After a recent admission to hospital I was diagnosed with type 2 diabetes. The hospital started me on 80mg of gliclazide twice a day and 500mg metformine once a day. I stayed on this for a week at hospital and was discharged on 80mg of gliclazide once a day, and 500mg metformine once a day. My hospital discharge letter stated my goal was to increase metformine to 500mg twice a day, and wean off gliclazide as metformine dosage increases. Three weeks later, I’ve been seen by my local diabetic nurse who, without looking at my sugar level records, wants me to stay on the gliclazide, and increase my metformine to 1000mg twice a day, a fourfold increase without checking my current blood sugars. This seems a lot, and in contradiction of the hospitals instructions. My sugars were between 7.0 and 11.0 over the three weeks since my hospital discharge. The nurse wanted me to increase by one metformine tablet per day, per week, so I’m currently taking 500mg in the morning and 500mg in the evening, plus the gliclazide. Over this week my sugars have now been between 5.0 and 9.0. I’m worried now that increasing my metformine to double the dosage I’m currently on is a, going beyond the hospitals recommendation, and b, going to cause my sugars to drop even lower. Who’s advice do I follow? I was very unsure about how keen the nurse was to up my medication without getting a current baseline reading, but I’m not sure who to ask for further advice.
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Who’s Advice To Follow.
- Thread starter Martin71
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Mbaker
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- Diet only
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Hi @Martin71 you are right to be wary. I had blood sugars double yours and was not put on the regime you have, and what is suggested. The best medicine is a low carbohydrate diet, it will regulate your numbers and help to heal your systems. Gliclazide will over work your pancreas which could lead to insulin being required in time. If you were to eat low carb / high healthy fat, you would get "natural" drops in blood sugars as you would have less in your system. Metformin has a mild effect on the liver, but again, consider letting your system self regulate.
Take a look at this page if you have not already.https://www.dietdoctor.com/low-carb/60-seconds. You may get conflicting advice from your health care team and even some on this site. I would say make up your own mind if the standard advice to eat around 50 - 60% carbs in your diet (Eatwell plate / guide), makes sense, compared with a diet that significantly reduces the very thing which raises blood sugars.
Tagging in @daisy1 for further valuable information.
Take a look at this page if you have not already.https://www.dietdoctor.com/low-carb/60-seconds. You may get conflicting advice from your health care team and even some on this site. I would say make up your own mind if the standard advice to eat around 50 - 60% carbs in your diet (Eatwell plate / guide), makes sense, compared with a diet that significantly reduces the very thing which raises blood sugars.
Tagging in @daisy1 for further valuable information.
sally and james
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Hi @Martin71 and welcome to the forum. I'll tag @daisy1 for the new member info. It'll be pasted into this thread sometime soon and is well worth reading. Also welcome to the world of diabetes care. As many find, it's important to try and learn as much as you can about this condition and then take control and begin to make your own decisions (with our help, if needed).
Now, personally, and this is NOT medical advice, I would be minded to wean off the gliclazide as this is a medicine where you need to be careful about going too low and therefore takes more management. ie the hospital's advice. Are you keeping a food diary and recording all your blood sugar readings, before and after meals? This is the way forward, finding out which foods raise your blood sugars and then cutting them out. Easier to do on Metformin. With any luck, once you have begun to understand how blood sugars get put up, you may be able to reduce that too.
Sally
Now, personally, and this is NOT medical advice, I would be minded to wean off the gliclazide as this is a medicine where you need to be careful about going too low and therefore takes more management. ie the hospital's advice. Are you keeping a food diary and recording all your blood sugar readings, before and after meals? This is the way forward, finding out which foods raise your blood sugars and then cutting them out. Easier to do on Metformin. With any luck, once you have begun to understand how blood sugars get put up, you may be able to reduce that too.
Sally
daisy1
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@Martin71
Hello Martin and welcome to the Forum
Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will 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 235,000 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:
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 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
Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.
Hello Martin and welcome to the Forum
Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will 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 235,000 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
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 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
- Before meals: 4 to 7 mmol/l
- 2 hours after meals: under 9 mmol/l
- Before meals: 4 to 8 mmol/l
- 2 hours after meals: under 10 mmol/l
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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.
- Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
- Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
