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Is this too much

B

brianb

Well-Known Member
Messages
151
Location
Hebburn, Tyne and Wear
Type of diabetes
Type 2
Treatment type
Insulin
Hi All

Was diagnosed as type 2 in march 2008 with 2 fasting BG levels of 8.9 and an HBA1c of 7.1 and have managed to control it on Diet exercise only untill now.

I managed to get my HBA1c down to to 5.9 on lowish carb but it has steadly crept upto 6.9 and after getting BG levels of upto 17 3 after meal the doctor decided to start me on Metformin :shock:

He has said to take 1 X 500 once a day for a week and each week increase it by one extra tablet untill i get upto 4 x 500 per day. Thats 2 in morning and 2 in the evening. To me this seems like a LOT of metformin for someone with an HBA1c of only 6.9....what does everone think?

He did tell me that the new guidlines had changed from HBA1C being below 7 to being below be 6.5 or less which is why he has started me on Metformin, im not sure where he got those figures from as i cant find any references to those new levels, has anyone got any info??

Just took my first tablet tonight....how long till the farting starts?? :lol: :lol: :lol:

Thanks all for any advice

Brian
 
Hi Brian.

I would think your GP is right to give you the Metformin. It isn't the HbA1c you should be looking at but those HIGH levels of 17.3 after meals. HbA1c is only an indication of the last 3 months levels, a trend. The daily levels are more important

You need to seriously look at what you are eating and/or get the medication to help you tame those levels.

Can you give us an idea of the sort of meals you eat throughout a typical day. One day will do. We might be able to better advise you with that information.

As for the new levels, they are the NICE guideline figures.

Ken.
 
Hi Ken

Thanks for the quick reply. :o

So there are new guielines then for HBA1c levels, i've search high and low and can't find them. Will trying looking through the Nice stuff a bit later. just seemed to be an excessive amount of metformin for my HBA1c levels.

Diet is pretty good and i've been folloing a lot of advice given on this site since diagnosis and worked out early on what to avoid. For me persally i found Bread, pastry, pasta and poatoes and root type vegetables to put me levels up so i have avoided these with only an occasional sneaky carb :lol:

I also suffer from a Liver problem call Non Alcoholic Steatosis Hepatites or N.A.S.H so dont know if this is effecting anything at the moment

I am over weight, I did loose nearly 2 stone in just a few months after diagnosis but i've put it all back on and im now at 17 stone again and im about 5ft 11" tall so BMI about 30ish I think

Don't and never have ate sweats and cakes, more of a savoury tooth. Never taken sugar either. And i dont snack between meals. maybe have 4 or 5 cups of Tea or coffee during the day and drink lots of water.

Dont drink Alcohol

Don't really eat breakfast and only have a cup of tea with semi skimmed milk(NO sugar)

Lunch is usually a Salad or maybe soup once in a very blue moon a ham sandwitch on Brown bread :twisted:

Evening meal typically is chicken with green beans, cabbage peas brocoli etc. Sometimes Fish which i hate. occasionally have a small portion of low carb pasta with maybe chicken.

I eat at least 5 bits of Fruit a day and have found that Apples, Peaches and a small bananah have little effect on me.

It only seems to have been the last 4 months that my levels have started to go up and I first noticed that my fasting levels in the mornings had cropped up from 5-6 to abaout 9ish then my after meal levels started to stay high for longer.

Im not exercising as much as work seems to het in the way lately, was doing a lot of Diving but just dont have the energy latley so that probabily accounts for the weight gain.

I dont think there is that much more i can do with my diet BUt im open to advice.

Thanks all for taking the time to read my rambles.

Brian
 
I wouldn't be worried about the windy pops but more the "wet ending" :shock: . Seriously though, take the meds and give it at least two weeks and see how you go. There is always the SR version of metformin if you have real trouble. I had to come off of it after suffering for eighteen months, but thats not always the case.
 
