A few questions …….. any advice welcomed

[Mgfg1rl]

So I was diagnosed in 2019 with type 2, and did really well, getting my hba1c right down. My doctor was really pleased and took me off meds.
Fast forward to earlier this year, I knew things were not good, multiple toilet visits in the night, excessive thirst, horrendous itching, cracked skin on hands, cramps in my feet in the morning, heart palpitations. Basically Covid, lockdowns, and a very stressful time with my 22 yr old son caused me to have no self care, I really neglected my own health, trying to keep my family together and basically was in the depths of depression.

Then my doctor vanished - surgery shut down and no telephone access, so managed to get a new doctor and went to share my symptoms. He arranged blood tests and expressed his concern that I needed to put myself first. I managed to keep losing weight and since may I have lost 10kg. Further blood tests this month resulted in him admitting me to hospital last week where I spent three days on an insulin pump and had a scan of my pancreas.
Thankfully all was ok with the scan and I left hospital with a big prescription.

So I am on 850 Metformin twice a day and 60mg of gliclazide daily. Plus Tuesdays I have to inject with a trulicity pen. They have also prescribed me statins.
It’s now three days since I started the new regime.I’ve had nausea and heartburn all day. Last night a bout 2am I had the most horrendous stomach ache and diahorrea. Is this down to the medication? Has anyone else experienced this? How long do the side effects last for?
I am testing my blood sugar before then two hrs after every meal and I am pleased to say it is coming down.
I successfully lost weight ( 30 kg total since 2019) through doing keto, however my consultant said I need to eat carbs.
Does Metformin help with weight loss? What does the trulicity pen do?
I’m in France so understanding it all is quite tricky with the language barrier,
Thank you for reading all this - any help greatly appreciated

 

[everydayupsanddowns]

Glad to hear you are getting yourself looked after, following the challenges that covid brought your way.

So I am on 850 Metformin twice a day and 60mg of gliclazide daily. Plus Tuesdays I have to inject with a trulicity pen. They have also prescribed me statins.
It’s now three days since I started the new regime.I’ve had nausea and heartburn all day. Last night a bout 2am I had the most horrendous stomach ache and diahorrea. Is this down to the medication? Has anyone else experienced this? How long do the side effects last for?

All medications have the potential of having side effects, but for the vast majority of people the side effects will be minor, short lived, or both. If you have concerns, or if the possible side effects are proving particularly difficult for you, or are lasting months and months with no sign of easing, it would be worth going back to your Dr for advice.

I am testing my blood sugar before then two hrs after every meal and I am pleased to say it is coming down.

Great to hear 🙂 Glad your new regime is working for you.

I successfully lost weight ( 30 kg total since 2019) through doing keto, however my consultant said I need to eat carbs.

It’s important to balance the medications you are taking with a menu that suits you, and your body’s ability to regulate blood glucose levels. Well done on the weight loss! That will have had huge health benefits, including most likely improving your sensitivity to your insulin.

Does Metformin help with weight loss? What does the trulicity pen do?

Metformin can assist with weight loss, as can Trulicity.

Trulicity is a GLP agonist, which works by encouraging your remaining beta cells to produce more insulin than they naturally would. I think Gliclazide does a similar job, but with a different method of action.

Getting your carbohydrate intake to be in balance with your medications (and your medications in balance with your carbohydrate intake) is a very important part of the diabetes-management jigsaw. 🙂

Well done on your progress so far. Hope the tummy upset settles down soon, and you continue to see improvements in your BG levels.

 

[Lucyr]

Have you gone straight from no medication to metformin 850 x2 a day? Is it modified release / slow release metformin or standard?

Metformin would normally be started at 500mg the first week, 1000 the second week, etc because it can cause upset stomachs. If the side effects continue you could ask to try the slow release metformin instead.

 

[Mgfg1rl]

So I did 3 days on an insulin pump + had a pancreas scan which then meant I could not start the Metformin for 48 hrs so started that Saturday .

