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Medications, side-effects and a GP that doesn't help

FierceViking

Member
Messages
9
Type of diabetes
Treatment type
Tablets (oral)
Hey guys,

Newbie here, both in terms of diabetes and on this forum. Be gentle :)

So, I got my diagnosis in March this year, after a random test when I applied for a job where they have requirements regarding health (diabetes automatically excludes you). The fasting BG was 11 and I had max score of sugars in my urine. (I didn't get the job because of that...)
I went to my GP a week later, and had a HbA1C of 11,5 and fasting BG at 11,5 (too), plus max score on the ustix. The days in between I had quitted almost all carbs whatsoever, to see if that influenced the fasting BG - which it did not.
I've probably had diabetes for almost a year, I've had 6 yeast infections down under between November and March, I've been thirsty all the time and needed to go to the bathroom every half an hour. This is kind of embarrasing since I'm a (non-practising) assistant nurse. I didn't see the signs, or more... I didn't want to see the signs. I'm over weight (BMI at about 37), and diabetes runs in the family. I've also got asthma, allergies and sleep apnea (diagnosed with 77 stops/hour) and have problems with leg cramps and tingling/loss of feeling in the lower part of my hands and fingers.

I live in Norway, and we have something called a "green prescription", which means that your GP gives you advice on nutrition and excersise. This is commonly given as a first off try for people with diabetes, over weight and so on. The GP gets reimbursed for the RX, because it relieves the strain on the social security system. His version of giving me a green prescription was "You need to ride your bike more". That's it.

Onto the treatment:
As mentioned, I was diagnosed in March. I haven't had any bloodwork done other than HbA1C and fasting BG.
I was started at Metformin 500mg x 3, and had a follow up a month after. This month was one of the worst periods of my life - I've never been as ill as then (and 3 years ago I got food poisoning in Egypt, with two weeks in bed/on the loo!). I had mummy tummy several times a day and had to plan my day after where I could find a loo. On the follow up, my HbA1C had gone down to 6,5, much because of me quitting carbs, so I was reduce to Metformin x 2. My stomach still didn't like the treatment and this went on until mid-June, when I had a new follow up.
I told my GP that I couldn't go on like this, and he switched me over to Eucreas, after a long discussion involving him getting angry with me as I wouldn't stand down on quitting/reducing Metformin or switching over to something else because of my stomach problems. I specifically asked if I could please try out either Lyxumia or Victoza, after reading a lot online on medications and treatments.
He told me he couldn't prescribe these on a blue RX* as "he had never used them before". He could "on my own risk" prescribe it on a white RX "if I so badly wanted to try it"....!
And to be honest, I'm still feeling ****, running to the loo every other hour or so, I'm guessing it's because Eucreas consists of mainly Metformin...
I've had some bad days where I just can't take the chance of being ill, and skipping medications. Both on these days, and some other ones I easily end up on 16-20 mmol readings, and feeling like ****. It doesn't always seem to matter what I eat - I had oatmeal for breakfast one morning before work (oatmeals, water and a little bit of yoghurt without sugars) and 2 hours later I read 16,4...! Unluckily, these values doesn't show up on the HbAC1-tests.

I also managed to get a referral to my local hospital which have a specialized diabetes team with diabetes nurses, endocrinologist and so on, after not standing down on this either. I received a notice of an appointment in late August, and I'll try moving my primary diabetes care over to them - as I don't feel my doctor is taking me seriously enough, and not giving me the treatment or attention I need to live a close-to-normal life as possible. I've also been scheduled to test for antibodies (looking for LADA) two weeks before.

On my own, I've cut down drastically on carbs, I've quit sodas and candies fully and try keeping my intake under 50gr/day. No low carb, but just more veggies, fullgrain bread and max 1 glass of milk/day. I also try to exercise more, walking to the train and so on, but it's not easy when going around feeling sick all the time.

Can I please have som advice from you guys, both regarding medication and how I should proceed further on with everything? I'm I'm especially interested in thoughts and comments regarding Victoza and/or Lyxumia, and your reactions to these. What about Metformin - is there a trick to make it easier on the body? My goal is to try to live without medications, but that's far down the road still. I hope to get rid of Metformin as I clearly can't keep on having the Pharaos revenge 5-6-7 times a day.

*Blue/white RX: Blue RX's are covered 60% by the goverment, for long lasting conditions (like diabetes). After around £220/year spent on co-payments, you receive a relief from this and get blue RX-medications for free until Dec 31st of that year. White RX's are prescriptions of drugs that are to treat more common and short-term illness, like antibiotics for an infection. These are covered fully by the patient itself and does not count on to the relief of co-payments.
 
