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Struggling

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titanmuse

Newbie
No matter what I do my HB1 has gone from 58 to 78 over the last 14 months. So yesterday the diabetic nurse practitioner (a completely new one to me whipped through the appointment in just over 5 minutes and gave me the choice of Pioglitazone tablets or Mounjaro injection. I'm not over keen on needles so went for the Pioglitazone 15mg. I'm under enought stress at work without discovering all the side effects. Today I discover that she is also putting me on something called Empaglifozin 10mg. This is on top of 20 mg glicazide twice a day and 10 mg dapaglifozin. I had to give up on Metformin as it was too good at emptying my bowels with 20 seconds notice:( Earlier today had a chance to look at the side effects for Pioglitazone and they are frightening - Common or very common. Bone fracture; increased risk of infection; numbness; visual impairment; weight increased. then I looked at Empaglifozin and those side effects are not quite as bad. But I'm 70 and had a triple heart bypass 14 years ago. Please can anyone help / reassure me about these drugs
 
Hi @titanmuse and welcome to the forum. I can’t comment on any of those medications as I have never taken them. However have you, or your nurses for that matter ever considered your diet? The current NHS guidelines don’t actually help type 2 diabetics. Many of us eat low carb and that, on its own or with a little medication helps keep our HbA1cs at non diabetic levels. Can you tell us what you eat in a typical day? I temper this with a little caution as on some meds low carbing can cause hypos.
Another thing that many of us do is test our own blood sugar levels at home, particularly before and after meals to see what different foods do to our blood sugars.
 
Hi @titanmuse. I've given pioglitazone a whirl for a few months, and found it didn't have any affect on my blood glucose, sadly, so did not warrent the potential side effects, which, like for you, I found a bit daunting!

This was very disappointing for me as I had high hopes for a drug that apparently sensitizers the cells to one's own insulin, if one, like me, is producing plenty of insulin oneself. (But am obviously highly insulin resistant.)

I have since read that one should give this drug quite a long period to start working, as in six months!(I can't remember where I read this - on some medications website. ) I may give it another go in combination with a drug I am on that has some effect, mild, but some - vildagliptin.

I think with all potential side effects one needs to look at one's physical cons and pros? Which is what your doctor and 'diabetes team' ought to be doing, and perhaps do? Hopefully! (I have not had this experience apart from my trusty GP.) How vulnerable are you to bone fractures/osteoporosis for instance? Cardio vascular problems? And conversely - how resiliant? This is what I did when looking at those scary potential side effects. As it was, I didn't have any, except one of those strange vision experiences in the wee hours of a morning. Which was a bit scary for sure.

But most hopefully, you have a good relationship with your GP or diabetes team member/s and can discuss your fears and hopefully be reassured by them?

You could try going through each potential side effect with your GP/prescribing medical professional, and hear what they say, considering your own health and diabetes presentation, is what I suggest.
 
titanmuse said:
No matter what I do my HB1 has gone from 58 to 78 over the last 14 months. So yesterday the diabetic nurse practitioner (a completely new one to me whipped through the appointment in just over 5 minutes and gave me the choice of Pioglitazone tablets or Mounjaro injection. I'm not over keen on needles so went for the Pioglitazone 15mg. I'm under enought stress at work without discovering all the side effects. Today I discover that she is also putting me on something called Empaglifozin 10mg. This is on top of 20 mg glicazide twice a day and 10 mg dapaglifozin. I had to give up on Metformin as it was too good at emptying my bowels with 20 seconds notice:( Earlier today had a chance to look at the side effects for Pioglitazone and they are frightening - Common or very common. Bone fracture; increased risk of infection; numbness; visual impairment; weight increased. then I looked at Empaglifozin and those side effects are not quite as bad. But I'm 70 and had a triple heart bypass 14 years ago. Please can anyone help / reassure me about these drugs
Click to expand...
I'm so sorry things have been rough, and you haven't exactly been heard by the people who are supposed to help you navigate this. Five minutes is nothing short of ridiculous.

Anyway, yeah... If you're worried about medication and side effects, a low carb diet could indeed help, but like others have mentioned, with what you're on, you are likely to experience a hypo (mainly due to the Gliclazide and Empaglifozin combo driving your blood glucose lower than it needs to, if you eat fewer carbohydrates). So if you want to try a lower carb way of eating, it'd be preferred if you don't try it alone, as your medication might need adjusting. Use a meter to keep an eye on your blood glucose, around meals and whenever you might feel a little off. And don't dive right in, just start very carefully, with small adjustments. Anything big might have too large an effect, and you don't want to hypo. If finger pricking is an issue (dunno how anti-needle you are), you might want to look into a CGM, which is a monitor stuck to your arm. Still will need a little prick, but then it stays in for 2 weeks.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- might help a little with the basics of lower carb eating. But again, do be very, very careful if you go that route, and if at all possible, try to get the nurse in your corner. Easier said than done, but if your meds need adjusting, the help would be nice.

Hang in there eh,
Jo
 
JoKalsbeek said:
f finger pricking is an issue (dunno how anti-needle you are), you might want to look into a CGM, which is a monitor stuck to your arm. Still will need a little prick, but then it stays in for 2 weeks.
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just to add a little info on cgm. if low/high its recremmend you check via fingerprick. will be a lot less fingerpricks than otherwise so imo awesome :D

heres a couple links to free trials of both dexcom and libre cgm brands thats 25 days free right there. ensure to take full advantage of any trial via marking down all meals and effects on your glucose levels alongside test various things out such as exercise walk 15/30 minutes shortly after meals.

https://www.dexcom.com/en-GB/one-plus-campaign-sample? (10 days)
https://www.freestyle.abbott/uk-en/getting-started/sampling.html (15 days)
 
Thank you all for your replies. I have managed to cope with the twice daily finger pricking but regular injections are different (think daily anti-clotting? injections into abdomen instead of those white elastic stockings when I was in hospital for my CABG). When I first started testing over 2 years ago, I managed to get my daily glucose readings down from around 11 to around 7. that was with low carb. But then things started to go up and I am now at daily readings of 13 or 14. I thought I was still doing low carb but maybe I'm not without realising - time to again start writing down everything I eat. I'm one of the lucky people who have never had a bone fracture in their life and I certainly don't want to start now. My CABG was a few years back now but I know it won't last forever. I was originally on Metformin and coped OK for a while but the bowel problem suddenly started so I was move to the SR version. The frequency of the problem decreased but the problem didn't go away - at least where I work people have got used to me suddenly rushing out of the room but it's very embarrassing when I'm in the middle of a public meeting. Hubby is retired emergency ambulance staff so at least he recognises a hypo and knows how to deal. and thanks for those links @grantg - I'll check them out.
 
Are you sure she intended to put you on empaglifloxin and dapaglifloxine together? Both these drugs work in a similar way and I’ve never heard of people being prescribed both. I’m not medically trained though so I could be wrong. Please check with your pharmacist before taking both just in case.
 
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