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So confused!

N

Nik_C

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi everyone.

I'm Nikki and was diagnosed with type 2 diabetes 3 weeks ago. I ended up at our local a&e due to it being a Sunday and my blood sugar was 20.1mmol/l. The doctor initially started me on 40mg of gliclazide but the following day the diabetes nurse at the hospital wasn't happy with that as she felt metformin was the better medication. I then started taking 1x500 mg of metformin in addition to the gliclazide. A week later I saw my own GP who upped the metformin to two tablets. She also wanted me to continue upping the metformin on a weekly basis until I am taking four tablets and continue the gliclazide.

I have also totally changed my diet, reducing sugar, carbs particularly and alcohol.

After a week of taking two metformin and the gliclazide I was feeling awful! My bg levels before meals was dropping to under 4. I took it upon myself to stop the gliclazide as I believe this was the issue.

Overall now my bg levels have changed dramatically. My morning level is my higest at around 7-7.5. The average for the day is 6-6.5. I have lost 8lb with the diet changes.

I didn't increase the metformin so am just taking two. I desperately want to control it myself.

I am seeing the nurse today. I am totally baffled by info relating to levels and medication. Am I too hopeful that I can currently stay on just two X 500mg metformin? I realise my levels were very high on diagnosis but my GP didn't seem to promote self management through diet and just wanted to discuss medication.

Any advice would be helpfully as I want if possible to avoid the nurse increasing my med.

Many many thanks
 
Hi and welcome. If you have excess weight then your T2 diagnosis is likely to be correct. Metformin is the drug of choice to start with and is very safe so increasing it as you were guided to do makes sense. Gliclazide stimulates the pancreas and is normally used for those who may be late onset T1 and typically slimmer. I suspect it was the Gliclazide causing your low sugars and I would suggest you talk to the nurse and say that you may not need it? 40mg is a very low dose (I was on 320mg for years!)
 
Hi @Nik_C and welcome to the forum. It is up to you if you want to take medication. Your GP or nurse may well suggest meds, it seems to be NHS policy, but it's for you to decide whether to accept the advice.
Your bs of 20.1 was high so it is understandable that meds were prescribed. Metafornin does help, and people on here who use it don't seem to have any problems with it. It is also supposed to suppress appetite so helps with weight loss.
You seem to be doing well managing your condition. So if you don't want to increase the meds tell the nurse you want to control your blood sugars by diet and exercise, and will see how that works.
You should have another HbA1c blood test within 3 months so can review your meds then.
 
I still feel ill after taking Metformin and year on. Sounds to me you know what you need to do I dont feel I will ever feel any better unless I loose weight which I am trying to do.
 
@Nic_C

Hello Nikki and welcome to the forum :) Here is the information we give to new members and I hope you will find it helpful, especially with respect to carbs and the Low Carb Program. Ask more questions when 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 well over 210,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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 blood glucose 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.
 
Thank you everyone!

I read your responses before seeing the nurse and I stood my ground on not increasing metformin. Thanks to the replies I felt more confident doing this.

I know it's early days and I may well need to up my dosage but feel loads better at least being able to try and control it mainly through diet.

Thanks again.
 
Hi @Nik_C , welcome to the forum. Now that you have stood your ground you should work out a plan to achieve the same result or better than the advised increase in medication. You have made a start and there is plenty advise and support here but you are the one who has to carry it through. Also don't forget that for type 2 there are two aspects to self help, diet is one with exercise being the other.
 
Hi @Nik_C and welcome
My fasting reading was 18 at diagnosis so I would encourage you to try and keep going particularly as your nurse is aware of how you want to manage your diabetes. I am diet controlled and now have readings in the non-diabetic range so I do think for some of us it is possible and worth trying. As you are monitoring you levels you will know if things are working which they seem to be even at this early stage. It took me several weeks to get my fasting readings to under 7. I worked on diet, weight loss and walking.
Do read the info from Daisy and come back and ask questions.
 
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