Advice please for a newbie

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ian1963

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Relationship to Diabetes
Type 2
This may seem long-winded, but please bare with me and read it all carefully, as your (the 'real' experts) advice and comments will be greatly appreciated..

I am a 45 year old male and was diagnosed as Type 2 last March. I had absolutely no symptons of diabetes at all but after having my bi-annual medical at work I was advised that my sugar levels were slightly raised and that I should make an appointment with my doctor. Anyway, sure enough, a fasting blood test showed that my blood sugar level was 7.2 and the doctor put me on 2 x 500mg of Metformin.
To be honest, I was angry at myself for getting myself into this postion, because I had 'let myself go' over the last couple of years. I used to do a lot of hill walking and also worked out at the gym 3 times a week, but here I was 2 years later, overweight and out of condition.
Anyway, I decided to dust myself down and get back into shape. By the time I came to have my next blood test (3 months later), I had lost one and a half stone and was feeling great again and my blood sugar reading was 5.2 (non-fasting). However, I was having a lot of headaches and would sometimes feel weak after excersise. My diabetic nurse suggested that the weak feeling I was having were hypos and that I was probably being over medicated. She went to have a chat with my doctor (the diabetic clinic is in the same building as the doctor's surgery) and when she came back she said that I would only have to take 1 Metformin tablet from now on with a view to taking me off the medication altogether if I showed the same progress by my next consultation.
Six months later (December) I had lost another stone in weight and was back for my blood tests and two weeks later I was told by my nurse that the reading was 5.3. I told her that I was still having hypos and had one particularly bad one whilst halfway up a mountain in Snowdonia where I frightened the life out of my wife, but thankfully after eating all the food in my rucsack and resting for one hour I had regained enough energy to get back down off the mountain. The nurse then told me that Metformin should not cause hypos (is this right?) but still thought that I should come off the medication but could not ok it without discussing it with my doctor first who was not in the surgery that day. She said that the doctor would almost certainly agree with her and she would ring me in a couple of days to confirm it.
Three days later I had heard nothing, so I rang the surgery myself and asked to speak to the diabetic nurse. After a long pause I was told by the recepionist that she was busy and that she would get her to ring me back. This went on for a week and when I finally got to speak to the nurse she said that she hadn't had the chance to speak to the doctor yet but would see him that day and ring me back. I waited all day for the phone call which eventually arrived at 4.30pm, but it wasn't the nurse that rang me, it was the receptionist and she told me that she had a message from the doctor for me saying that there was no change to my medication. I was not entirely happy with the decision but it was now December 22nd and I decided to wait until after the Christmas holidays and see how it goes.
This month was only 2 weeks old when I had already had 3 hypos (2 in work and 1 whilst out walking) but I was well prepared for them this time. Two days ago I decided to buy a test meter from the pharmacists (against the wishes of my doctor, I must add) so that I could check what my levels were the next time I had a hypo. My wife picked it up for me and out of curiosity I took a reading straightaway and I had a reading of 3.8 !! I wondered if the meter was accurate, so my wife (non diabetic) took a reading of herself and hers was 5.7. I have taken 3 readings since and they have come out at 4.9 ( 1 hour after breakfast), 4.3 ( mid afternoon) and 4.5 (last thing at night).
To top it all off, my wife went to pick up my prescription from the doctor's yesterday and aswell as the Metformin tablets she was also given Simvastatin (40mg) tablets and when she questioned them she was told that the doctor wants to get my cholesterol below 4 because I am 5 times more likely to have a heart attack being diabetic. My last cholesterol reading was 5.1 but was 6+ when I was first diagnosed with diabetes. I am now totally disillusioned and to be honest with you, it is starting to really stress me out. I feel like I am trying my very best to get off the medication but I am not being helped by my doctor who seems (to me) to be intent on keeping me on medication. I am confident that I could manage my diabetes and cholesterol with diet alone, but I am not being given the chance to try it. I suppose I could just stop taking the tablets without telling them and see how it goes, but I don't want to do that. I therefore made an appointment this morning to see my doctor next week to discuss how I feel. All I am asking for is 6 months to prove that I can control everything with diet alone, but I somehow doubt it will happen :(
I am affraid that the doctor will persuade me to carry on taking the Metformin and now the Simvastatin as I am usually nervous of doctors because prior to being diagnosed I had only visited the doctors twice in the last 20 years. Any advice from the 'veterans' on here on what to say or do would be greatly appreciated.

