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Looking for advice on pros and cons of type 2 medications

Discussion in 'Type 2 with Insulin' started by Emmar, Dec 16, 2019.

  1. Emmar

    Emmar Type 2 · Well-Known Member

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    Hi. I am about to be put on new medication for my type 2. My last Hba1c was 90 - I have no idea what this converts to as previously I was given it as a percentage. I am on max dose Metformin which appears to do nothing. Dr has mentioned Glipizide which I've heard bad things about (weight gain, hypos - I take a beta blocker). Is Januvia worth considering? Any advice gratefully received. Emma
     
  2. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Have you changed your diet?
     
  3. DCUKMod

    DCUKMod I reversed my Type 2 · Master
    Staff Member Administrator

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    Hi Emmar - this is how your A1c score looks, converted:

    upload_2019-12-16_18-54-13.png

    I haven't ever taken any meds for diabetes, but I wonder if you've read much about it? This might help, a bit: https://www.webmd.com/drugs/2/drug-145704/januvia-oral/details

    As well as your Metformin, did you try making any adjustments to your diet at all? Many of us find that to be pivotal in controlling our T2.
     
  4. Emmar

    Emmar Type 2 · Well-Known Member

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    Hi yes, I've been type 2 for several years, originally diet controlled then Metformin and here we are. I struggled with low carb woe but I'm going to be honest here, I have not been taking my condition seriously. Then last week I ended up in a and e - I had breathlessness, rapid heartbeat, dizziness, weakness, very high blood sugar 24.5, lactic acid 3.1, dehydrated, horrendous night sweats. My doctor is insisting on a new med. Honestly, this has been the shock I needed, I'm feeling awful. So I'm back to low carb, totally sticking to it, lost 4lb in a week, but bloods aren't lowering below 10. I don't need anyone to tell me how stupid I've been, I am very aware. I appreciate anyone taking the time to reply to me. Thank you.
     
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  5. Emmar

    Emmar Type 2 · Well-Known Member

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    Sorry just realised I posted in the wrong section.
     
  6. HSSS

    HSSS Type 2 · Well-Known Member

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    The past is the past. What you can change is the future.

    Perhaps if you don’t want medication you can ask to stick to the low carb regime for a short while and be retested and see if it’s improving. Although a quick retest might not get you all the way to where you want to be it might be enough to convince both you and the dr there’s other options that can work. Some drs have never seen low carb in action and have no idea how effective it can be. It seems reasonable to at least consider it and try it out before starting on meds that can lead to hypos. It may not be for you but many find it easier than they expected especially after a few weeks and all the support you can get in here.

    do you have the knowledge and resources to low carb effectively? Can you test at home? Both will be important if it’s to work well.

    here’s some blurb that might help. Some you might be familiar with already so skip over those bits.

    Try clicking these links for more detailed explanations that are well worth readings.


    http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/


    https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ for info including low carb made simple


    And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation


    and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas


    also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Excellent site and first port of call for many getting their head round low carb.


    Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.


    Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3, 6 or even 12 months and then have no idea what had what effect. It also helps keep an eye out that any meds are working appropriately not too much or too little. Getting a blood glucose meter is the only way to do this (no matter what contradictory advice you may have heard - it’s usually budget based rather than anything more scientific). Test before a meal and 2hrs later hoping for a rise of 2mmol or less. More and the carbs eaten were too many! Please ask if you want any guidance on this.


    IMPORTANT FOR ANYONE ON DIABETIC MEDS (other than metformin): if you lower your carbs then any glucose lowering meds or insulin increasing meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc than your new carb intake requires. (This is not a concern for metformin on its own). Keep a very close eye on your numbers and do this with your dr’s knowledge. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around.
     
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  7. Emmar

    Emmar Type 2 · Well-Known Member

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    Thanks HSSS I do fund my own test strips which I agree is really important. I'm very shocked by my levels at the moment though - on waking I was 13 so thought I'd wait to eat, an hour later I was 16?! Have been strict low carb for a week now and my numbers are getting worse not better! Thanks for the reading material, gonna be a rough few weeks I think.
     
