Cereal help!!

[rebrascora]

I buy Lidl dark chocolate too, although the 85% is a little too strong for my tastes. A single square of the 70% Dark Chocolate or the Salted Caramel or sometimes the Raspberry variety are my choice with a spoon of crunchy peanut butter to make them more satisfying.

 

[Busdriver60]

I think the issue with Gliclazide is that it is a Type 2 medication. It encourages or pushes the pancreas to produce more insulin. If it is unable to do that because it is damaged by disease or surgery or trauma, then the medication will not be effective or may put the failing pancreas under sufficient pressure that it fails quicker. Your nurse or GP has likely prescribed this medication because you are considered by them to be Type 2 and they probably have little or no understanding or Type 1 or Type 3c diabetes.
I was started on Gliclazide when I was first diagnosed and assumed Type 2 and it had no appreciable effect on me although lowering my carb intake like you are doing, did work initially as I didn't need my pancreas to release significant amounts of insulin to deal with carbs in my food and it was still able to trickle out enough to cover my basal needs ie. the steady trickle of glucose from my liver, for a while. You are already using basal insulin cover this function, so it may be that your remaining healthy beta cells are having a bit of a breather, particularly now you are eating lower carb, so they may be able to respond to the Gliclazide short term, but in the longer term almost certainly not and you will most likely eventually need a fast acting insulin for your meals, even if you are able to eat very low carb long term. Most likely if the Glic has any effect, it will put more strain on your remaining beta cells and they will fail more quickly and you will see your levels start to rise again. You have a means to monitor your levels very closely with the Libre and you are already on basal insulin so this reduces the possibility of you having a DKA (Diabetic KetoAcidosis) event so I think the only issue with Glic is that it will likely bring about the demise of your remaining beta cells more quickly. This can be a good thing and a bad thing in my opinion. The good thing is that you need a fast acting insulin sooner rather than later and be able to eat more normally rather than low carb but of course it is more injections and you have to learn how to carb count and adjust those doses for the food you eat and the timing of those in injections, which is doable but it is more complicated until you get used to it.... much like learning to drive a car from scratch.... gradually you do things on autopilot but initially you have to think about every single little task and what order to do them in.
I don't necessarily see the Gliclazide as a risk because you have CGM to monitor your levels in the unlikely event that your beta cells do manage to throw out enough insulin to cause a potential hypo, so as long as you are prepared for that risk you should be fine and if it does work a bit then you would be able to eat a few more carbs at least short term. I think the damage to your pancreas is almost certainly progressive from the point of view of its ability to perform these functions so you will most likely need both insulins eventually so I am not sure there is anything much to lose by giving it a go, particularly if you don't want to continue whittling your carbs down to a very low level with all your meals, but my gut feeling is that it is a short term stop gap treatment that may not be effective at all or may work a little bit for a period of time.....

Just my thoughts having used Gliclazide myself in a similar situation in that my insulin production was failing.... albeit that, unlike you, I didn't have any injected insulin when I was taking it, so my remaining beta cells were already at max capacity trying to cope with liver output and an increasingly very low carb diet.

So I have some interviews for driving jobs next week. What do you suggest I should say to the prospective employers?
I am referring to possible risks of hypos as a result of taking gliclazide.

 

[Judithdalston]

I took gliclazide for two decades until this Jan.when a diabetic nurse from the hospital thought it might be causing me hypos. that for the first time were being proven with new used Libre 2 sensors. They were only occasional and early morning in bed. Can’t say I have noticed any obvious difference, but then at the same time I was changed from Humulin to Fiasp and Toujeo and left on metformin. You know about the ‘five to drive’ safety warning that your BG should be at 5 before you should drive I presume, you could set your Libre 2 sensor to go off say at 5.2 on driving work days to catch any potential hypos. and feed appropriately. You must have told the DVL office anyway.

 

[rebrascora]

So I have some interviews for driving jobs next week. What do you suggest I should say to the prospective employers?
I am referring to possible risks of hypos as a result of taking gliclazide.

You already have risks of possible hypos from your basal insulin so the Gliclazide doesn't really change that in my view.
I don't know if you need to declare your diabetes and possible hypos other than to say you have a Medically Restricted Driving Licence and elaborate if they ask more. I would maybe contact the DUK helpline to see if you even need to declare that unless it is on the application form or you are asked, although I imagine it would be if it is a driving job. So it may ask if you hold a full UK driving licence and assuming you have informed DVLA about your insulin usage which you must do, then you would have to answer that you have a 3 year medically restricted licence.

 

[rebrascora]

I took gliclazide for two decades until this Jan.when a diabetic nurse from the hospital thought it might be causing me hypos. that for the first time were being proven with new used Libre 2 sensors. They were only occasional and early morning in bed. Can’t say I have noticed any obvious difference, but then at the same time I was changed from Humulin to Fiasp and Toujeo and left on metformin. You know about the ‘five to drive’ safety warning that your BG should be at 5 before you should drive I presume, you could set your Libre 2 sensor to go off say at 5.2 on driving work days to catch any potential hypos. and feed appropriately. You must have told the DVL office anyway.

