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Metformin What Comes Next ?

pamK

Well-Known Member
Messages
168
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi I have been on Metformin now for 11 yrs starting on 500mg twice a day then 18mths ago went on 2 in the morning and 2 at night I think soon will come the time when another tablet will be given to me . Not knowing anything about other tablets what they are and do they cause Hypo;s etc m I thought it would be nice to hear from other members about there thoughts and experiences using Metformin plus additional tablets and if there was any teething problems
I hope it is QK for me to post this
Thanks
 
Hi and no problem in posting as many ask about Metformin. Increasing the dose of Met is the law of diminishing returns like many drugs. Met acts mainly to reduce insulin resistance in the overweight but also reduces the appetite a bit and the output of glucose from the liver. Gliclazide is commonly prescribed when the pancreas needs to be stimulated to produce more insulin and may be targetted more at those with normal weight and who may possibly be LADA. Too much Glic can cause a hypo. Sitagliptin is also quite common and helps the pancreas produce more insulin after a meal by extending the time it produces; also used more for those who are not overweight. Sitagliptin by itself doesn't cause hypos as it's effect reduces as blood sugar comes near to normal. I was on max dose of all three of these prior to insulin and had no problems at all except in the end they had no effect.
 
I have just been prescribed Sitagliptin - 1 x 100mg per day. I am already on 2 Metformin and 2 gliclazide twice a day. Concerned about taking sitagliptin as well - are there any complications taking all 3?
 
Hi Elaine. I can only say that even on max dose of all three meds for years I had no problems except for mild headaches for the first week when Sitagliptin was added. It doesn't often cause problems but can rarely have serious side effects as the leaflet says. I'm not aware of any interaction problems between the three but as you may know already, Gliclazide can cause hypos if the dose is too large.
 
@pamK and @ElaineJose can I ask what you eat? We often hear claims about T2 diabetes inevitably requiring more drugs over time, but many find that diet (low carbing) can avoid or at least minimise the need for that. More medication is not necessarily the best solution.
 
I have been in denial about my diabetes so have not been as careful as what I should be. Chocolate is my downfall. I really am not happy at taking more medication, I know I have to make changes - but it isn't easy
 
Hi Elaine. Sanguine is right that if you are overweight, then having a low-carb diet will help enormously as you can get into a vicious circle where the body is swimming in insulin already but can't use it due to insulin resistance. If you are not overweight then the possibility of LADA is always there and was why I had to finally move onto insulin as all the tablets won't work long-term even with low-carbing. BTW, I always have 85% Green & Blacks dark chocolate when I do have it as it's quite low carb
 
Hi Elaine. Sanguine is right that if you are overweight, then having a low-carb diet will help enormously as you can get into a vicious circle where the body is swimming in insulin already but can't use it due to insulin resistance. If you are not overweight then the possibility of LADA is always there and was why I had to finally move onto insulin as all the tablets won't work long-term even with low-carbing. BTW, I always have 85% Green & Blacks dark chocolate when I do have it as it's quite low carb
 
I have been in denial about my diabetes so have not been as careful as what I should be. Chocolate is my downfall. I really am not happy at taking more medication, I know I have to make changes - but it isn't easy

It's easier than dealing with the nasty complications if you don't!

Despite what you may have been told, it's carbohydrates that are the problem as much as sugar and chocolate. Have a read of the thread linked below (the top one) and ask any questions. It's not too late to get your blood sugars down to a point where you won't have to take more medications, we can help and support you. Do you test your blood to see what different foods do to you? Do you know what your history of HbA1c values is?
 
Have only just joined this forum. Don't know what LADA is. Thanks for info on the chocolate will give it a try
 
I have been in denial about my diabetes so have not been as careful as what I should be. Chocolate is my downfall. I really am not happy at taking more medication, I know I have to make changes - but it isn't easy

Hi, Elaine Jose, At least you have acknowledged that you have not done enough so far, but if you leave it too late you will regret it.

It's amazing what the right diet can do. So stick around ask lots of questions and see what these people do on here.

I was diagnosed just border line, and now technically out of the diabetic range but it still affected my feet within a year, so don't leave it too late.

What are your sugars like and are your testing your blood for when you eat?

I have chocolate everyday from Lidl 70% dark with raspberry or orange flavor 2 pieces. Really enjoy it now, started to prefer over milk.

Neil
 
Hi, Elaine Jose, At least you have acknowledged that you have not done enough so far, but if you leave it too late you will regret it.

It's amazing what the right diet can do. So stick around ask lots of questions and see what these people do on here.

I was diagnosed just border line, and now technically out of the diabetic range but it still affected my feet within a year, so don't leave it too late.

What are your sugars like and are your testing your blood for when you eat?