Hi welcome to the forum.:)

I'm sorry I don't have time to answer all of your post right now. I'm just going to talk about metformin. The SR version is meant to be milder than the other one. The only times I had any problems with metformin at all was when I consumed more carbs than usual. Once when I had potatoes and once when I had beer. Other than those 2 incidents my stomach was fine with metformin, my normal carb level back then was around 60g a day.
 
Hi welcome to the forum.:)

I'm sorry I don't have time to answer all of your post right now. I'm just going to talk about metformin. The SR version is meant to be milder than the other one. The only times I had any problems with metformin at all was when I consumed more carbs than usual. Once when I had potatoes and once when I had beer. Other than those 2 incidents my stomach was fine with metformin, my normal carb level back then was around 60g a day.
Hey.

Thanks for the advice! The problem is that there aren't any Metformin SR drugs marketed in Norway, we only have the regular type.
 
I was one of the lucky ones who was fine on the standard version. :) I'll read the rest of your post later. In the meantime I hope others more knowledgeable than me will provide you with answers. :)
 
I am only pre diabetic but I found my bg readings shot up if I eat bread what are you eating in a typical day? Have you a meter, if not you must get one. Then test before and after eating too see what increases your blood sugar. I found it was carbs that increased my bg even low gi ones like lentils or chick peas. I also tested my fasting to see the result of the previous nights eating. Then eat too your meter solely no cheating , I found the weight fell off me with no effort.
Sorry no experience of metformin.
 
I was one of the lucky ones who was fine on the standard version. :) I'll read the rest of your post later. In the meantime I hope others more knowledgeable than me will provide you with answers. :)

Thanks :)

I am only pre diabetic but I found my bg readings shot up if I eat bread what are you eating in a typical day? Have you a meter, if not you must get one. Then test before and after eating too see what increases your blood sugar. I found it was carbs that increased my bg even low gi ones like lentils or chick peas. I also tested my fasting to see the result of the previous nights eating. Then eat too your meter solely no cheating , I found the weight fell off me with no effort.
Sorry no experience of metformin.

Well, that depends... I work kinda odd hours (7 days on, 7 days off - only evenings Mon-Fri, and 12 hours shifts on the weekends), which makes me live almost 2 different lifestyles.
On my working weeks, I'm not home until around 1am, and I get up at somewhere between 0830-1000. I then have a couple of hours at home before I have to go to work.
I genereally don't eat breakfast (never have, usually not hungry until around noon), but troughout the day I try to keep the meals small and regular -> about every 4 hours or so.
On my weeks off, I'm usually up around 0900 and try to have the same regime with small and regular meals. The difference is that I don't have the stress factor on my weeks off.
I usually eat 1 or 2 slices of fullgrain bread a day, and a Skyr (high protein, no sugar added yoghurt'ish product from Iceland) in between. A normal dinner is fish or meats (clean, almost never any processed), and veggies (peas, carrots, cabbage). Around 5/7 days a week we have salad with dinner. I eat potatoes, rice, pasta and other high starch foods less that 3 times a month.
I've quit sugars (switched sodas for tap water or carbonated water without additives/sugar) and use stevia or erythriol as a sweetener in my tea. I sometimes switch out the bread (that I usually have as a first meal of the day) with oatmeal.
I've lost around 25 pounds since I quit sugars (much because of my body getting rid of the excess water).
 
That doesn't sound a lot of carbs, however do you test for example when I was first diagnosed I couldn't eat Carby veg such as peas or carrots without my bg going too high. Also I found it better to less frequently as otherwise my bg never went down enough between meals.
 
That doesn't sound a lot of carbs, however do you test for example when I was first diagnosed I couldn't eat Carby veg such as peas or carrots without my bg going too high. Also I found it better to less frequently as otherwise my bg never went down enough between meals.

Yeah, I test (every day) when getting up, the fasting levels are anything between 5 - 9, and what I ate the night before doesn't really seem to matter that much.
I can eat dinner at 7pm (baked salmon, sallad and 1 small potato), two hours later it's 7,5 and the morning after, 12-14 hours later, it's up to 9+ again.
Then on other occasions, I can have dinner at 5pm and have the same readings.
I measure every morning before eating anything, and 2 hours after dinner. Occasionally I also check if I'm feeling something's off (I'm sweating for no reason, I feel my body is uneased and so on) - and I'm usually right; my BG is 11+.
I seldom test after breakfast (which is when I take one of my 2 Eucras; the other one at dinnertime), but if I do the levels are usually fine. So the meds are effective, but I don't know if I can live with the side effects.

