Bad results

[snowball12]

My Hba1c today was 72. I am almost in tears. Before Covid and Pneumonia last year my numbers were always in low 50's. Not perfect but acceptable to my GP after 13 years a diabetic. I thought I had followed low carb as well as I could but obviously not. I take 2000mg of Metformin and 160g glicazide. I am absolutely distraught and feel such a failure. I really want to give up and accept that diabetes will kill me eventually!!!

 

[Leadinglights]

My Hba1c today was 72. I am almost in tears. Before Covid and Pneumonia last year my numbers were always in low 50's. Not perfect but acceptable to my GP after 13 years a diabetic. I thought I had followed low carb as well as I could but obviously not. I take 2000mg of Metformin and 160g glicazide. I am absolutely distraught and feel such a failure. I really want to give up and accept that diabetes will kill me eventually!!!

That is disappointing for you especially as you thought you had been doing all the right things. It may be the gliclazide is not working for you if your pancreas just cannot produce enough insulin to cope with the carbs you are eating despite being given the signals to do so by the medication. Hopefully your GP will have some suggestions as to what you can do next. Meanwhile it may be useful to keep a good record of what you are eating and about how many carbs to provide evidence that the meds are not working.
If you have your monitor than you could do testing of your blood glucose before and after meals to show your GP as well to go alongside the food diary.
I know it sounds like going back to basics but it may reveal some explanation that means you can move forward to improve things./

 

[snowball12]

That is disappointing for you especially as you thought you had been doing all the right things. It may be the gliclazide is not working for you if your pancreas just cannot produce enough insulin to cope with the carbs you are eating despite being given the signals to do so by the medication. Hopefully your GP will have some suggestions as to what you can do next. Meanwhile it may be useful to keep a good record of what you are eating and about how many carbs to provide evidence that the meds are not working.
If you have your monitor than you could do testing of your blood glucose before and after meals to show your GP as well to go alongside the food diary.
I know it sounds like going back to basics but it may reveal some explanation that means you can move forward to improve things./

Thank you so much for your support and I agree, time to go back to basics. I have to get a telephone appt with GP. Made more difficult by the fact I have to ring at 8am on the days he works! Monday and Wednesday!!! He is the diabetes GP! No wonder I haven't seen him for about six years!!!!

 

[rebrascora]

Really sorry to hear that your levels have risen despite your efforts. That must be really upsetting. I know low carb is really difficult for you because you dislike salad and many veg too, so increased medication may be the best option for you.
Have you considered your possible options in that respect before you speak to the GP, so that you can give them some consideration before you discuss them.
You are currently on Metformin and Gliclazide. I am guessing that they will likely want to increase the Glic as I don't think that is the maximum dose but have you thought about insulin? My thoughts are that your pancreas may not be producing much insulin otherwise your dietary efforts together with your current meds should have shown some improvement. I just wondered how you feel about insulin as that would give you more dietary freedom. I know it may seem like a big step which is why it is worth thinking about it before your appointment because that 10 min appointment can seem very short and if you haven't given it prior thought, you can be left feeling a bit shell shocked.... I know I was even though I knew before the appointment that I needed insulin.
Just really saying that it is worth giving it some thought before hand and being prepared to discuss it with your doctor. I imagine for many people, the temptation can be to bury their head in the sand and hope it doesn't come to that, but firstly it isn't anywhere near as bad as you imagine and I also just feel that it may be a beneficial next step for you and allow you to be a bit less restricted with your food. .

 

[snowball12]

Really sorry to hear that your levels have risen despite your efforts. That must be really upsetting. I know low carb is really difficult for you because you dislike salad and many veg too, so increased medication may be the best option for you.
Have you considered your possible options in that respect before you speak to the GP, so that you can give them some consideration before you discuss them.
You are currently on Metformin and Gliclazide. I am guessing that they will likely want to increase the Glic as I don't think that is the maximum dose but have you thought about insulin? My thoughts are that your pancreas may not be producing much insulin otherwise your dietary efforts together with your current meds should have shown some improvement. I just wondered how you feel about insulin as that would give you more dietary freedom. I know it may seem like a big step which is why it is worth thinking about it before your appointment because that 10 min appointment can seem very short and if you haven't given it prior thought, you can be left feeling a bit shell shocked.... I know I was even though I knew before the appointment that I needed insulin.
Just really saying that it is worth giving it some thought before hand and being prepared to discuss it with your doctor. I imagine for many people, the temptation can be to bury their head in the sand and hope it doesn't come to that, but firstly it isn't anywhere near as bad as you imagine and I also just feel that it may be a beneficial next step for you and allow you to be a bit less restricted with your food. .

