Type 2 - Worsening Conditon

[chriswalke]

Hi

I have been diagnosed as a type 2 diabetic for four or five years now (forget precisely how long!!). ON initial diagnosis I was prescribed 30mg gliclazide which worked very weel for a time, so much so that I found myself having to eat emergency rations as my blood sugars would, occasionally dip too low. As time went on my blood sugars started to rise to the pint that I was prescribed 500md metformin as well as the same gliclazide, Again this worked for a perios and to cut a long story short I now take two gliclazide (30mg) and two 850mg metformin tablets (in morning and evening) per day together with an aspirin, cadesartan, ramipril and simvastatin. However it is now noticeable that my sugars are rising to higher levels, sometimes 16, and more often that before. My sugars first thing this morning were 12.4. My latest HBa1C was 7.4. My doctor has never offered any advice on this but merely states that my HBA1C is acceptable and just keep measuring. I have never been offerred dietary advice and feel somewhat ignored and frustrated. I have been to my doctors on at least four occasions this year querying the blood sugar levels but came away feeling that I was just wasting their time. Keep taking the tablets. I am a little worried as to complicate matters I do only have one kidney and I would like the opportunity to preserve its life and I believe that the increase in my blood sugar levels will eventually have an effect on its function. I already have early gae cataracts in both eyes, reportedly and possible to to the onset of diabetes which are to be operated on in the near future. Any advice or feedback would be most welcomed.

 

[ShyGirl]

Hi, Sorry to hear you are having a rough time of it.
If you think your doctors are ignoring you , would it be possible to ask for a referral to your local hospital? As a patient with one kidney you need to be strict and probably need extra help. There's no reason why you shouldn't be aiming for a hbc under 6% so it's sad that you've been told 7,4 is fine , my consultant thinks 7 is too high .Doctors may be trained but it's our bodies that have to deal with complications if they arise so it's important to help yourself as much as possible.

 

[Dillinger]

Hi,

Have a look at the low-carb forum success stories for some inspiration; diabetes does not necessarily mean a continual decline. The diet is the key thing; once you've cracked that everything should come back into line.

Dillinger

 

[Dobbs]

hi chriswalke,
I really think modifying your diet will help you. You'll get varied opinions on how to vary it, but I personally found reducing carbohydrates considerably made enormous differences. I felt already a bit better after about a week and considerably better after a month or two. This forum is full of good advice about that.

 

[hanadr]

Hi Chriswalke
I too think you could do better with a reduction of carbs in your diet. If, in the early stages, you needed to take extra glucose to counteract the effects of Gliclazide, you were taking too much and it should have been reduced. It probably hawsn't done your pancreas much good.
Did you also put on weight?
You have 2 choices, more medication or radical rethink on diet.
Read through the diet threads and the "stickies" .
I've been diagnosed longer than you and manage on much less medication successfully! because I choose a low carb diet. this isn't for everyone, but it works for me.
If you want to know more about this tactic, pm me and I'll give you references to the books that helped me
Hana

 

[FordPrefect]

I would try and find another doctor 7.4 is not good at all running that level long term means a significant possibility of suffering from complications. 7 should be the absolute top but really should be less than 6.5 but even lower is better if you can manage it. You also need to consider your carb intake and reduce portion sizes of carbs and try and put more protein and even more veg/salad on your plate. If you can get a blood glucose testing meter so you can try out various foods and see there effect on your blood sugar levels different people seem to react differently to different foods although the GI diet is a good place to start its always best to test yourself!

 

[chriswalke]

Hi All

Thank you very much for all of your valued replies. I was originally, and still am on 30mg gliclazide which, I was told, is the lowest dose in a tablet. However, I now take this two times a day together with two 850mg metformin. These appear to have little or no effect and, in fact, my BG has increased since they put me on the 850mg metformin in place of the 500md metformin. Strange but true. The trouble is I cannot work out why this would be and how I reverse it. I am going to try a radical diet change to low carb to see if this can reduce my BG significantly. I will keep you posted.

Thanks all

 

[cugila]

Hi All

Thank you very much for all of your valued replies. I was originally, and still am on 30mg gliclazide which, I was told, is the lowest dose in a tablet. However, I now take this two times a day together with two 850mg metformin. These appear to have little or no effect and, in fact, my BG has increased since they put me on the 850mg metformin in place of the 500md metformin. Strange but true. The trouble is I cannot work out why this would be and how I reverse it. I am going to try a radical diet change to low carb to see if this can reduce my BG significantly. I will keep you posted.

