Newbie - overwhelmed and confused

Hi All,

I was diagnosed (T2) in December and started Metformin in January (initially 500mg per day, ramped up to 2000mg).
My initial HbA1c level was 120 followed by 119 about 2 weeks later. My BGL was 21mmol (all before starting the meds).
The GP has not had any further contact with me - apart from offering me Flu vaccine etc.

I had my first clinic appointment at the hospital last week - my BGL was 17.4mmol, so it has come down a bit. I don't know what my HbA1c level was as I am still waiting for my Patient Access to update with all the test results from the new bloods they took. The doctor reduced my Metformin to 1000mg per day due to the nausea and started me on 0.75mg Dulaglutide weekly injection.

Initially I felt fine, but since having the second injection earlier this week, I have had a migraine that just won't go away. I have also been feeling mild hypo symptoms (dizziness, nausea, palpitations, clammy palms). I assume that this is a false hypo and is normal while my body adjusts to lower BGL???

I don't have a glucometer yet, so I can't see if that is the case. There is a 3 week wait to get even a telephone appointment with the GP.

Any advice or reassurance welcome!

Thank you, Goonergal!
I did get a similar leaflet with the Trulicity, but don't recall the section on hypos. I couldn't have read it as well as I thought I had! :/

I will give the GP a call and see if I can get an appointment sooner than the 3 weeks they are currently estimating on Patient Access.

Daibell said:

Hi. Do buy a meter as it's an essential piece of kit for us. Do you have excess weight? The Glutide meds are normally only given where there is a need to reduce weight and they do have some side effects for some. The best way to lose weight is to reduce the carbs in the diet. BTW if you have issues with metformin do ask the GP to change you to Metformin SR, the Slow Release version as it's much kinder

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Yes, my BMI is about 37, having struggled with my weight for a number of years. I have already lost some weight (7lbs since starting the Metformin SR at the beginning of January). 2lb of that is since starting the Trulicity last week.

I didn't have nausea as such with the Metformin, it was more a loss of appetite and aversion to certain foods; akin to what a pregnant lady might have. I can't stand any strong flavours or aromas at the moment. The nausea is new since starting the dulaglutide and I think it is more to do with a drop in BGL as it is always at the same time as having palpitations and dizziness.

As I haven't seen the dietician yet, I don't want to change too much yet as I also have other health concerns that may be affected. I have already started to make simple changes to portion sizes etc and have reduced the amount of bread and high sugar fruits that I eat.

Thanks for the info about carbs in T2. I plan on getting low-carb bread. I tend to have overnight oats for breakfast, and as I still have loads in the cupboard thought I would mix the oats I have left with hemp and chia seeds at a ratio of 1 part oats to 1 part seeds so that I am halving the carbs at breakfast. I know that the Metformin is less effective in a high fibre diet, and the chia and hemp are high fibre, so I hope I'm not going too far there...

Daibell said:

Hi. Do buy a meter as it's an essential piece of kit for us. Do you have excess weight? The Glutide meds are normally only given where there is a need to reduce weight and they do have some side effects for some. The best way to lose weight is to reduce the carbs in the diet. BTW if you have issues with metformin do ask the GP to change you to Metformin SR, the Slow Release version as it's much kinder

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This might be a silly question...
You say that I should buy a glucometer. Don't I need a prescription to be able to buy one?
I use a CPAP for sleep apnoea and I can't just buy one if I choose not to use the NHS issued one - I have to show a valid prescription at the time of purchase.

The Dr at the hospital last week said that she would refer me to the local support services to get me a glucometer. It isn't even dealt with by the GP! Such a minefield and so many different services.

If I don't need a prescription, I will order one today!

Estragon said:

@CJLeeUK - Man Alive! My blood is boiling over. You need help and guidance NOW! This is not your fault. You need support and direction.

Please please please keep us informed!

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Thank you! Yes!!!
I am reluctant to make too many changes on my own in case I do more harm than good. But I also don't want to do nothing because that's already left me with BGL of over 3 times the norm.

TriciaWs said:

Dieticians are not always up-to-date on research on low carb for T2.
I ignored the advice mine provided as I knew more about it than she appeared to. As a result I lowered my blood sugar quickly, and it only took a few months to get into remission.
The nurse at my surgery was amazed and asked for the website for the lowcarbprogram.
The program is available via the NHS in some areas as it is approved by the NHS (but some local trusts won't fund it).
You can get more information about that programme on this site, or if you want just read up on Jason Fung, Dr David Unwin, etc.

In order to get the best from going low carb you'll need a meter so you can check how many carbs your system can tolerate.

My usual breakfast, as I don't like eggs etc first thing, is a low carb porridge made with milled flaxseed, chia seeds and a little oatbran - I add some extra seeds such as pumpkin and some nuts plus cinnamon and mix it with water, then have it with double cream. I slowly up the flaxseed and decreased the amount of oatbran over a few weeks.

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Thanks so much, TriciaWs.
I will get a glucometer and try flax as well! Sounds like I was on the right lines by substituting some of the oats with seeds. I make a pumpkin seed, sunflower seed and chopped nut mix that goes with it too, as well as some apple or blueberries. I am substituting my usual honey Greek yogurt for plain Greek yogurt and making sure to get a no-added sugar, full fat version.

I have also reduced my morning large glass of orange juice to a small orange juice topped up with sparkling water until I can wean myself off.

Goonergal said:

Be careful with meters. The cost of the strips is most important as they’ll be what you spend most on. Don’t be seduced by offers of free meters with expensive strips!

The meter with the cheapest strips is the Gluco Navii (the Codefree, from the same provider has similarly priced strips, but is being phased out). https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/. https://homehealth-uk.com/all-products/gluconavii-blood-sugar-meter-glucose-monitor-starter-kit/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips. Buying a pack of 10 boxes of strips using the discount code works out at £5.68.

The Tee2+ from Spirit Healthcare also has relatively cheap strips, (although they have recently gone up in price): http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ with the strips found here: http://spirit-healthcare.co.uk/product/tee2-testing-strips/ I got a free Tee2+ by phoning up to order the meter and 10 boxes of strips and they threw the meter in for free. Phone number 0800 8815423. I daresay home health would do the same.

Also from Spirit Healthcare, with more expensive strips than the Tee2+ is their Caresens Dual. This can be used for testing ketones too (strips for that very expensive). https://shop.spirit-health.co.uk/collections/caresens-dual

Don’t forget to check the box (or mention on the phone) to say you have diabetes so you can buy VAT free. (for all meters and strips).

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Thank you. That is really helpful.