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New to diabetes

Two days of Metaformin. Belching, feeling of indigestion. Abdominal pains two hours after taking and diahorrea. The same this morning for two hours before the day started. Breakfast of Greek yoghurt and some strawberries, belching after every mouthful and after every sip of black decaff tea. Belching after lunch of salad and smoked trout and during drinking lemon and ginger tea. Is this normal? Does it continue? Have asked for an advice call but would appreciate any advice. Thank you all for holding my hands as a newbie.
 
Ceppo said:
Two days of Metaformin. Belching, feeling of indigestion. Abdominal pains two hours after taking and diahorrea. The same this morning for two hours before the day started. Breakfast of Greek yoghurt and some strawberries, belching after every mouthful and after every sip of black decaff tea. Belching after lunch of salad and smoked trout and during drinking lemon and ginger tea. Is this normal? Does it continue? Have asked for an advice call but would appreciate any advice. Thank you all for holding my hands as a newbie.
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I had side effects on normal. Nothing on slow release (for over a decade) so hopefully nurse/doctor can try that for you
 
A nice nurse practitioner changed it to slow release today. Starting to get post dinner belches but we'll have to wait and see.
 
Ceppo said:
Without all of you I would feel very isolated. Thank you for your warmth and information. I am reading my way through Fung and have finished Caldesi today. Working with low carb eating since Sunday night and that seems to be going OK at the moment.

But I wanted to share with you the following text message from my gps received this morning.

"Your Initial Diabetic review is due. Due to the coronavirus situation NHS England has advised that routine reviews should not be carried out at present so we will not be inviting you in at this time. If you have any changes or problems with your condition please do contact the surgery."

I wonder what happened to Facetime or WhatsApp or the telephone. Quite shocking really.
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My surgery has a medical video app for apointments. Despite this still not doing any diabetes checks. I was diagnosed last year and was due to have check up in April.

Didn't happen. Seemed to have forgotten about me. Good job I test at home or I would have no idea of my condition.

Luckily just got the eysight test in which took 6 months to get apointment.

Same with high bp. No one bothers to check medicebe is working.
 
Well still issues with Metformin really provoked lots of nausea about 11.30 am if intermittent fasting. Have been advised to take it in the morning and that it needs food - so that makes it difficult to intermittent fast - except over night and between meals.
Just wanted to ask what you think of my initial Lipid results. I'm in need to more experience to feel any confidence in my conclusions so would appreciate the support.
DN wants them under 4 naturally with statins. I've not agreed and said I'll think about it when there's been a second test.

Total chloresteral 5.8
HDL 2
LDL 3.2
split 2.9
Triglycerides 1.3

Appreciate a bit of advice and handholding on this.:)
 
Ceppo said:
Well still issues with Metformin really provoked lots of nausea about 11.30 am if intermittent fasting. Have been advised to take it in the morning and that it needs food - so that makes it difficult to intermittent fast - except over night and between meals.
Just wanted to ask what you think of my initial Lipid results. I'm in need to more experience to feel any confidence in my conclusions so would appreciate the support.
DN wants them under 4 naturally with statins. I've not agreed and said I'll think about it when there's been a second test.

Total chloresteral 5.8
HDL 2
LDL 3.2
split 2.9
Triglycerides 1.3

Appreciate a bit of advice and handholding on this.:)
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Hi @Ceppo,

If you would like to skip breakfast and rather fast, could you take the metformin when you have your meal later? Metformin tends to build up in the body over time anyway (which explains the effect on blood sugar levels) rather than one tablet having a direct effect.

As to cholesterol, maybe this calculator is helpful: https://www.hughcalc.org/chol-si.php.

Ideally, many HCPs would like you to have cholesterol under 4.0 if you are diabetic (compared to the general population where this level is 5.0) -- this is due to effect of diabetes on cardiovascular health ... and tbh statins are believed to have some anti-inflammatory effects, so they may help a bit, though they also came with a number of not so pleasant side effects.

The question remains however, what happens if we manage to normalize blood sugar levels by changing the way we eat? Should there still be a lower threshold for cholesterol levels?

You might also want to google Zoe Harcombe, who has written her Ph.D. dissertation on the validity of the dietary fat guidelines. Here is an article by her that might help: https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/
 
Well thanks for your reply. Interesting that although the overall number is borderline - the breakdown is full of optimals and ideals. That is a very new perspective on things for me. Very helpful. So much to learn.

I'm only two weeks into the new way of eating so there is time to see where I get.
 
