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Newly diagnosed and totally confused

Discussion in 'Type 2 Diabetes' started by midiman, Apr 16, 2020.

  1. midiman

    midiman · Member

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    Hi, I was diagnosed as being Type 2 in January this year 2020 with a high hba1c score of 110. So, my GP decided to put me straight onto Metaformin and review me again in April.

    Since then I have made some major lifestyle changes to my diet and tried to cut out as much sugar as I can.

    At my recent check up the other day my Diabetic Clinic Nurse said that my hba1c score had gone down, but not as much as they would have expected in 3 months and that it was now at 70. So, she said she was going to ask the Doctor to add 2 x 40mg of Gliclazide to my plan and give me a blood testing machine.

    Now I'm totally confused, and scared because the Gliclazide adds a whole new level of side effects that contradict what I have been doing.

    Over the past week I have refined my diet even further, and I am now only eating meat, fish, eggs, and cheese in order to stay under 20g of carbs a day. But, the Gliclazide instructions say that I can't miss a meal and that I have to have some kind of carbs and sugar in my diet to stop me from going into a low blood sugar hypo state!!

    I have not started the Gliclazide yet because I am worried about what it will do, and I would prefer to bring my blood sugar levels down by means of a strict LCHF diet, exercise and metaformin.

    My point is do you think I have given it enough time. Should I continue with my near zero carb diet, exercise and metaforim for a while longer, and then get a retest in 3 months’ time? Or should I start taking the Gliclazide on top of my Metaformin now in order to get my hba1c level down as fast as possible.

    Thanks
     
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  2. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    First - your diabetic clinic nurse has completely ignored your diet - I assume that you told her about it, though you report reducing sugar - is that actually carbohydrate or have you been eating starches?
    You have been prescribed something you know that you should not be taking on a low carb diet, so second, I suggest that you contact your GP - or send an email or letter, and go over the information again - then perhaps suggest that as your levels have not dropped as would be expected if you were an ordinary type two, that you might be some other type.
     
  3. Brunneria

    Brunneria Other · Moderator
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    Your HbA1c dropped from 110 to 70 in 3 months.
    That IS a big drop, and it will have been almost completely due to diet change since while Metformin has an effect on blood glucose, the effect is nowhere like as large as a 40 point drop on an HbA1c.

    congratulations for that reduction by the way. You should be proud of yourself. :D

    Gliclazide is a much more powerful drug than Metformin, and my concern would be that if you have reduced your diet to under 20 g carbs a day, and then add Gliclazide on top, you may push your blood glucose down into some nasty hypos.

    did your nurse prescribe you a blood glucose testing meter and instruct you on how to use it?

    If not, then I would strongly urge you to get one (shop around, some brands are much more expensive to keep supplied with test strips! I use the Tee2 myself).

    by testing your blood glucose you will be able to see whether your less than20g carbs has brought you down lower, and then you will be able to make a much more informed decision on the Gliclazide. Your testing results will also be useful discussing the matter with your nurse.

    Not everyone’s body will allow them to control bg with diet, or with diet and Metformin. Some of us need extra help, and Glic can be a very useful drug, but it is very important to know what blood glucose levels are, and avoid hypos.

    please let us know how you get on?
     
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  4. resander

    resander Type 2 · Well-Known Member

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    You may already know, but here is a summary:

    Foods: Carbohydrates and Fats and Proteins
    Carbohydrates: Starches and Sugars

    Starches: Potatoes, Rice, Pasta, Bread, Porridge, Beans, Vegetables, Cereals, Anything containing flour,...

    Sugars: Granulated/cubes, Fruits, Biscuits, Cakes, Candies, Frosties, Soft drinks,.. (sweet taste)

    The body converts carbohydrates to glucose (blood sugar) needed for energy. People with diabetes need to know and carefully monitor glucose levels and carbohydrate intake.

    Nutrient information is available online in the major super markets, for example at: www:asda.com, www.tesco.com and www.sainsburys.com
    To get the nutrients of Baby Spinach at ASDA:

    - goto: www.asda.com
    - enter search key: Baby Spinach (shows a list of matches)
    - click on the spinach match wanted, for example:

    ASDA Mild Tender Baby Spinach Per 100g
    Energy kcal 20
    Fat 0.6g
    Carbohydrates <0.5g (less than 0.5g)
    Fibre 1.0g
    Protein 2.6g
    Salt 0.08g

    Meat, fish, chicken, high-content meat sausages, bacon, eggs, cheese usually have no carbohydrates.

    Food labels in EU are standardised and most supermarkets show the same nutrients.
     