 

[Leadinglights]

So I did 3 days on an insulin pump + had a pancreas scan which then meant I could not start the Metformin for 48 hrs so started that Saturday .

Metformin is usually started at a low dose 500mg for a week or so then increased at an extra 500g a week up to the dose you need to be on, that helps with the stomach issues. Also taking with food can help as well.

 

[rebrascora]

What @Lucyr is asking is if you have gone from No Metformin straight onto this 850mg twice a day? Metformin is well known for it's ability to upset the digestive system and is usually graded in slowly over a period of weeks so I would suspect that your upset stomach/colic pain and diarrhoea in the middle of the night was caused by that. You might want to half the dose for a week and see how you go and increase it when your hopefully your body settles down to it. I was started on 500mg tablets and it was 1 the first week and 2 the second up to max dose of 4 by week 4. Taking them mid meal with plenty of food also helped.
I believe the Trulicity may make you feel a bit nauseous and cause heartburn..... although Metformin can also cause heartburn) I think it works by tricking your body into thinking it is full when you have eaten a lot less than would actually make you full.

Hopefully you will get the balance of meds sorted soon but do talk to your doctor about the problems you are experiencing. Sometimes one particular brand of Metformin can cause you problems but another one causes less digestive upset. It can be to do with the coatings used on the modified release version as well as the active ingredient in the regular Metformin.

 

[Mgfg1rl]

Hi yes , sorry for not making it clear. I was in hospital last week, scan prevented me from taking the Metformin until Saturday and yes I was. prescribed 850 mg tablets 2 x day

 

[DaveB]

Hi. Make sure you are on Metformin SR (Slow Release) as this is much kinder than the standard version which can cause bowel upset. I believe Trulicity can also sometimes cause the same problem. I don't agree with your consultant who is pushing standard NHS Eat Well Plate advice ref carbs. In practice you only need a low level of carbs as the body can produce glucose from fats and proteins if needed. In principle you should match meds to the carbs you eat and not vice versa if you want to lose weight. You may need to reduce both the Gliclazide and even the Trulicity as you reduce the carbs so be careful to avoid hypos with the Gliclazide and seek advice from the nurse or consultant along the way but you may need to argue the amount of carbs!

 

[Mgfg1rl]

Hi. Make sure you are on Metformin SR (Slow Release) as this is much kinder than the standard version which can cause bowel upset. I believe Trulicity can also sometimes cause the same problem. I don't agree with your consultant who is pushing standard NHS Eat Well Plate advice ref carbs. In practice you only need a low level of carbs as the body can produce glucose from fats and proteins if needed. In principle you should match meds to the carbs you eat and not vice versa if you want to lose weight. You may need to reduce both the Gliclazide and even the Trulicity as you reduce the carbs so be careful to avoid hypos with the Gliclazide and seek advice from the nurse or consultant along the way but you may need to argue the amount of carbs!

Thank you I told my consultant I’d been doing the keto diet with minimum carbs and she said I needed to eat them. She’s French , I’m in France… - made sure I was given half a baguette at each meal! Plus potatoes or pasta or rice but only 100g. I’m going to speak to my doctor about the slow release… hoping they have it here.

 

[grovesy]

Sometimes called modified release aswell.

 

[Leadinglights]

Many people who are Type 2 and are dietary managed and/or just metformin would probably be looking to have less than 130g per day carbohydrate and some considerably less however you are taking a number of medications so do now need to be careful, as the gliclazide in particular may cause low blood glucose as it induces the pancreas to produce more insulin which is why your doctor may have been advising you to have some carbs.

 

[Drummer]

Your consultant seems to be completely out of touch with the successful treatment of type 2 by diet alone.
Is there no one you can go to for a more scientific approach?