I have chocolate everyday from Lidl 70% dark with raspberry or orange flavor 2 pieces. Really enjoy it now, started to prefer over milk.

Neil
I'm normally 15 - 17 when I take my blood sugar which is why dr prescribed sitagliptin. I take it before breakfast or before bed 3 to 4 times a week
 
I have been in denial about my diabetes so have not been as careful as what I should be. Chocolate is my downfall. I really am not happy at taking more medication, I know I have to make changes - but it isn't easy
mmmmmmmmmmmmmmmm .......chocolate .....:hungry:
have a read of the forum while you drink this hot chocolate , virtually no carbs ..so have 2 cups :)
cooking cocoa powder, a touch of vanilla concentrate and peppermint essence, made with cream and half water
( some coffee in it and have a mocha for a change)

I use to knock off a family bar of normal milk chocolate in 20 minutes..now a line or sometimes 2 of 85% and I'm satisfied

I found carbs so addictive, the first 2 days were hell
http://lowcarbdiets.about.com/od/lowcarbliving/a/Food-Cravings.htm
 
Last edited by a moderator:
I'm normally 15 - 17 when I take my blood sugar which is why dr prescribed sitagliptin. I take it before breakfast or before bed 3 to 4 times a week

15 to 17 I'm sorry to say, is not good. Normal sugars for non Diabetic are between 4mmol/L to 7.5mmol/L even NICE say for diabetics 8.5 should be the max. If you continue at these levels you will get some serious complications but you can reduce them and it's not too difficult.

The medication is only a minor help and I do stress minor, you have to do it

You have not mentioned what you are eating but foods like bread, pasta, rice, some cereals. even fruit like bananas are NO NO's
Give us an idea of what your typical days meals are?

Neil
 
One oatibix for breakfast and maybe a banana. Lunch could beans on toast or ham salad sandwich - wholemeal bread normally. For di normally potatoes or rice with meat and veg. probably have some biscuits or chocolate. Like Indian food. Have this once or twice a month. Drink lot of tea and coffee. No alcohol
 
@pamK @ElaineJose

Welcome to the forum :)

Here is the information we give to new members, newly diagnosed or not, and I hope you will both find it useful. Ask all the questions you need to and someone will 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 130,000 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.
 
One oatibix for breakfast and maybe a banana. Lunch could beans on toast or ham salad sandwich - wholemeal bread normally. For di normally potatoes or rice with meat and veg. probably have some biscuits or chocolate. Like Indian food. Have this once or twice a month. Drink lot of tea and coffee. No alcohol
you're hungry with that diet, aren't you?
tomorrow morning have a fry-up of eggs, bacon, fried tomato or mushrooms.
lunch
ham salad with olive oil and vinegar ..if at work take oil and vinegar in a little bottle ..soggy salad is never nice..
tea
meat and non-starch veg with a chunk of real butter
supper
cheese
some 85% chocolate

it’s a long page and a few good video’s
http://www.dietdoctor.com/lchf
For me, the more carbs we eat the more carbs we want. they don’t give up easy
http://lowcarbdiets.about.com/od/lowcarb101/a/firstweek.htm
 
One oatibix for breakfast and maybe a banana. Lunch could beans on toast or ham salad sandwich - wholemeal bread normally. For di normally potatoes or rice with meat and veg. probably have some biscuits or chocolate. Like Indian food. Have this once or twice a month. Drink lot of tea and coffee. No alcohol

Have a look at the carbs on the Oatbix thats not the sugars it what it says are the carbs is, I would imagine it's very high and the milk will also be high. What lots have on here is full fat Greek yogurt with berries & I have some Flaxseed 2 teaspoons sprinkled on. Or eggs and Bacon mushrooms, or an Omelette or scrambled eggs or poached eggs. The banana will be no good for you

For me & I believe most on here will have to have either Hovis Seed Sensations 13g carbs per slice only 1 slice at a meal time, or Burgen Soya & Linseed 12g carbs per slice all the others are in the 18 & 20's per slice.

The meat and veg is ok but the veg's should be from above the ground some root veg's have a lot of carbs including the potatoes. I only manage 1/2 a jacket maybe once week with lots of butter & cheese.

The biscuits are a NO NO just full of sugar & carbs, sorry.

I love indian food too, but the rice you would have to look at the portion sizes also any naan's or poppadoms, but if you were doing the rest through the weeks you could maybe have your indian treat.

You have to start to test just before you start a meal to see where you are at then test at at least 2 hrs you do not want to have moved more than 2mmol/L from start to the finish if you have there is something in there that you need to remove or have a smaller quantity. I would personally test at 1hr also in the early stages. Once you know what you can eat you don't need to do all the testing.

Your number will come down , a little exersize will help 1/2 walking a day.

Good luck
Neil
 
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