  5. JoKalsbeek

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

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    It's not advisable to mix Gliclazide with a low carb diet, as you'd very likely hypo. And believe me, those are NOT fun. Eating carbs to accommodate taking medication is a bit backwards, probably. It's between you and your doc though, as we can't give medical advice here. Just something to think about; your idea of just trying this for 3 more months and re-testing then is a good one, though I'll touch on that some more in a sec. As for your HbA1c, you did pretty good, especially having been thrown off the deep end, so the response you got after just being put on metformin with no further guidance... Is a bit disappointing. And probably typical too: just throw more medication at the patient. Ah well. You've moved on to a ketogenic way of eating, and that will make quite the impact on your blood sugars. Get yourself a meter and watch a miracle happen<-- no waiting for 3 months, but getting results in real time. It's a great motivator. ;) Mind you, I'm missing above ground vegetables and the like in your current diet. While going full carnivore is fine, (and quite a few here swear by it), you might want to have some veggies, for variety's sake. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html has some ideas, and there's a load of ideas over on dietdoctor.com and diabetes.co.uk .

    Good luck!
    Jo
     
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  6. sarahmorter2

    sarahmorter2 Carer · Member

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    Hi - well done on your amazing HbA1c reduction - this is fantastic. 110-70 on your own.. don't underestimate that.
    I'm not T2, but my hubby has been for about 12 years, he's been low carbing for the last 2+ years, and brought his levels down from 101 to around 50-60. However, at his last annual check, he mentioned that he takes less insulin by injection now because he eats 'low carb' and his nurse advised that "perhaps he should start eating more carbs so he can take his medication". My message to you is not to just ACCEPT what they say - LISTEN and REFLECT and share with community here - they are so helpful. More recently they put him on Gliclazide 40mg, to bring his BG levels down further, but this has not had much effect.
    There is life after T2 - Keep your chin up - you are doing great :)
     
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  7. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    Just to emphasise - you should not start to take Gliclazide whilst on a very low carb diet - the nurse should know that - the doctor ought to know that. I strongly advise consulting the doctor and explaining your diet if you are urged to take a totally contra indicated medication. We are not supposed to give medical advice, but when medical advice is so very doubtful...….
     
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  8. midiman

    midiman · Member

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    Hi, yes I am going to seek a second opinion and ask to speak to a doctor.

    It's early days for the strict near zero carb diet for me and I don't appear to be losing any weight.

    But at least I know what I am eating has no carbs or sugar in it.

    Thanks
     
  9. midiman

    midiman · Member

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    Hi Jo, all of this Corona lockdown doesnt help. I had to have a telephone conversation with them and she sounded hurried and just wanted to get me off the phone.

    I had to get to the practice to pickup a blood monitor but it wasn't explained to me at all because I wasn't allowed in the building.

    So I ended up going home with boxes of Glicazide and a Monitor to use without any information.
     
  10. midiman

    midiman · Member

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    Hi,

    This is all that I have been living on for the past week now Meat, fish, chicken, sausages, bacon, eggs, cheese and I am sticking to it for ever because I want to get my hbac1 back to a normal level.

    But i,m still not losing any weight.

    Maybe thats something to do with the BP medication that I am on.

    Thanks
     
  11. midiman

    midiman · Member

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    Hi, all of this Corona lock down doesn't help. I had to have a telephone conversation with them and she sounded hurried and just wanted to get me off the phone.

    I had to get to the practice to pickup a blood monitor but it wasn't explained to me at all because I wasn't allowed in the building.

    So I ended up going home with boxes of Glicazide and a Monitor to use without any information.

    I've got a AgaMatrix WaveSense Jazz with 25 strips and 30 lances. The quick start guide looks ok, but it would have been nice to have someone show you what to do. I'm going to have to read up about it this weekend.

    Thanks
     
  12. Rubette

    Rubette Type 2 · Member

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    There is so much information out there, and misinformation from diabetics who follow their own path...it’s confusing to say the least. I find the figures confusing... for example, my diabetic nurse said she wasn’t my number to get down to fifty. Fifty what, her answer confused me!
    If any of you have routine blood tests at your surgery, are you attending or preferring to remain in isolation?

    Good luck to all on here, stay safe.
     
  13. Daibell

    Daibell LADA · Master

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    I agree with the other posts. If you do decide to start the Gliclazide only use one 40mg tablet and only when you have the meter. You can then check your BS level. Gliclazide lasts up to 10 hours or so. The low-carb diet is far more important than the medication so keep that going. Its always possible you are late onset T1 and not T2. if so the Gliclazide may well be needed over the coming months. If the BS does not continue to come down and you are slim, consider asking for the two T1 tests.
     
  14. JoKalsbeek

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

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    They have to give you a monitor when they put you on Glic, simply because it can cause hypo's. You'd have to test before driving to see if you're okay to drive. (I think it's 5 to drive, but as I don't have a license myself I'm not 100% on that). If you're lower you have to eat to get your numbers up, or risk being uninsured when you get an accident. That's basically the impact Glic can have on your life: always having to be careful not to hypo. I responded badly to metformin and was switched to glic, but also had started on a low carb way of eating. My own endo didn't know that gliclazide causes hypo's when you're low carbing! She kept telling me it wasn't possible, while I was hitting below 3,5 mmol's regularly. (I self-funded the strips, I still do). Hence the warning. It's in the leaflet, but hypo's really are no fun at all. In the end I got rid of the glic with my GP's backing, haven't been on medication since, with non-diabetic blood sugars.