Thanks in advance

Ian 🙂
 
Sometimes managing your healthcare team can require as much effort as managing diabetes, of what ever type and whatever treatment! Then managing high cholesterol is another aspect. However, seems you've shown that upping your exercise and modifying diet is going at least some way to manage weight, diabetes & cholesterol, so seems far to give it a go.

As you mention hill walking, you might also find this group (informal, international group of people with diabetes who love mountains and actiivities) useful: http://diabetic.friendsinhighplaces.org/
 
Wow that was quick, I wasn't expecting a reply so soon.

Sometimes managing your healthcare team can require as much effort as managing diabetes


Yeah, tell me about it 🙄

Thanks for the encouragement and the URL link, I've had a quick look and will have a proper look when I get more time. Do you walk mountains yourself?

Me and the wife love it and up until a couple of years ago, used to go every year to the Pyrenees.
 
Metformin normally only causes hypos if taken in combination with a drug that stimulates the pancreas to make more insulin such as Gliclazide, so it is more likely that your weak spells are due to your dieting combined with extra exercise that you are not yet used to.

It is possible that your doctor wants to keep you on Metformin because it helps to protect the heart and the same thing goes for Simvastatin. There is a school of thought that all T2 diabetics should be put on Metformin and a statin as a matter of course even if their glucose level and cholesterol are reasonably well controlled.
 
Yes, I'm keen on mountains, UK, overseas [including Pyrennes a couple of times], anywhere - hill / fell walking, mountain marathons & adventure races (some competing, but usually marsalling, while non diabetic, but more significantly, non-driving partner competes), orienteering, kayaking, geocaching (more practical in East Anglia!) etc - a range from moderate to pretty active. MAD website is a bit quiet, but email group is more active.

Anyone can become hypoglycaemic with excess exercise not balanced adequate food intake, not just with diabetes. I certainly had some hypo episodes in hills / rivers / lakes as a skinny teenager, long before getting Type 1 as a young adult. I've encouraged (sometimes quite forcibly!) plenty of adventure racers / mountain marathoners to get some sugar drinks and / or food down themselves when suffering.
 
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Ian, I'm not sure if many/anyone will agree with this but I'd try and manage without the pills. You seem very conscientious and responsible about your condition and I'd commend you for that. With the greatest respect to our healthcare professionals they don't always seem to 'know best' or fully understand diabetes, especially the everyday practicalities. There does appear to be vastly different opinions and attitudes and you obviously don't think that your current treatment is appropriate. Listening to the experiences of others on here, there does often seem to be a 'one size fits all' solution offered. See what the folks with experience of type 2 say. Good luck.
 
Don't be too hard on yourself. If you have been very active and done all the right things, it does come as a shock to find out you're diabetic.

I was diagnosed in 1986 after a healthcare event at work whre I went along for loads of tests and to see what it was all about. OK so it's not a brilliant way of finding out, but at least we know.

Between my diabetes (it's mine and no one elses), and my husbands dairy intolernace, then adopting a four year old who is a fussy eater, I have done a whole lot of learning. There are things I have to avoid that I used to eat like no tomorow (treacle by the tin full for example). and I am now learning to like drinks with no sugar and low carbs.

You are less likely to get a hypo on metformin, but it is not impossible.

Be patient with yourself, love your self for the positives, and treat each new day as an adventure. I still have lots to learn, as I am sure do many people. It is not the end of the world. Diabetes is not your whole life, just something you have to look out for...
 
Thanks everyone for your comments, they are much appreciated. To be honest with you, I am not too bothered with having to stay on Metformin. Afterall, I have been taking it for nearly a year now and it is no big deal.
It is having to take the Simvastatin that is really worrying me because, against my better judgement, I decided to do some research on the internet and came across some real horror stories of what happens to some people after taking them. Maybe I just need some reassurance from someone on here who is taking them.
I am also annoyed that my GP didn't have the decency to talk to me first about it before slipping them in with the Metformin prescription 😡

Ian
 
My doctor prescribed gliclizade without telling me. The recpetionist phoned to tell me my prescrition was ready and I said what prescription.

