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Advice please - I don’t know how to manage my T2.

F

FedUp!

New Member
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Type 2
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Hi

Firstly, apologies if this is in the wrong place, I wasn’t sure where to post it.

Due to prolonged Prednisolone use, I was diagnosed with T2 in December. My dr is hoping that stopping the steroids will bring my blood sugar down again, but in the meantime my level is around 70mmol and I have been prescribed Metformin.

I was given the Metformin and told to build up to 2x500 twice per day over a month, which I did by mid January, but I wasn’t really given any more information, and I haven’t yet been able to see a diabetes nurse.

So I’ve been taking 2x500 when I wake up, and 2x500 when I go to sleep.

I had a hypo this morning but I didn’t know that’s what it was until my sister did the finger test and my level was 1.9.
I felt like I had a really bad hangover (I stopped drinking a couple of years ago) and I was getting confused and a bit disoriented. I felt really awful and didn’t know why.

It’s made me realise I don’t have a clue how to manage this as I took the 2x500 first thing when my level must have already been low.

My GP told me not to bother with the finger test monitor as it wasn’t really helpful but thankfully my sister had one so now I’m going to get one.

So I don’t really know the best place to look for advice. Could anyone point me in the right direction of the best way to take the medication please?

I have tried to cut out all sugar and carbs to bring the levels down and reverse the T2 but I’m not sure this is the right thing to do, and there seems to be so much conflicting information on what I should eat.

I have an appointment with the nurse next week, but this morning scared me a bit and I thought I’d better get some advice asap.

If anyone could point me in the right direction on good management information I’d be really grateful.

Sorry for the long post!
 
Welcome to the forum
Metformin is a medication which helps the body use the insulin it produces more effectively and reduces the release of glucose by the liver, it does not usually cause hypos nor does it work directly on the food you eat but sort of works in the background. It is not uncommon for people taking steroids to develop diabetes which is referred to as steroid induced. The can also cause weight gain.
You have got the right idea about reducing your intake of carbs and many find that a successful approach but it is not NO carbs so you may have taken things a bit too far.
However I would think that a reading of 1.9mmol/l was possibly a bit rogue as at than level you would likely have been unconscious and needed medical attention. However what you may have experienced may have been a false hypo caused by your blood glucose being lower than you have previously been at.
I think that a having a look at this link may help you understand a bit more about dietary changes and a sensible low carb approach which would be a more gradual reduction in blood glucose. It is based on a suggested no more than 130g carbs not just sugar per day, not NO carbs.
lowcarbfreshwell.com

Freshwell Low Carb Project - Home

lowcarbfreshwell.com lowcarbfreshwell.com
Whilst you are on steroids you may have a bit of an uphill battle so may need additional medication if the diet is not taking you in the right direction.
 
Goodness what a nasty experience for you @FedUp!

As @Leadinglights says, that would be quite unusual on Metformin.

1.9mmol/L is really low. And if your BG levels have been running higher recently because of the steroids, it would have hit you like a train. I wonder if perhaps your levels were on the low side, but not quite as low as the meter indicated?

The spaced-out feelings you describe do sound like low glucose, but it might have been worth rechecking with a fresh strip. Some meters can give slightly dodgy readings if the strip isn’t filled fully.

Sorry that you are feeling like you haven’t really got a handle on your diabetes, and how best to manage it, especially with your ongoing need for steroids :(

You might find there are some good basics to get you started in the Learning Zone (the orange tab in the main menu)?

Hope you also get some help and advice at your appointment next week.
 
Leadinglights thank you so much for your reply and your advice.

I’m a bit scared of everything that seems to be going wrong with my health since I’ve been on steroids (BP has gone up and I’m showing signs of kidney damage). This morning was a bit of a wake up call, and I’ve realised that I want to come off of all my medication as I’m sure it can’t be doing me any good. I’ve put on 1.5 stone since I started the steroids and I don’t recognise myself any more.