    As for testing: Put the pen against the side of your finger, not on the pad. There's a lot of nerves in there and if you test often, which is advisable especially when you're starting out, you don't want your finger to hurt. Set it to 2 or something, because you don't want it to go too deep. Just start there and see whether that'll get you the required drop. If you're going low carb, test before a meal and 2 hours after the first bite. If your values go up more than 2.0 mmol/l, then there were more carbs in the meal than you could handle. I know, if you only have 25 strips, that's not going to last you very long. Sorry. A lot of people here self-fund a meter, and it's the strips that are the expense, so if it comes down to that, get a meter that's got less dear strips, like the Tee2.

    There was no Corona when I was diagnosed, but everyone was on holiday, so it took months for me to see everyone I was supposed to see. It's a scary time, being diagnosed, and if you're left to your own devices it's, well... Traumatic. It's bad enough getting a life changing diagnosis, but being left on your own with it, whatever the reason, is HARD. For me, what helped, was reading Dr. Jason Fung's the Diabetes Code. I learned everything I could about diabetes and how to treat it with food, what the terms, goals and expectations were... It helps if you know what's going on. This is an entirely manageable condition that doesn't have to lead to painful, possibly deadly complications, contrary to what the general public, and some GP's, think. You do have a say in this.

    Good luck,
    Jo
     
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  15. JoKalsbeek

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

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    Hey @Rubette ,

    The 50 mmol/mol will be your HbA1c, the average of 3 months' worth of blood glucose, which is just barely in the diabetic range. You should be able to get it back into the prediabetic and then, non-diabetc range soon with just a few tweaks in your diet. So yes, here's another diabetic who marches to the beat of her own drum's advice: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html If you're up for a long read though, try Dr. Jason Fung's the Diabetes Code. It deconstructs the dynamics of this whole condition, and it helps to know what's going on in your body and what to do about it. And hey, don't take some stranger's word for anything on the internet: Trust your meter. If you want to try someone's advice or other, test before a meal and 2 hours after the first bite. If you went up more than 2.0 mmol/l, then that meal was no good for you. (Because your body couldn't process what was put in). A meter is a completely unbiased tool, it won't try to sell you on some diet or dogma. It just tells you what works specifically for you. Because you know what? Your needs may differ from mine, or the next forum attendee, or the next. Your insulin resistance/sensitivity and output are like fingerprints: they're quite unique. I eat 20 grams of carbs a day or less, so I usually hover around 9 grams per day. That works for me. Could well be you do fine on 40 grams a day, or 80. Maybe even 120! You won't know until you test and find out what suits your needs best.

    Good luck!
    Jo
     
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  16. Rubette

    Rubette Type 2 · Member

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    The 50mmol she mentioned is the figure the nurse wants me to achieve, the meds aren't doing much good any more as I am at 124, hence the need to start insulin.
     
  17. midiman

    midiman · Member

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    Hi Jo,

    The Nurse said that I should be around the 50 mark and that I am currently at 70. I'm going to ask to speak to one of the doctors because she is not much use and they keep changing who I speak to all the time.

    I managed to get my hba1c down from 110 to 70 in 3 months, and if I can do that again then I would be down to 30. Not forgetting that during the first 3 months I have not been on a strict low carb diet. Now I am on under 20g a day so my next hbac1c would be telling.

    I used to have a really good Nurse that was looking after me but like I said all this Corona going on has disrupted everything and I cant get to see anyone in person. I' don't know how much the strips cost and it looks like that I may to self fund them myself too.

    I'm reading the instructions now and it says that my readings would be
    too high 10mmol/L
    too low 4mmol/L

    I will see if I can take a reading tonight.

    Thanks
     
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  18. midiman

    midiman · Member

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    Hi Jo,

    I tried taking some measurements but I can't even get the machine to work.

    It keeps giving me an error once it takes the blood. I have spoken to my clinic and they have suggested that I go to a Chemist to make sure that I am doing it right, and come and see them if the machine is faulty.

    Question [I don't seem to get betting a lot of blood coming out of me either when I lance myself. I have set depth settings to low and high and taken it from the side of my finger, palm and forearm but barely anything comes out and its making a mess of me with bruises]

    I have the Aga Matrix WaveSense Jazz monitor.

    Thanks
     
  19. Tipetoo

    Tipetoo Type 2 · Expert

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    Here's an instructional video that will show how to use you meter...

     
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  20. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    You don't have to take the Gliclazide, you can't be forced to take it. Just remember that, it's your decision to take it or not, and your progress is to be commended. Why on earth you would want to change good progress with the addition of a drug that carries serious risks on low carb diet is beyond me.

    The real enemy here is insulin resistance (IR) - gliclzide makes IR worse by forcing the pancreas tp produce even more insulin which the body has become resistant to in order to protect your organs from too much insulin. You have done a great job in 3 months, that is how you reduce IR. So why change what you are doing when it is clearly working?

    Again, it's up to you to decide whether to take it or not.

    In regards to testing, if your fingers are dry, wash them under some warm water then dry them on something clean and then try, make sure you set the depth at a comfortable level on finger pricker... it is adjustable.
     
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