generally considered to be self regulating in that it works hard when there is excess glucose, but tapers off as bgl levels drop, In the research I did when I used this med, the DKA effect was thought to be due to dehydration, and most reported events were involving T1D patients who were also using an oral med like this. There is a sticky thread on this forum that describes SGLT-2 med problems, and some users here have also reported hospital admisions.You are absolutely correct that there are some risk of euglycemic diabetic ketoacidosis when taking SGLT2 inhibitors. So it is recommended not to lower carbs too much when on SGLT2 inhibitors.
Risk of Diabetic Ketoacidosis after Initiation of an SGLT2 Inhibitor
https://www.nejm.org/doi/full/10.1056/NEJMc1701990
Euglycemic Diabetic Ketoacidosis: A Predictable, Detectable, and Preventable Safety Concern With SGLT2 Inhibitors
http://care.diabetesjournals.org/content/38/9/1638
Well that certainly shouldn't cause a huge spike either so maybe a combination of food and meds..Cabbage, small turkey steak (grilled), half an egg and a super tiny potato.
Well that certainly shouldn't cause a huge spike either so maybe a combination of food and meds..
Although I have to ask why the potato?
There are two supermarkets here in the UK who have a reputation for adding sugar to things that you would not expect. I had a couple of sausages from one, and they were 'flavoured' and they spiked me quite badly. Another time I found the chicken breasts spiked me more than potato, and again they had injected the pieces with watery gunk that was not declared on the label.No specific reason, maybe a very small treat I guess, half the size of an egg... I like potato but yes it’s unnecessary and high in starch.
There are two supermarkets here in the UK who have a reputation for adding sugar to things that you would not expect..
I knew someone would ask this, and I am not at liberty to divulge. All I will say is look at the shelves, and if most of what they stock is ready made meals or convenience food, and if their home cooked section or home baking aisle is small by comparison, then be suspicious.Which ones?
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