Tablets effecting BM

[DeepThought]

I have been a type 1 for 23years and my diabetic care has been complicated by more than a few other chronic conditions (Systemic Lupus, ostio arthritis, high BP, Vasculitus, asthma and mini strokes are to name a few), along with an unrelated hereditary kidney disease (PKD) resulting in a kidney transplant after 12 years of dialysis (don't ever work in a nuclear related environment if you can help it!).
As the years have gone by, my medication has increased exponentially; to the point where I am now 'consuming' 233 tablets a week. I say 'consuming' because my blood sugar levels most definitely increase a short while after I have taken them. I may wake up in the morning with a BM reading of 7 or 8 mmol's but, after I take my morning medication at 9am, my BM increases to 12-15mmol's or so. I now have to take extra insulin to cover the increase resulting in taking my medication 4 times a day.
My problem however, is that no one at my hospital clinic or Dr's surgery wants to discuss or tackle the problem. I am sure I can't be the only one to experience this extra meal effect through taking lots of medication.
Other than continuing to avert the problem by taking an insulin injection with tablets, can anyone advise me as to how I can remedy this problem?
The reason I ask, is that I had a kidney transplant two years ago that saw the majority increase in tablet intake, since then I have really struggled to keep my weight under control. I eat really healthily but still keep puting on more weight each month. I have been stuck in the usual catch 22 position of needing more insulin to combat increasing blood sugars, followed by weight gain requiring more insulin etc. My Diabetic team say I need to diet but dietetics say there is nothing more I can do to loose weight; in fact they want me to eat more meat and more healthy fats. At the time of my transplant I was 93 kilo's, I am now 128 kilo's. I am at a loss, worried and have no one to answer my question. What can I do?

 

[Juicyj]

Hello @DeepThought and welcome to the forum.

Sadly with the amount of medication you are taking it would be quite hard for anyone on the forum to comment on this, what struck me though is that with the levels of medication you are taking that your team should really be on top of this simply due to the fact that with taking medication there can be reactions between different medications and this should be monitored for your BG's sake. I appreciate because of the specialist nature of your condition with the kidney transplant that your GP would be too 'general' to offer specialist advice, so can you get a referral to a specialist at either your local hospital or at another one with a larger hospital ? It is quite clear that you need to be under the guidance of a specialist team to help you. Sorry I can't offer any more help than this x

 

[Daibell]

I would suggest you ask your local pharmacy to do a medicines review. A good pharmacist will just take a view on the tablets and any that are in conflict or will increase blood sugar or even that may no longer be needed. I suspect you may have some steroid tablets in your list and these can dramatically increase blood sugar. After that I would then see the appropriate GP/consultant to see whether any of the meds can be reduced or removed. Doctors very often add meds without reviewing what you are already on.

 

[DeepThought]

Thank you JuicyJ for your comment. I live in a very rural area of the North East and my GP practice gives me far from adequate patient care. A few months ago, my Dr gave me antibiotics for a bladder infection that started to affect the viability of my transplant, it was only because I had a renal appointment and mentioned the medication that saved my kidney. I was told to stop the tablets immediately to prevent permanent damage as the antibiotics in question were known to instigate transplanted renal failure. Incidents of this nature have occurred too many times over the years but there is no other GP practice I can go to without involving the same Dr's. The draw back of rural living I suppose.
I recently moved my Diabetic care to a much larger and better hospital and have much more confidence in the new team. The last Hospital I used to attend for Diabetes did not even send my GP, or myself, anyletters concerning visits let alone address the issues of long term diabetes. The new team want me to try a new treatment for weight loss for T1 patients, however, they tell me that it has never been done on a transplanted patient before and it could well present its own complications. Needless to say, I am pretty reticent about starting this kind of treatment and wish to take things one step at a time. I have been fortunate enough to have had the same team member several times now and it helps immensely with the continuity of care. She is a very nice person and actively makes herself aware of my concerns; she has helped me to formulate an alternative diet before we get to try out the alternatives. Sensible advice indeed, but it does not address the other issue. As you are no doubt aware, the time restrictions at these clinics are very limited and I have tried to broach the subject of medication affecting my glucose readings and the possibility of interactions, her suggestion is for me to ensure my GP acts as coordinator between all my different clinics and to monitor such things. Quite simple, I personally think my GP does not want the job and on those occasions I have spoken to him, his reluctance is obvious as he always tells me to speak to the relevent clinical team. Clinical teams don't seem to want to address issues that may overlap with other disciplines and so I am left 'high and dry' as it were. I do not wish to call into question the abilities of my GP to act accordingly, but the situation speaks for itself. I fully understand why other medical professionals are reluctant to hear criticisms or complaints relating to others in their profession but it is so frustrating after so many years of going around in the same circles. For example, my renal transplant team do not comment at all on my weight gain since transplant, and do not have the time to address my concerns or worries, they are only interested in the function of the new kidney and see me every 6-8 weeks. It has often been the case for me to research my own symptoms and problems, subsequently taking my own action. This has prevents major complication on a few occasions. There has been the odd occasion where I have had to go armed with the appropriate information to clinics/GP to present my case. It has been my experience that most Dr's do not like this very much and hate the Internet for informing patients. None of them ever look at the data but it makes them pay attention to what I am trying to say. This does cause a certain amount of tension at the appointment but I have felt I had to do this because it is my life at risk. I really do think that many Dr's look at an obese patient and think 'fatso so should cut back on the pies'! I had one renal Dr tell me that "you can only put On what you put it in". How can I get anywhere with that kind of ignorance? There is no need for you to reply to this post, I just wanted to give you an idea of what it's like in the NHS for someone Dr's regularly refere to as 'complicated'.