Thanks all

You are on a very low dose of Gliclazide which can be increased and should help reduce your Bg levels. I think that this coupled with a change of diet may be more beneficial to you.

I also think that a change of tactics is called for. After checking over the previous posts in this thread I notice that nobody has suggested you get referred to a Specialist, an Endocrinologist. It is patently obvious that your GP has no idea and is not supportive. That is simply not acceptable.

So, my advice to you is get a second opinion, a referral. If your GP won't go with this, then change GP's and ask the new one. It is your life we are talking about.

 

[chriswalke]

HI All

Thank you very much for all of your replies. After careful consideration I decided that the best way forward in order to try to regain some control over my BG was to adopt a low carb diet. I have for the last three days avoided most carbohydrates like the plague and the result has been quite encouraging insofar as my BG is lower than it has been for the last few years save last night when, for speed and other committments, we had to have fish and chips. My BG has gone from its usual 10 - 12 in the morning to 7 ish. I now have to work out how to make a balanced diet taking into account those foods that are grossly affecting my BG. I even managed to get a call back from the specialist Diabetic doctor at our surgery who suggested that I go to see the die£ician for advice...Hmmmm and also that I could safely take one of two more gliclazide tablets during the day. I think that it may be better to see the effects of the low carb before altering any meds though. I will keep you posted. All of you advice has been gratefully received and I would like to thank you all.

 

[Irishroyalty 1]

I have been a diabetic now since 1995, my gp is ok with my readings of 7 to 10 but says i should try my best to keep levels below 10. best readings i get is 5 to 7, so i dont understand what all the fuss is about, you will never get 2 doctors to agree on anything, i 2 was on Aspirin 75mils, this caused heart failure in feb of this yr due to massive internal stomach bleeding, too many doctors are in the pockets of pharmaceutical companies for my liking. Irishroyalty 1

 

[hanadr]

Gliclazide has some side effects, such as weight gain and pancreas burn out, which I wouldn't want.
I have been diagnosed since 2003 and started on1/2 a gliclazide with 3 x 500mg Metformin. I was getting numbers up to 14 on that and the so-called balanced diet.[ latest Hba1c 5.3%}
Now I eat low carb, exercise a lot and use 2 x 500mg of Met per day. I keep my BG below 6 at all times[except when I had an infection recently]
It isn't necessary for T2 to get worse, but it will if you follow the guidelines most GPs give. Mine told me that I will inevitably end up on insulin.
I took charge, did all the research and can get by without any medication for several days.[that's as long as I've tried]
It's all down to eating fewer carbs.
the actual carb amount is individual, but pretty much everyone can benefit by cutting down. EVEN NON -DIABETICS
It's much simpler for the doctors if they get us all onto insulin. Then they can tell us to keep increasing the doses and nag when we inevitably put on weight. Which puts blood pressure up and increases insulin resistance thus startin the " downhill spiral".
The conventional method of treatment by pharmacy rather than by diet and lifestyle, proves them right AND makes a profit for the Pharma companies.

 

[Sweet enough]

Hi Chris
I thought I was the only person in the world with only 1 kidney and T2 diabetes
I've found controlling carbs - or limiitng certain foods, works very well. My mornings have lowered from 15.8 to around 8/8.5 which while still high are almost half of what they were.
I've got to admit Ive fallen off the wagon and followed the NHS dietary advice this week and have had scary readings of up to 14 so I know its the foodtypes I'm eating causing the rises.
Breakfast is the main problem as even all bran sends my bloods shooting up. yet wholemeal pasta (50g uncooked weight :shock: ) has no effect, white bread makes it astronomical so is out alltogether and replaced with burgen bread - tasty but makes a great damp chipboard substitute :lol: and a galss of red wine lowers my BGL whatever I've eaten though the diabetic nurse tells me bl suffer next morning !

I got the impression from my Dr that I should follow the NHS diet advice and medicate to bring levels under control but even a week of that has wiped out the last 8 weeks work.
Rhinopathy results were negative so some good news !

 

[kentishman]

I am a very long standing T2 and had consistent high readings until the nurse said if I didn't lower my readings I would go on insulin. That did it.
As well as the usual medications I take Rosiglitazone twice a day and a low carb diet. Testing shows what puts up the readings. For instance, I find I can eat a decent helping of potatos but not muc bread. My HBA1C is now down to 6. A doctor sayin 10 is ok should be struck off.7 is the maximum you should strive for.