I need to start taking things seriously and that starts with learning to control the T2.
I’m going to make an appointment with my GP to get a game plan together.

I will have a look at the link and get some ideas.

Thanks again!
 
FedUp! said:
Leadinglights thank you so much for your reply and your advice.

I’m a bit scared of everything that seems to be going wrong with my health since I’ve been on steroids (BP has gone up and I’m showing signs of kidney damage). This morning was a bit of a wake up call, and I’ve realised that I want to come off of all my medication as I’m sure it can’t be doing me any good. I’ve put on 1.5 stone since I started the steroids and I don’t recognise myself any more.

I need to start taking things seriously and that starts with learning to control the T2.
I’m going to make an appointment with my GP to get a game plan together.

I will have a look at the link and get some ideas.

Thanks again!
Click to expand...
My other half was on steroids for 3 months for a serious Crohn's flareup and put on a huge amount of weight which even now is not shifting.
He asked the gastro consultant if she had any advice for losing the weight and all she said was 'if you find out, I'd love to know'
 
Hi @FedUp! Living with diabetes can be frustrating and contrary and you are still in the early stages of diagnosis.
If your blood glucose is high then it is generally recommended to bring the levels down slowly as this kinder on your fine blood vessels and nerves.
I am on the same dose of metformin as you but it hasn't caused any hypos. I did get a few false hypos last summer as I also started taking gliclazide at the same time as cutting down carbs to less than 130g. My HbA1C was still over 100 at that point. I increased carbs from 130 to 150g per day and felt better. My Glucose Levels still went down gradually until Christmas.
I think your 1.9 reading was an aberration, but even false hypos make you feel lousy if you are used to living with high blood glucose.
My doctor also told me to take 2 metformin tablets with or immediately after breakfast and 2 with my evening meal. This minimises the gastric side effects which some people suffer from.
As others have stated, reducing carbs rather than cutting out completely has worked for them. Whatever changes you make should to be enjoyable and sustainable so you maintain them even if your diabetes goes into remission.
 
@FedUp! Welcome to the forum. I'm not testing at the moment though know i should be. My DCN told me unnecessary but when first diagnosed in July I wanted to know how my body was responding. I have had two eye ops in last few months and am on steroids at the moment _ in each case a fortnight either side of op. You can test first thing and track a trend hopefully downwards or can test immediately before you eat then 2 hours after the first test. You are looking for a rise between 2 to 3. Whilst on steroids previously I did get a reading of 13. My original hba1c was 69 by December it was 44. I started lowish carb 80 to 130 and lost weight. My drugs changed in September so I couldn't be as low carb.
Basically reduce your portions of carbs or replace with lower carb items. I still have bread if I eat out and occasionally potatoes but have cut out rice and pasta. I'm on slow release metformin which is supposed to be kinder to your gut.i take it at the end of a meal. For breakfast I have full fat Greek yoghurt with berries and nuts or seeds. Moving more helps eg 10 minute walk after food or housework or gardening. I like swimming though cannot at moment cos of eye op. The Freshwell site is good.
I don't know how kidney problems are addressed from a dietary point of view. I was told my cholestral was a bit high so I ate less meat and more veg.

There is a site in Hampshire which has links to various website like caldesi moseley and freshwell.

newforestpcn.co.uk

Diabetes & Metabolic Health | New Forest PCN

newforestpcn.co.uk newforestpcn.co.uk
 
Hello @FedUp!, welcome to the forum. If only to help with one small background piece of your 'jigsaw' you might find something that helps broaden your understanding of steroid induced diabetes from this bit of Diabetes UK's website:

Steroid-induced diabetes

Steroids can cause high blood glucose (sugar) levels. That’s why some people who take steroids go on to develop diabetes. This is known as steroid-induced diabetes, and is more common in people who are at higher risk of type 2 diabetes. What are steroids? Steroids are also known as...
www.diabetes.org.uk www.diabetes.org.uk

Apologies if you already are familiar with this info.
 