 

[42istheanswer]

@Drummer diet alone has already proven not to be enough for Mgfg1rl - hospitalisation needing 3 days of insulin treatment does not suggest that right now she should be trying to control it without medication

 

[Drummer]

@Drummer diet alone has already proven not to be enough for Mgfg1rl - hospitalisation needing 3 days of insulin treatment does not suggest that right now she should be trying to control it without medication

Bread plus potatoes pasta or rice at every meal - trulicity, gliclazide, metformin and a statin. Nausea, heartburn, stomach ache and diarrhoea.

Imagine how much improvement there might be without those high carb foods interfering at every single mealtime. Imagine how much those side effects interfere with normal activities.

I never suggested stopping medication, but surely insisting on high carb foods like that is pouring petrol onto a flame - not going to end well.

 

[42istheanswer]

Bread plus potatoes pasta or rice at every meal - trulicity, gliclazide, metformin and a statin. Nausea, heartburn, stomach ache and diarrhoea.

Imagine how much improvement there might be without those high carb foods interfering at every single mealtime. Imagine how much those side effects interfere with normal activities.

I never suggested stopping medication, but surely insisting on high carb foods like that is pouring petrol onto a flame - not going to end well.

Bread plus another carb rich food sounds too much, I agree. But low carb on those medications would be risky, so either bread or potatoes/ rice/ pasta but a measured amount does make sense

 

[Drummer]

Bread plus another carb rich food sounds too much, I agree. But low carb on those medications would be risky, so either bread or potatoes/ rice/ pasta but a measured amount does make sense

Well - of course - medication designed to reduce the amount of glucose in the blood could lead to hypos - it was the whole shebang which I was aghast at. I never suggested low carb with all that's being put into the system.

 

[Mgfg1rl]

Bread plus potatoes pasta or rice at every meal - trulicity, gliclazide, metformin and a statin. Nausea, heartburn, stomach ache and diarrhoea.

Imagine how much improvement there might be without those high carb foods interfering at every single mealtime. Imagine how much those side effects interfere with normal activities.

I never suggested stopping medication, but surely insisting on high carb foods like that is pouring petrol onto a flame - not going to end well.

These were the carbohydrates the hospital were giving me at every meal. I didn’t actually eat them. I was just surprised to see my plate every mealtime. I appreciate your advice and I am eating a low carb/ no carb diet now I’m home . I just wanted to hear others experiences and if there was anything I should do. I do have ( from last year) a box of Metformin 500 so thinking I might take those for now instead of the 850,,,,,,

 

[Deleted member 21371]

These were the carbohydrates the hospital were giving me at every meal. I didn’t actually eat them. I was just surprised to see my plate every mealtime. I appreciate your advice and I am eating a low carb/ no carb diet now I’m home . I just wanted to hear others experiences and if there was anything I should do. I do have ( from last year) a box of Metformin 500 so thinking I might take those for now instead of the 850,,,,,,

Personally I concentrated on getting my BG to a reasonable number, and followed my HCPs advice until I could see if it was working or not at the next review.
(It did)
I got told I should go low carb and be med free as well, however, without anyone knowing what I was actually on, I obviously ignored it.

 

[Drummer]

These were the carbohydrates the hospital were giving me at every meal. I didn’t actually eat them. I was just surprised to see my plate every mealtime. I appreciate your advice and I am eating a low carb/ no carb diet now I’m home . I just wanted to hear others experiences and if there was anything I should do. I do have ( from last year) a box of Metformin 500 so thinking I might take those for now instead of the 850,,,,,,

I am very relieved to read that.

 

[Mgfg1rl]

Just a quick update. I’ve been strict with the medication, watched my diet carefully with only minimum carbs and now have readings of between 4.9 and 5.9 during the day. Went back to my doctor who was really pleased and said my hba1c will be a lot lower than 13.5 when I go back in early December if I keep this up. I’ve lost another 3kg and my blood pressure has come down too. So thank you for all your advice and support.