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Talking of Metformin.
Has anyone else developed a facial rash on the chin, nose, moving onto cheeks and patches on both sides of the forehead? On slow release and have been told to take it in the morning. The rash is reasonable in the morning and gets steadily worse all day. Not so easy to see except in the right light on in a mirror. When I had it looked at the nurse said it appeared to be ectopic dermatitis and booked me in with the DN. Although she was uncertain that it was related. I suppose it could be stress or sun sensitivity- in this grey northern and rainy weather.

I have taken an antihistamine for the last two days which has taken away the burning and most of the itching. But not this evening and the itching is starting up. Tomorrow I think I shall stop the Metformin for a couple of days to test whether it makes a difference to the rash.

On Wednesday I am due to see the DN with a view to taking the next level of medication - one that requires use of a glucose meter and has risks of hypos - probably weight gain too - begins with a G. Just what I need at the moment. Just getting to grips with losing weight steadily.

Its been suggested to me that I should refuse medication and concentrate on diet for the next couple of months. A option not given to me by the belligerent GP who rang me with my blood test result.

Incidentally, I am also getting pins and needles and sharp stabbing sensations in hands and feet. Even in the top of the head and neck. Any idea if that could be related. Sigh. Its just so hard to know what to think and how much to tolerate.
 
Ceppo said:
Hello everyone, I was diagnosed yesterday over the telephone. Haven't got through all the emotions yet and moved onto adjustment - its still feeling like a dream.

Horridly high test result of 100. GP set a target of below 53 for me. Dr prescribed 2 x metaformin per day - starting with 1 a day the first two weeks. He thought it would require something else in addition. Although he had a resonable attitude to low carb eating he was very dismissive of being able to reverse diabetes or bring it into remission and challenged me to prove him wrong several times. Is there any hope with low carb and weight loss to improve things or is he right.... I'm doomed.... Not the most helpful thing for me as encouragement goes a long way. He wasn't interested in me testing my glucose with a monitor. I am wondering about getting one - any recommendations?

I'm being sent on a DESMOND course sometime and there will be the local gp diabetic clinic. and an eye test - who knows what has gone on in my body. The blood re-test will be in October as we expect to go away in a few weeks for the whole of September.

Dr Fung's book has dropped through the door today so lots of reading there and the Caldesi recipe book coming soon. What else would people recommend? I'm also looking for a carb app or reference book.

I have been browsing the forum. There is so much helpful information and experience here but I'd greatly appreciate some wise words to balance against the negative attitude of the GP.
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I would not put too much store in the GP's attitude. They are often overworked and suffer from the doctor complex - "just the facts ma'am", which can come across as brutal or dismissive. The best first thing to do is keep a BGL log and food log. Your machine will spew a bunch of numbers which a doctor can read fast, but the discipline of keeping a log and seeing what food does what to you in real life is highly effective. You also start to become conscious of the otherwise unconscious food habits we all tend to accumulate.

Use the nutrition info panel on the packaging on all foods - carbs hide everywhere . this is a numbers game and a doctor you see every three months cannot do what you can do every day - which is provide your own discipline adn get to know how your body reacts. Your range will become tighter and your HBa1C will decrease - it ins't a driving test or school exam and you cannot fail, but be disciplined and it will get where you want it.

There are no magic cures though - this is a malfunction that needs to be managed rather than cured.
 
You might be allergic to the Metformin, or one of the additions made to it to make the tablets. I'd certainly discontinue them to see if that is the problem as it can be rather nasty if it is - it only gets worse if you keep taking them.
 
Ceppo said:
Talking of Metformin.
Has anyone else developed a facial rash on the chin, nose, moving onto cheeks and patches on both sides of the forehead? On slow release and have been told to take it in the morning. The rash is reasonable in the morning and gets steadily worse all day. Not so easy to see except in the right light on in a mirror. When I had it looked at the nurse said it appeared to be ectopic dermatitis and booked me in with the DN. Although she was uncertain that it was related. I suppose it could be stress or sun sensitivity- in this grey northern and rainy weather.

I have taken an antihistamine for the last two days which has taken away the burning and most of the itching. But not this evening and the itching is starting up. Tomorrow I think I shall stop the Metformin for a couple of days to test whether it makes a difference to the rash.

On Wednesday I am due to see the DN with a view to taking the next level of medication - one that requires use of a glucose meter and has risks of hypos - probably weight gain too - begins with a G. Just what I need at the moment. Just getting to grips with losing weight steadily.

Its been suggested to me that I should refuse medication and concentrate on diet for the next couple of months. A option not given to me by the belligerent GP who rang me with my blood test result.