One of the other problems I'm having with this is that my eyes have started to really dry out, and my vision is blurrier than ever - even with contacts/glasses. I've used glasses since I was 12 (I'm 29, by the way). I now have both glasses and contacts, but I prefer contacts. On long days at work, I have to switch the contacts for glasses, but I have to drip my eyes with eye drops every hour or so both with glasses and contacts. I tried telling my GP, but he just prescribed more allergy medications, in the form of eye drops, instead of actually looking at the problem it self.
I talked to my opthometrist about it, and I've tried all the contact variations they recommended for dry eyes, without any luck.
I forgot to mention that the diabetes team at the hospital also have a eye doctor with them, and I'll try to get some answers and help from him about the dry eyes...
 
@FierceViking

Hello and welcome to the forum :)

Here is the information for new members which Catherine mentioned above. I hope you will find this is helpful to you. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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

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.
 
Are you sure? That amazes me as so many people have problems with plain Metformin and there are several SR brands available in the UK.

Yeah, I've checked, double-checked and checked again! It frustrates me, because I read everywhere that people that don't tolerate regular Metformin have good results with the SR...
I guess it's got something to do with us being a small country or something, as 99% of the meds approved and recommended by EMA are automatically approved for distribution here too... :)
 
Hi @FierceViking,
Welcome to the forums. Your are sounding like your eating low carbs .. But cannot see any fat in your food list ! Try cutting out the bread and oats and then testing before and two hours after your meal ... I would also look at your fat intake.. Coconut oil, olive oil, butter , cheese and cream are good for adding to your diet .. Then you will be doing the Low Carb High Fat way of eating .. It keeps my bs numbers down and I am no longer on any medication for my diabetes ... I am T2 ..
 
Hi @FierceViking,
Welcome to the forums. Your are sounding like your eating low carbs .. But cannot see any fat in your food list ! Try cutting out the bread and oats and then testing before and two hours after your meal ... I would also look at your fat intake.. Coconut oil, olive oil, butter , cheese and cream are good for adding to your diet .. Then you will be doing the Low Carb High Fat way of eating .. It keeps my bs numbers down and I am no longer on any medication for my diabetes ... I am T2 ..

Hey,

Thank you!

I've been on the LCHF diet some years ago, and lost over 80 pounds on it. My problem was that it was hard keeping that up when I "suddenly" didn't live alone anymore.
I've tried a couple of times the last years to get down in weight again, but I've had to quit after 4-12 weeks on LCHF because of the side effects. My stomach becomes so upset with so little fiber and that amount of fat.
But - I do include fat in my diet, usually with butter (not margarine) on my sandwiches and gravy or something at dinner. If I have yoghurt, sour cream, cottage cheese and so on I always go for the full fat variant.

I was warned by the diabetes nurse I talked to a couple of weeks ago about having to much fat in the meals I eat around the time I take my meds, as more fat just accelerates the bad effects Metformin has on my stomach.

But thanks for the advice! LCHF is good for those who can tolerate it and have the strenght to keeping the diet tight. I was once a proof of that myself :)
 
Hey,

Thank you!

I've been on the LCHF diet some years ago, and lost over 80 pounds on it. My problem was that it was hard keeping that up when I "suddenly" didn't live alone anymore.
I've tried a couple of times the last years to get down in weight again, but I've had to quit after 4-12 weeks on LCHF because of the side effects. My stomach becomes so upset with so little fiber and that amount of fat.
But - I do include fat in my diet, usually with butter (not margarine) on my sandwiches and gravy or something at dinner. If I have yoghurt, sour cream, cottage cheese and so on I always go for the full fat variant.

I was warned by the diabetes nurse I talked to a couple of weeks ago about having to much fat in the meals I eat around the time I take my meds, as more fat just accelerates the bad effects Metformin has on my stomach.

But thanks for the advice! LCHF is good for those who can tolerate it and have the strenght to keeping the diet tight. I was once a proof of that myself :)

Sorry you are unable to do the LCHF way of eating .(it's not a diet ! Just a way of eating) . I have lost 5st in 18 months and feel brilliant .. It also has my bs in the normal range, so that's a plus.. It was easy for me to adjust to this way of eating .. But I am a vegetarian .. I have lots of fibre from my vegetables. I could not take the medication for DBs as it really upset my system . Now I am looking at dropping some of my HF meds as my way of eating has got my blood levels all in the normal range now.
Yes sadly the medical profession have no idea right how the LCHF diet works so are still rolling out outdated advice. I know what I would want out of taking meds or eating great food ! But as I said it must be easer being a veggie.. Hope you get sorted out soon
 
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