Thank you all so much for replying. I feel better knowing that other people are dealing with this and have had to learn too. I’m lucky because I get the benefit of all your advice!

You’ve made me understand things a bit more, and I feel a bit more confident that I can manage this.

@Everyday ups and downs, I will look at the learning zone and hopefully understand more about the T2. Thanks for pointing me towards it.

@Leadinglights, I’m sorry your partner is going through the steroid issues too. I know they’re supposed to help, but the side effects are horrendous! I started them because I have eosinophilic fasciitis and they’ve helped the tissue but left the rest of me in quite a state.

The link you suggested is great! I’ve learned loads already, the sugar converter thing is eye opening, all that sugar in bread!

@silver minion, thanks for the advice on timings, that makes sense and gives me something more concrete, rather than just my random times at the moment. I never thought to take them with food, I think I thought they wouldn’t work if I did that, but actually it seems the most sensible approach. I will introduce some carbs and see if that helps.
To be honest I was on the verge of trying that carnivore diet as I couldn’t think what else to eat but the thought of just 3lbs of steak every day was putting me off, much as I love them!

@saffron15, thank you for talking numbers. I’m getting the test monitor so I will know what to look for. Thanks also for the advice to exercise, I’ve been putting that off due to other health issues, but I need to do it, especially if it will help getting my numbers lower.
I sympathise with the cholesterol, that seems to have happened to me too. I was normal before the steroids (2.5-3.5 usually), but now I’m up at 8+ which is frightening. They want me to take statins but I just can’t bring myself to do it. Don’t know why, maybe I’ll feel differently when I’ve got the hang of metformin. Statins just seem such a big step.
I will look at the link you sent and do some research.

@Proud to be erratic- thank you also for the link, I will have a look at that too as I had no idea steroids could cause all this. My rheumatologist never mentioned any of the side effects apart from ‘possibly a very small weight gain’!

Right, I’m going to have some breakfast and take my pills, then I am going to do some research on those links.

Above all, I am going to take my health a bit more seriously and take control rather than just accepting pills and having more and more side effects and generally getting worse.

You have all lifted a weight off my shoulders and I can’t thank you enough. I was really scared yesterday, but this morning I feel hopeful.

You guys rock!
 
@FedUp! there is something called dawn phenomenon which means liver releases glucose for the days activities so reading first thing can be high even before you eat. You will look at trends. As far as finger pricking make sure hands are clean and warm eg hug a mug. You do not need to change your lancet each time ( obviously you must if more than one user) i thought it was wasteful and there are experienced users who go many months using the same needle. If you think it maybe slightly blunt change it.
I've just taken my steroids but fortunately they finish Thursday.
 
Once you have had a read through the links and info I'm sure you may have many questions so don't hesitate to come back and ask away.
Incidentally after the steroids the gastro consultant put him on immunosuppressants which he did not tolerate at all, he felt really unwell and decided it was worse than the symptoms from a Crohn's flareup.
Sometimes the side effects from the treatment are worse than the condition so it is always a balancing act.
Once you start doing some testing it helps to keep a food diary alongside so you can see any problem foods and meals if the increase is more than 2-3mmol/l from before eating to 2 hours after.
 
I am currently on same medication dose as you 2 x 1000mg Metformin slow release. My diabetic nurse told me to take both tablets so full dose in the evening with my biggest meal. That seems to have worked for me and my body given my recent repeat HbA1C result (see my signature as do not want to bore everyone again with it as I did a separate post too recently).

My nurse also said for me to reduce how many times I finger prick test given risk of hyposnis less now that Gliclazide was removed from my medication. So with just the current metformin dose nurse said for me to finger prick test once a day and I have been doing this when waking up so a fasted test.

Initially I still did test more than the once to get an idea of how my day went so would test before going sleep.

I am long way off being stable in my journey and fingers crossed I continue the way I have so far. Like others have said this forum and resources are amazing and certainly been great support to me after being diagnosed in November 2024!

Hopefully things will be clearer once you meet with diabetic nurse 🙂
 
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