Hi Brian.
My concern here is that if you are eating right and in moderation then there may be something else at work. What other medications are you taking ? Some can have a detrimental effect on Bg levels as I know because of the anti-Cancer drugs I am on at the moment my Bg levels are all over the place !

So we need to check out each drug for any interactions and side effects first. Can you give us a list please. If you would rather do it off the board, pm me.

Do you test your Bg levels before and at least 2 hrs after meals. This is important to show what certain foods are doing to your levels, if foods are to blame ?

Bit more information please and we will see what we can come up with.

I would also suggest that you need a good chat with GP/DSN about this as there are many complications involved which are not easy to separate.

Ken
 
Brian.

An extract from the NICE guidelines:
When setting a target glycated haemoglobin (HbA1c):
− involve the person in decisions about their individual HbA1c target level, which may be above that of 6.5% set for people with type 2 diabetes in general
− encourage the person to maintain their individual target unless the resulting side effects (including hypoglycaemia) or their efforts to achieve this impair their quality of life
− offer therapy (lifestyle and medication) to help achieve and maintain the HbA1c target level
− inform a person with a higher HbA1c that any reduction in HbA1c towards the agreed target is advantageous to future health
− avoid pursuing highly intensive management to levels of less than 6.5%.

Hope that helps.

Ken
 
Hi Ken
Well im on Candersaryan for high Blood Pressure, This was increased from 8mg to 16Mg about a month ago. I also take an Asprin every day as well.

Pre meal reading are usually about 7ish and i usually check 2 or 3 hours after meals to see when i spike and for how long.

Brian
 
Brian.
I think we are talking about CANDESARTAN CILEXETIL, an anti hypertensive drug. I have checked out any interactions and side effects and there is nothing which stands out as affecting Bg levels.

If those are the only drugs you are taking then I can't pinpoint anything at all with the resources to hand.

I think in the circumstances you definitely need to discuss this with your HCP, maybe get a referral to an Endocrinologist who will be able to juggle all the variables and help sort things out. I think that in some ways the Liver problem may also have a bearing on this. Aspirin may also have a bearing on your Liver condition. Discuss please with your HCP.

Ken
 
Hi Ken

Thanks for the replys.

I think I've done all i can dieat wise bar loose some extra weight and maybe its just my time for a little extra help in the form of Metformin. I have read somewhere that some people loose weight on metformin so maybe it will help my weight as well :-) which hopefully will help.

Will see how things are in a few weeks, if no real improvement will have a word with the doctor.

The doctor i saw today i have never met before and to be honest he was hard to understand so i did not ask maybe as many questions as i could or should have.

Thanks again for your help.
 
OH GOD!!!!!
I was wondering how long it might take for any side effects to appear........my 3rd day and 3rd tablet and started with a mild stomach upset this morning and this afternoon I've been running to the loo non stop,

I can see how metformin might help you loose weight, its all the running to the loo :lol:

I now know to my embarresment what they mean by "Never Trust a Fart" :oops:

I just hope by the time i up the dose next week that things will have settled down.

Brian
 
I told you Brian about the "Wet Endings" ! hopefully it won't last for you, but be warned I had explosive diahorrea for eighteen months, even on the SR version before the Doc changed me over to different drug Coz I threatened to throw myself off a Kerb :shock: It'll take a few weeks to settle down if it's going to to hang on in there :D
 
Thanks Giblet for the words of encouragement, I've never experianced this kind of stomach upset in my life :shock:

I hope it does settle down fast or ill be jumping off the kerb next to you :D

Brian
 
Dippy3102

I was in the same frame of mind as you and was never goinf to take meds BUT sometimes there is no choice and you just have to accept that you need a bit extra help. Its not impossible for some people to do without but for some its a nessesary evil.

Brian
 
Sorry Dippy, Not intending to put you off. It certainly doesn't happen to everyone, and there is usually an alternative if you cannot get on with metformin. As Brian says you have to think about the long term consequences of running with a high sugar level ( legs dropping off, damage to eyes, neuropathy etc etc.) and usually there is a point where you need medication regardless of diet.
 
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