Incidentally, I am also getting pins and needles and sharp stabbing sensations in hands and feet. Even in the top of the head and neck. Any idea if that could be related. Sigh. Its just so hard to know what to think and how much to tolerate.
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Hi @Ceppo,

Is it possible that you are allergic to one of the inactive ingredients of slow-release metformin? If this is the reason for the rash (and no, I haven't heard of this as a common side effect), switching to a different brand might help. Maybe could ask about this at your appointment next Wednesday?

Have you started testing you blood sugar levels yet? What do they look like? Has your change in the way of eating had an impact yet? I know these are lots of questions, but sharing a record of your blood sugar readings might be helpful when having your appointment. Maybe they might even hold off on adding the new medicine (which I suspect is Gliclazide).

Gliclazide forces your pancreas to produce more insulin (regardless of what you eat) -- and some would argue that (a) it would exhaust the beta cells of your pancreas (which produce insulin) even faster and (b) that adding more insulin to an already high level of insulin (which tends to be typical for T2s) is not necessarily beneficial as it increases insulin resistance. For example, for Virta Health (a remote care U.S.-based health care company which focuses on reversing T2 and has a success rate of around 60% with people who had T2 for around 10 years on average) gliclazide is the first medicine to be eliminated when people join their program.

If low-carb is working for you and you are approaching near normal levels, the addition of gliclazide might push you into hypo (blood sugar levels which are too low) territory. So, it if you decide to take them (and yes, it is ultimately your decision not your GP's or DN's), make sure you monitor your blood sugar levels frequently. Let your GP/DN know if this medication is pushing down your blood sugars to a level which is too low (less than 4 mmol) regularly.

Good luck with your appointment on Wednesday.
 
My experience was somewhat similar. Diagnosed in July 2019 with raging diabetes; constantly thirsty, drinking all the time and up in the night to pee three times! I was also starting to lose weight and my pulse was raging). No real surprise when blood test came back showing HbA1C at 105. My father died of pancreatic cancer so doctor very quickly got me scanned at hospital -thankfully clear (except for fatty liver). I was put on metformin 0.5g twice a day and told to lose weight. By going to a very small lunch and cutting my carbs right down I did manage to lose weight and the blood sugar came down too (55 in Oct 2019 and 33 in Jan 2020; weight fell from 104kg initially to 90kg). Doctor suggested trying without metformin so came off that at the end of Jan. So far my blood glucose does seem under control (I test several times a day) although having lost a few more kgs of weight I’ve now put it back on again so am back at 91kg (**** covid19). I have my one year check up this week but am confident that as long as I keep the weight off my diabetes will stay in remission.

So ignore your doctor! If you can lose weight you do have a chance of putting the disease into remission and living life medicine free (note I don’t think I’m cured, if I put the weight back on the diabetes will return). Not easy and a constant struggle but I am now going to try a 5/2 diet to see if that is the best way of keeping the weight off.

Id also recommend getting a meter. I bought a cheap one on Amazon, less than £20 including initial strips. Really helps you understand the impact of carbs and diet. One other practical suggestion I have is to switch to wholewheat rice, pasta and bread and also weigh everything to make sure you have one portion and not several as I was having! Meat and fish are fine to eat and just increase the veg at the same time as reducing the carbs as they will fill you up (and help cholestrol too)
 
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RichW said:
My experience was somewhat similar. Diagnosed in July 2019 with raging diabetes; constantly thirsty, drinking all the time and up in the night to pee three times! I was also starting to lose weight and my pulse was raging). No real surprise when blood test came back showing HbA1C at 105. My father died of pancreatic cancer so doctor very quickly got me scanned at hospital -thankfully clear (except for fatty liver). I was put on metformin 0.5g twice a day and told to lose weight. By going to a very small lunch and cutting my carbs right down I did manage to lose weight and the blood sugar came down too (55 in Oct 2019 and 33 in Jan 2020; weight fell from 104kg initially to 90kg). Doctor suggested trying without metformin so came off that at the end of Jan. So far my blood glucose does seem under control (I test several times a day) although having lost a few more kgs of weight I’ve now put it back on again so am back at 91kg (**** covid19). I have my one year check up this week but am confident that as long as I keep the weight off my diabetes will stay in remission.

So ignore your doctor! If you can lose weight you do have a chance of putting the disease into remission and living life medicine free (note I don’t think I’m cured, if I put the weight back on the diabetes will return). Not easy and a constant struggle but I am now going to try a 5/2 diet to see if that is the best way of keeping the weight off.