When I went to talk to my GP he still didn't want to talk about it with me and he had prescribed more than is usual. When I went to collect it from the pharmacist I normally use, even he queried the ammount.

At the moment I a trying to get my care transferred to the hospital as I am not happy with the diabetic care my GP gives me, and the lack of dicussion.

I guess we all have issues one way and another...
 
The vast majority of people have no side effects from Simvastatin whatsoever and those that do suffer side effects usually find they are mild and go after a short time. If you were to turn out to be one of the few who have a more severe reaction there are other statins such as Pravastatin and Atorvastatin which you could be switched to and may be better tollerated. So there is no need to worry and research does indicate that it is beneficial for anyone with a medical condition that increases the risk of cardiovascular problems to take a statin.
 
Thanks everyone for your comments, they are much appreciated. To be honest with you, I am not too bothered with having to stay on Metformin. Afterall, I have been taking it for nearly a year now and it is no big deal.
It is having to take the Simvastatin that is really worrying me because, against my better judgement, I decided to do some research on the internet and came across some real horror stories of what happens to some people after taking them. Maybe I just need some reassurance from someone on here who is taking them.
I am also annoyed that my GP didn't have the decency to talk to me first about it before slipping them in with the Metformin prescription 😡

Ian

Hi Ian,

I suspect you are somewhat like me, in that prior to all this you were pretty much drug-free. When I was diagnosed I came out of hospital on 11 different daily medications. It turns out that I seem to be one of those 5% of people who suffers whatever side-effects the drugs have to offer, and it's taken several months of working with my GP to sort out which ones were causing the problems, what alternatives could be used and which I could cut out altogether.

One of the ones that seemed to be causing a problem was Simvastatin. At one point I had stopped everything, but my GP wanted to reintroduce simvastatin despite my cholesterol being 3.7. I've gradually been upping the dose from 10mg and am now on 40mg which I appear to be able to tolerate OK. We think it was the combination of drugs in the past that was making me ill - now I'm just on 5 meds.

I'm better now about having to take daily drugs, as long as they don't have adverse side-effects. My cholesterol is fine, but there is apparently still some benefit in taking statins so I'll go along with that. I think you need to give things time, see what the blood tests etc. say, and then consider whether it's worthwhile for you to continue.

I've been much luckier than you regarding my care. My GP hasn't dealt with my diabetes, just the drugs and their effects. The local diabetes clinic have taken care of my diabetes and done a splendid job. I hope that you find a doctor or nurse who listens and responds to your concerns - what you say and feel is of the utmost importance if your treatment is to have maximum benefit.
 
Ian, I'm not sure if many/anyone will agree with this but I'd try and manage without the pills. You seem very conscientious and responsible about your condition and I'd commend you for that. With the greatest respect to our healthcare professionals they don't always seem to 'know best' or fully understand diabetes, especially the everyday practicalities. There does appear to be vastly different opinions and attitudes and you obviously don't think that your current treatment is appropriate. Listening to the experiences of others on here, there does often seem to be a 'one size fits all' solution offered. See what the folks with experience of type 2 say. Good luck.

I agree with Alan about the metformin. As long as you are careful and test blood sugar regularly it seems to me that it might be worth trying to do without the metformin. Having a lot of hypos makes you feel really bad, and since you have to eat it undoes your hard work with exercising, and more importantly, if your blood sugar is consistently low you may be at risk of losing hypo awareness symptoms as your body becomes accustomed to low sugar levels and does not register as a hypo until it is dangerously low.

As for the statins, my GPs have been trying to get me to take statins for ages and I refuse. I don't agree with medicating people unless they have an actual diagnosed condition, this preventative medicating seems to me like it costs the NHS a lot of money and I am unsure that it has any real effect. If you take statins and do not have a heart attack, is there any way of proving conclusively that the statins prevented this, or could it be possible that you would not have had a heart attack whether or not you took statins? Especially since most people change their lifestyle at the same time as starting statins, by exercising more and eating healthy foods.
 