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  8. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    No-one's going to tell you you've been stupid: we all deal with this condition differently, and sometimes we'd rather ignore it and hope it goes away. Sadly, it doesn't work like that, but at least you tried! ;) Seriously though, your body is used to higher levels, so when you don't eat in the morning your liver will dump glucose to get you up to the levels it THINKS you should be at. It thinks its helping, and it'll take a little while for it to get used to the new normal, that's not going to happen in a week's time. So do give your liver and yourself a moment to get used to the way things are going to be from here on in.

    Now that that's covered: You tried low carb, and you had trouble with it. With what part(s) of it, exactly? The food, the cooking, the groceries, the feeling of missing out or being different? What was it that made you think "Nah, this isn't for me"? Maybe there's work-arounds we can help with?

    Also, keep in mind that if you go back to low carbing, your bloodpressure'll probably drop considerably too. Dunno if you've been eating bread and such, but when you cut those out your salt intake goes down too, and with it, your blood pressure. So do keep an eye on yourself, and if the room goes dark when you stand up, or you get dizzy, have a pinch of salt with some water. If it continues you might have to discuss changing the dosage of your beta blocker with the doc.

    You can do this you know. You don't have to do it on your own.
    Hugs,
    Jo
     
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  9. bulkbiker

    bulkbiker Type 2 · Oracle

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    Probably down to your body dumping as much stored glucose as it can while is has a chance.
    Keep on with the low carbing and they should start to reduce.
    Maybe even try skipping a meal or two providing your medication will allow.
     
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  10. Energize

    Energize Type 2 · Well-Known Member

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    Hi @Emmar

    I take Glipizide and have no side effects. (I was originally prescribed Gliclazide but I didn't tolerate it well - made me feel unwell.)

    If you are prescribed a glucose-lowering medication, ie Glipizide, you will be given a Glucometer and prescribed some testing strips. You will need to watch your blood glucose levels very carefully. You will also need to test your Blood Glucose levels before driving and 2-hourly thereafter if driving for that period of time, or longer.

    Weight gain should be controlled by yourself, by diet. If you eat LCHF, you will likely find you need less medication, if on something, like Glipizide, as it's basically a balance between how much insulin vs carbohydrate you take in.

    Weight gain is mainly due to the insulin in your body/circulation, rather than just the food you eat. So, if you drop the amount of carbs eaten, your body will need less insulin. If you find you are having to eat more to prevent hypo's, then you will likely gain weight. Also, when you eat, your body will produce insulin hence your insulin levels may stay higher. I would recommend 'The Diabetes Code' (book) by Jason Fung. I find he explains all this very well, and it's reasonably easy'ish reading.

    Wish you all the best
     
  11. Emmar

    Emmar Type 2 · Well-Known Member

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    Thank you so much for all your kind replies - my eyes are leaking! Is that another symptom?? JoKalsbeek my main problem with low carb was I felt hungry all the time - did it for about 9 months, didn't lose weight and my blood sugars didn't lower. I was very strict, some days my carbs were below 20g. I used ketostix so I know I was in ketosis. I do wonder if I wasn't consuming enough fat though. It also felt like the diet took a lot of my time, planning, shopping, cooking but I have to accept it needs to a priority in my life again. I really appreciate all of your encouragement, it's given me a real positive boost. I can do this x
     
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  12. HSSS

    HSSS Type 2 · Well-Known Member

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    You should never feel hungry on low carb. Almost always it’s because people are scared of fat and end up restricting all foods and their metabolism slows down as a result.

    It’s incredibly rare that blood sugars don’t lower though. Even type 1’s that do it seem to see lower and more stable blood sugars. I’m puzzled there if you were confirmed as in ketosis.
     
  13. mouseee

    mouseee · Well-Known Member

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    What is a typical days LC for you? Quite often carbs will sneak up on you....
    I haven't been hungry on LC but I do eat fat, although I wouldn't say HF. I fact I eat far far less at meals than I did.
     