 

[wallycorker]

Hi Chris,

As a Type 2 myself, I recommend that the foods that you really ought to cut back on are the starchy carbohydrates - i.e. cereals, bread, potatoes, pasta and rice. Doing that usually leads to a big improvement of blood glucose levels in many Type 2s.

Personally, I can eat quite a lot of carbohydrate just so long as it is in fruit or veg form.

Best wishes - John

 

[hanadr]

Latest guidelines on HbA1c are; "less than or equal to 6.5%".
10 is so out of date, probably about 20 years. Until recently it was" Less than 7.5%"
Look at the leaflets put out by Diabetes UK [ they are useful for something. 8) ] You can download and take to your doctor.

 

[-Gordon-]

Yep, I'd agree with that.

My Doc aims for HBA1c below 7, but gives you one instance of up to 7.5.
If you go over 7.5, or have two consective months in th 7 - 7.5 region its time to review the medication.

This give you the chance to bring it down again through diet or excercise, or he'll introduce more meds.

 

[Sweet enough]

.............. I find I can eat a decent helping of potatos..............

Its amazing how different we all are in what we can tolerate ! I'm ok with 100g of Pasta, yet 50g of potatoes are like pure sugar to me.....which makes the "one size fits all" NHS dietry recommendations a farce- and a dangerous farce at that.

 

[kay957]

Hi

I have been diagnosed as a type 2 diabetic for four or five years now (forget precisely how long!!). ON initial diagnosis I was prescribed 30mg gliclazide which worked very weel for a time, so much so that I found myself having to eat emergency rations as my blood sugars would, occasionally dip too low. As time went on my blood sugars started to rise to the pint that I was prescribed 500md metformin as well as the same gliclazide, Again this worked for a perios and to cut a long story short I now take two gliclazide (30mg) and two 850mg metformin tablets (in morning and evening) per day together with an aspirin, cadesartan, ramipril and simvastatin. However it is now noticeable that my sugars are rising to higher levels, sometimes 16, and more often that before. My sugars first thing this morning were 12.4. My latest HBa1C was 7.4. My doctor has never offered any advice on this but merely states that my HBA1C is acceptable and just keep measuring. I have never been offerred dietary advice and feel somewhat ignored and frustrated. I have been to my doctors on at least four occasions this year querying the blood sugar levels but came away feeling that I was just wasting their time. Keep taking the tablets. I am a little worried as to complicate matters I do only have one kidney and I would like the opportunity to preserve its life and I believe that the increase in my blood sugar levels will eventually have an effect on its function. I already have early gae cataracts in both eyes, reportedly and possible to to the onset of diabetes which are to be operated on in the near future. Any advice or feedback would be most welcomed.

I have had the same trouble as you, but they put me on Januvia and my diabetes is better controlled and I don't have that many hypos anymore. The glclizide was the problem in lowering my BG levels too low, the Januvia solved the problem.

 

[babylonblue69]

hello i have been on tablets for 3 years the last 9 months i have had reading of 30.2 - 40.8 dayly i have been in a living hell on insulin now 4 times a day still thinking is it really wroth it i feel so low getting so tierd of it all the doctors have mismanage my diabetes its hard on my partner and children got a 6 month old baby girl am i going to be alive to see her grow up ?? have had hypers and now have hypos what am i going to do ! sorry shouldnt go on doctor dont know what to try on highest dose at moment i hope you in furtue you can help youself if you feel you are not getting the treatment you want and need find out for yourself whats out there and ask . its your life there is no wrong treatment look for yourself and always ask

 

[cugila]

hello i have been on tablets for 3 years the last 9 months i have had reading of 30.2 - 40.8 dayly i have been in a living hell on insulin now 4 times a day still thinking is it really wroth it i feel so low getting so tierd of it all the doctors have mismanage my diabetes its hard on my partner and children got a 6 month old baby girl am i going to be alive to see her grow up ?? have had hypers and now have hypos what am i going to do ! sorry shouldnt go on doctor dont know what to try on highest dose at moment i hope you in furtue you can help youself if you feel you are not getting the treatment you want and need find out for yourself whats out there and ask . its your life there is no wrong treatment look for yourself and always ask

Hi.
Welcome to the forum. Can you please clarify the numbers you are quoting....are they in our UK mmol/l or US mg/dl ? It does make a big difference to us here.