Id also recommend getting a meter. I bought a cheap one on Amazon, less than £20 including initial strips. Really helps you understand the impact of carbs and diet. One other practical suggestion I have is to switch to wholewheat rice, pasta and bread and also weigh everything to make sure you have one portion and not several as I was having! Meat and fish are fine to eat and just increase the veg at the same time as reducing the carbs as they will fill you up (and help cholestrol too)
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Hi @RichW,

Welcome to the forum.

Just out of curiosity -- have you taken readings after having wholewheat rice, pasta and bread?

If your blood sugar doesn't go up, this is really well done ... and would put you into a category that very few us would be able to achieve. One might be even tempted to argue you are cured. Personally (and this only applies to me), I doubt that I would be able to eat this many carbs without blood sugars going higher than I am comfortable with.
 
I haven't started testing yet. Perhaps tomorrow.

I think the rash is 1 in 10,000. There are a few sad medical journal research articles where people have been wrongly dermatologically treated for long periods without success, only to forget to take their medication and within a week the rash is gone.

I am losing weight steadily and am bright with lots of energy and will be devastated to be medicated in a way that reverses my progress with other negative effects. I am eating a very low carb diet - haven't touched a starchy carbohydrate in weeks.

I haven't taken Metaformin today and the rash has not got worse, it appears to be improving.

I could be allergic to components in SR M but I have had no success in asking for allergy testing in the past. It seems I would have to have that done privately. It would of course be thinking outside of the box for them to learn a common additive or binder was the cause of a problem like this.

I haven't had a consultation with a doctor, just two telephone calls one to pronounce test results and medication and the other with the DN who I will be seeing on Wednesday. I am still very new to all this; hence the cries for advice.

I was due to go away for a few weeks but have delayed that for a fortnight to try to sort this out. I am inclined to refuse medication until I return and continue the LCHF diet with testing. There will be another test in October. I'm not sure how that would go down with them.
 
Thanks for the positive report on your progress @RichW and @ziggy_w I see the great progress you have made too. Its always good to hear about that. Gives me hope.

Unfortunately I don't yet have the confidence and knowledge base to steer their prescribing. But three days without Metformin should make it clearer if it is the prime culprit. I wouldn't consider starting any further medication for at least a week to see if the rash completely clears or improves.

@Resurgam I know very little about alternative brands/formulations - they just prescribe the cheapest don't they? I doubt they do either at that level.
 
Ceppo said:
Talking of Metformin.
Has anyone else developed a facial rash on the chin, nose, moving onto cheeks and patches on both sides of the forehead? On slow release and have been told to take it in the morning. The rash is reasonable in the morning and gets steadily worse all day. Not so easy to see except in the right light on in a mirror. When I had it looked at the nurse said it appeared to be ectopic dermatitis and booked me in with the DN. Although she was uncertain that it was related. I suppose it could be stress or sun sensitivity- in this grey northern and rainy weather.

I have taken an antihistamine for the last two days which has taken away the burning and most of the itching. But not this evening and the itching is starting up. Tomorrow I think I shall stop the Metformin for a couple of days to test whether it makes a difference to the rash.

On Wednesday I am due to see the DN with a view to taking the next level of medication - one that requires use of a glucose meter and has risks of hypos - probably weight gain too - begins with a G. Just what I need at the moment. Just getting to grips with losing weight steadily.

Its been suggested to me that I should refuse medication and concentrate on diet for the next couple of months. A option not given to me by the belligerent GP who rang me with my blood test result.

Incidentally, I am also getting pins and needles and sharp stabbing sensations in hands and feet. Even in the top of the head and neck. Any idea if that could be related. Sigh. Its just so hard to know what to think and how much to tolerate.
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I am now on metformin SR 1000mg , but was told by GP and the leaflet to take with evening meal as it then works to reduce the release of glucose from liver whilst you sleep.
Some mornings I need to go to toilet a lot for about 2 hours after getting up, same symptoms as ibs but that happens about twice in a week most days ok.
The longer i took metformin the IBS decreased.
I have only been on metformin for two months and occasionally my left foot gets tingling and a bit numbness but not for long .
Strange how you have been advised to take in morning when I was advised to take in evening.
Just read the leaflet that came with metformin again and it does recommend taking with evening meal.
 
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I did start off in the evening but was interested in some intermittent fasting in the morning. A late brunch made me so nauseous that I couldn't eat, then predictable bathroom visit and exhaustion. After this DN told me to take it in the morning. Yes, the boxes were labelled that way too. She told me it needed food to do its work. It is a strange world.
 
@ziggy_w Have mastered the unfamiliar technique now - although it took me a while to work it all out... still so much to learn and adjust to.
first reading 7.6 at 10.00 am before breakfast. Will test again around 12.
Should I have done it before getting out of bed?
 
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