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  14. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Yeah, hunger shouldn't factor into it. You really do need to up the fats, keep protein moderate, and eat until you are FULL. If your body's letting you know it wants more, it doesn't need to be a carb craving: it can be signalling that you are not getting enough nutrients! So, keep it simple for now, so you don't get overwhelmed in the grocerystore. You don't need to read every single label, there's enough foods out there that are low to no carb that can be the basis for your most common meals. Find those, and stick with low carb foods that fill you up. A salad is fine, but add something fatty to it. Bacon, a can of tuna, some salmon, a BIG chunk of warmed goat's cheese, anything to bulk a meal up. Eggs with bacon, mushrooms, tomatoes and cheese will keep you going all morning, probably well into the afternoon. Meat, fish, above ground veggies in the evening, and if those don't fill you up, add in some cheese for good measure, or some extra bacon. Coffee with double cream (Or clotted cream!) for dessert, if you feel like it. Just go back to the beginning, start over, keep it simple... And when/if you feel like spicing things up a little you can take further steps. But right now... Back to the basics. There's 3 macro-nutrients, and it's not just what you do with the carbs that's important, eh. Keep an eye on the fats too (again, up those) and proteins (moderate) too. You don't want to deprive yourself of vital minerals and nutrients. No-one wants you to get scurvy. ;)
     
  15. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    One more thing: If your blood sugars didn't lower, at all, and you were indeed in ketosis, have you gone in for a C-Peptide and GAD set of tests? Could well be you're not a T2 at all. Something to consider. @mouseee poses a good question: what did a typical day look like for you, food wise?
     
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  16. Emmar

    Emmar Type 2 · Well-Known Member

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    Last couple of days meal plans
    (B) 2 poached eggs on 1 slice whole grain buttered toast
    (L) ate as late as possible - small amount cheese and ham
    (D) cheesey cauli mash with low carb pork and mushroom casserole (homemade)

    (B) scrambled eggs
    (L) cream of celery soup (homemade)
    (D) mushrooms stuffed with goats cheese and steak

    If I'm hungry I have a bit of cheese or 10 Brazil nuts.
    My sugars are always high in the morning, improve over the day. Last 2 nights I've been around 8 or 9 before dinner and same again at bedtime. 7.4 been my lowest for a very very long time!

    How does this look? Anything I'm doing glaringly wrong?
     
  17. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Looks reasonable except for the toast. I found that quantities also affected my bs. A big deep bowl of homemade mushroom soup spiked me. The next day a cereal bowl from the same batch had no effect.
     
  18. Ricky

    Ricky Prediabetes · Well-Known Member

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    I have been low card/low GI for about 17 years and I also have a problem with high fasting numbers. Mine would do exactly the same as yours - go up if I waiting before having breakfast. The way I see it is that sometime during the night your liver decided that your blood sugar had reduced too much and proceeded to convert the stored glycogen in the liver to glucose and dump it in the blood hence the blood sugars are high in the morning.
    I eat my usual low carb breakfast and then don't eat again until my blood sugar has gone down to below 6 even if I am hungry. I never snack between meals. I find that if I go for a 20 minute fast walk (or other exercise) it will bring those blood sugars down.
    I sleep badly - have down for 17 years - since menopause and I think quality of sleep has a lot to do with fasting blood sugars. I am determined to stay off medication for as long as I can.
    All the best to you
     
  19. Derbysocks

    Derbysocks Type 2 · Active Member

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    I have taken gliclazide & the only reason I stopped was after a 1.5 years of taking insulin. I have never had any problems. To many people on this site look up information & just like the information on vaccines it is often wrong. Just take what your doctor recommends. They are here to keep you alive.
     
  20. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Actually, not too sure about this. I would rather (at least) consider advice from people who live with this condition, and who have learned how to reduce, and sustain, their numbers.

    I have had some rubbish advice from some so called health care professionals.

    I would certainly say you should not just take advice from forums or facebook pages. You should always do your own research. Many of us have other conditions to take into account. Diabetes can be very complicated to deal with.
     
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