Hi

I'm going to throw a spanner in the works here and say 'are you really diabetic'. The reason I say this is because yes ok it was a fasting BG and yes it was 7.2 but that is not mega mega high. Did they only do the one test? From you post and obviously you can't go into extreme detail but you seem to have more problems post diagnosis with the tablets then pre diagnosis plus no symtoms and I know not everyone has symptoms. I would do another couple of fasting tests yourself at home. What have your HbA1c results been?

I agree with one of the others and I would be tempted to stop the tablets myself for a month and see what happens. Test yourself more than morning, first thing in the morning and 2hrs after a meal and make a chart.

Medical teams are sometimes next to useless. Some are great don't get me wrong but I just find that from people I have spoken to, who are under the GP, they are not specialised enough to help as they should be doing. I would be tempted to find out what your hospital team are like and if better get transferred.

I admit I don't know much about type 2, I'm a parent of a type 1 but I have been involved with diabetes for nearly 10 years now.

Take care and good luck
 
Hi Ian

I take simvastatin since being diagnosed and apart from a few side effects for a few days when I first started taking it (tiredness and nausea) I dont get any now. Its also good for bringing your cholesterol down to what the doctors like it to be if you do have diabetes. Good luck with it - and dont believe all you read on t'internet - tis sometimes a dangerous thing. My godson was recently diagnosed with epilepsy - but we took a few comments from his x-ray and used the internet - and as far as we were concerned he had a brain tumour.....
 
Hello Ian

Sorry to hear you are having a difficult time getting your diabetes under control in partnership with your GP. I've been very fortunate with my general practice so want to assure you that some of us do strike lucky.


As a Type 2 myself, I wouldn't change my medication regime without fully discussing it on a face-to-face basis with my doctor - however difficult that conversation might be. I would go armed with my self-testing results, examples of when I've gone hypo and what I've been doing at the time plus diet history alongside your weigth loss record. I would also consider taking someone with me to "listen in" as sometimes I'm not very good at remembering all the details of the conversation and then have to go back again and seek clarification

I've taken statins since I was diagnosed with no ill effects whatsoever



Vanessa
 
I did have a problem with Simvastatin full strength. I started to get quite bad muscle weakness and pains and told my doctor that I was not prepared to go on taking them if they were turning me into an old cripple especially as my cholesterol levels were not that high. I have now been put on half strength tablets which seem to do the trick without affecting my muscles. It sweems all diabetics get given statins
 
Hi Ian,

I take 12 tablets a day for my diabetes 3 of them being 850mg metformin and touch wood no side effects. Been on these for a while as well in conjunction with full daily dosage of gliclazide.

I also take a 40mg simvastatin each day with no side effects all prescribed by my GP/diabetes clinic. Whilst in conversation with one of our Occupational Health Doctors he asked me if I was taking a stating, I obviously replied yes. He then said if he had his way ALL people over 40 would be given the option of taking a statin every day to reduce the chance of heart problems and also to help cholesterol - this would also be anyone with no health problems.

Just passing on what he said for you to think about as I know there are mixed feelings about statins and I dont really have a view on them even though I take one a day for the rest of my life.

Thanks and regards.

Andy
 
I think much is horses for courses. I am on 20mg symvastatin each night plus a plethora of other medication including warfarin for Atrial Fib, several strokes, hypertension and a host of other minor probs gathered over the years. The diabetes dianosis is fairly recent as the result of a test for under active thyroid cross checkd with a bg test.
What I am feeding on in terms of medication/chemicals would help to have me certified if I read and took note of all the side effects and contraindications in the packets.

Life is great. I have my porridge and read the paper. Finding I'm not in the obituary column cheers me up and I then get on with enjoying the day, periodically self inflicting finger wounds.
This has led to an alteration of pressure settings on all my computer keyboards

If I go into town I see some people with serious medical probs who don't complain and others who winge about a sore thumb from texting on their mobiles.

Thank goodness we are all different.
 
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...Life is great. I have my porridge and read the paper. Finding I'm not in the obituary column cheers me up and I then get on with enjoying the day, periodically self inflicting finger wounds.
This has led to an alteration of pressure settings on all my computer keyboards...

John, I love it - thanks for making me smile!:D
 
Caroline, are you actually taking drugs that your GP didn't want to talk to you about? the dose of which your pharmacist queried?
 
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