I must admit Insulin terrifies me! As I have a mental health condition my brain is telling me it's all my fault and I have failed. As you say I hope GP will alter my medication, he has asked for a telephone consultation once again! So I won't get to see him. I will ask him about insulin, I am not a person who buries their head in the sand, I leave that to my husband lol. So watch this space!! Thanks for your help

 

[Lucyr]

You are currently on Metformin and Gliclazide. I am guessing that they will likely want to increase the Glic as I don't think that is the maximum dose but have you thought about insulin?

I’m pretty sure that the standard flowchart means you need to have tried 3 type 2 medications before adding insulin is considered, unless there’s a good specific reason

 

[rebrascora]

@Lucyr I think there is also new guidance suggesting that early intervention with insulin in Type 2 can be beneficial if levels are high or oral meds are not being effective. I think @everydayupsanddowns posted a link about it just the other day.
I appreciate that @snowball12 has been diagnosed a long time so not "early intervention" as such but I think the new guidance covered that scenario too. Not sure if it is UK guidance though as I seem to remember the units were in mg/dl.

 

[rebrascora]

Also, I was only on Metformin and Gliclazide before going on to insulin, even though I was diagnosed Type 2 initially, so they can stray from the guidance..

 

[everydayupsanddowns]

@Lucyr I think there is also new guidance suggesting that early intervention with insulin in Type 2 can be beneficial if levels are high or oral meds are not being effective. I think @everydayupsanddowns posted a link about it just the other day.
I appreciate that @snowball12 has been diagnosed a long time so not "early intervention" as such but I think the new guidance covered that scenario too. Not sure if it is UK guidance though as I seem to remember the units were in mg/dl.

I think what I was thinking of was this extension to the venerable UKPDS - a very long running investigation into T2 outcomes.

It suggests that early and intensive treatment can have lifetime benefits over and above delaying things, but that furthermore it’s never too late to make improvements

Early blood glucose control for people with type 2 diabetes is crucial for reducing complications and prolonging life | University of Oxford

Research led by scientists from the Universities of Oxford and Edinburgh has found that early good blood glucose control can minimise the lifetime risk of diabetes-related complications, including heart attacks, kidney failure and vision loss.

www.ox.ac.uk

 

[Vonny]

@snowball12 you have not failed. You are doing the best you can which is all any of us can do. You're now seeking advice from the GP (if you can get an appointment!) and seeking to improve things, so you are still doing the best you can. This condition is rubbish sometimes. {{Hugs}} xx

 

[snowball12]

@snowball12 you have not failed. You are doing the best you can which is all any of us can do. You're now seeking advice from the GP (if you can get an appointment!) and seeking to improve things, so you are still doing the best you can. This condition is rubbish sometimes. {{Hugs}} xx

Thanks so much, hugs gratefully accepted

 

[snowball12]

Quick update, after 43 mins trying to get through to GP surgery I was told that there were no appts left for my GP who asked me to make appt!!! He is in on Wednesday and that's it for a week!! I must admit in my frustration I was a little rude to receptionist. So try again Wednesday it is!. I am lucky enough to qualify for two GP practices. I applied to join the other one this morning. Fingers crossed 🙂

 

[snowball12]

Another update! Finally got to speak to my GP who was as useful as a chocolate teapot!! Told him what was going on and he completely ignored me and said I am increasing your glicazide by 40mg!!! have another blood test in September and that was it. Been accepted by other doctors practice where I live. A blessing I hope.

 

[Leadinglights]

Another update! Finally got to speak to my GP who was as useful as a chocolate teapot!! Told him what was going on and he completely ignored me and said I am increasing your glicazide by 40mg!!! have another blood test in September and that was it. Been accepted by other doctors practice /

where I live. A blessing I hope.

 

[Lucyr]

I am increasing your glicazide by 40mg!!! have another blood test in September and that was it.

That sounds pretty decent to me to be honest, thought you were going to say retest at next annual review

 

[rebrascora]

That sounds pretty decent to me to be honest, thought you were going to say retest at next annual review

I agree. I think it was probably the most predictable outcome and in line with guidelines I believe, although it is poor that you felt they were not listening to you. A follow up appointment in September is good to check if that increase in Glic is working.

Did you broach the subject of insulin at all with the GP and if so what did they say?

What did you hope for from the appointment? I think sometimes having a goal to achieve from the appointment is important. I tend to write a list of questions I have for such appointments and tick them off as I get a response to them and ask them again at the end if I haven't got a response.

 

[snowball12]

I agree. I think it was probably the most predictable outcome and in line with guidelines I believe, although it is poor that you felt they were not listening to you. A follow up appointment in September is good to check if that increase in Glic is working.

Did you broach the subject of insulin at all with the GP and if so what did they say?

What did you hope for from the appointment? I think sometimes having a goal to achieve from the appointment is important. I tend to write a list of questions I have for such appointments and tick them off as I get a response to them and ask them again at the end if I haven't got a response.

It was a telephone consultation. I could hardly get a word in. He has always been like that. It may have been predictable! but throwing more tablets at the problem isn't the answer. I would have liked a bit more support from a GP!!!!!