I am guessing that you were not aware that Libre are prone to what we refer to as "Compression Lows" where lying on the sensor in your sleep causes it to progressively read lower until it shows you are hypo and then when you roll off it again it slowly comes back up. It takes about 20 mins of pressure to create a compression low. I imagine your nurse did not know this as many do not.

If you are continuing to use Libre or other CGM it is worth reading this list about the limitations and quirks of Libre and other CGM....

CGM limitations and precautions

Moderator Note: This helpful reply was copied from another thread as it details some of the commonly experienced limitations of continuous glucose sensors. My blood sugar has been in perfect range for days now, but although I haven't changed anything, I'm starting to get very short periods of...

forum.diabetes.org.uk

 

[Wendal]

So I have some interviews for driving jobs next week. What do you suggest I should say to the prospective employers?
I am referring to possible risks of hypos as a result of taking gliclazide.

Afternoon as Barbara says the risk of having hypos applying to Gliclazide is exactly the same with having insulin so basically too much insulin either given exogenously via your bolus/ basal or by increasing production of your endogenous insulin via the Gliclazide.
As a type 3c if you have some remaining pancreatic function so that your endocrine ( Beta) cells are still capable of producing some insulin ( depending on level and location of necrosis) then I can see why they may have prescribed it.
The normal non insulin medication would be Metaformin in this situation but Gliclazide could be an alternative if Metaformin was not suitable for yourself.
It does however seem strange if you are already being prescribed insulin and should be checked out with your GP or DSN and ask for clarification.
I was put straight on insulin as my GP did not realise Metaformin was a possibility but as I got decent glycemic control with Insulin then I am happy to carry on.
Like most on here we can’t give specific medical advice and I am happy with my insulin regime.
In some ways it would have been nice to have had a more informed discussion with my GP and normally I can have a good discussion.
Am lucky enough to have an understanding of how these medicines work and interact but the imperative was to get my BG level which was 124 stabilised and I simply followed the GP advice.
Later on they had done sone more research and said Metaformin May be a possibility but as I am stable on insulin I am happy to stay on it.
Suppose I could have a C peptide test to find out but as I said am happy enough as things are.
If I had gone down the private route I may have done that but once I was in the NHS system with the pancreatitis my Consultant made it very clear I was better off in the NHS system and the diabetes support has been first class since.
Good luck with the job hunting and again my employer has been totally supportive during my pancreatitis and diabetes diagnosis and in fact it has helped given me an insight into explaining how our diabetes products work.

 

[Judithdalston]

I am guessing that you were not aware that Libre are prone to what we refer to as "Compression Lows" where lying on the sensor in your sleep causes it to progressively read lower until it shows you are hypo and then when you roll off it again it slowly comes back up. It takes about 20 mins of pressure to create a compression low. I imagine your nurse did not know this as many do not.

If you are continuing to use Libre or other CGM it is worth reading this list about the limitations and quirks of Libre and other CGM....

CGM limitations and precautions

Moderator Note: This helpful reply was copied from another thread as it details some of the commonly experienced limitations of continuous glucose sensors. My blood sugar has been in perfect range for days now, but although I haven't changed anything, I'm starting to get very short periods of...

forum.diabetes.org.uk

Yes, I have caught the compression lows…very inconvenient when alarm wakes you up and you then have to find the finger prick equipment, and jellies if needed, when all you really want is sleep! The lows that frightened the nurse were when I was on old regime of Humulin, gliclazide and metformin and no sensor, and I had queried for some years ( ie including covid) my HbA1c might be all right but it must be an average including the lows I had noticed…but then Gp surgery not interested! Yesterday with a new sensor of about 12 hours I got lots of lows…heaven knows why ( it was 12-14degrees C where I live in far NW England, so not hot weather)…after 6 months with my new regime I am learning these things happen!

 

[Busdriver60]

Afternoon as Barbara says the risk of having hypos applying to Gliclazide is exactly the same with having insulin so basically too much insulin either given exogenously via your bolus/ basal or by increasing production of your endogenous insulin via the Gliclazide.
As a type 3c if you have some remaining pancreatic function so that your endocrine ( Beta) cells are still capable of producing some insulin ( depending on level and location of necrosis) then I can see why they may have prescribed it.
The normal non insulin medication would be Metaformin in this situation but Gliclazide could be an alternative if Metaformin was not suitable for yourself.
It does however seem strange if you are already being prescribed insulin and should be checked out with your GP or DSN and ask for clarification.
I was put straight on insulin as my GP did not realise Metaformin was a possibility but as I got decent glycemic control with Insulin then I am happy to carry on.
Like most on here we can’t give specific medical advice and I am happy with my insulin regime.
In some ways it would have been nice to have had a more informed discussion with my GP and normally I can have a good discussion.
Am lucky enough to have an understanding of how these medicines work and interact but the imperative was to get my BG level which was 124 stabilised and I simply followed the GP advice.
Later on they had done sone more research and said Metaformin May be a possibility but as I am stable on insulin I am happy to stay on it.
Suppose I could have a C peptide test to find out but as I said am happy enough as things are.
If I had gone down the private route I may have done that but once I was in the NHS system with the pancreatitis my Consultant made it very clear I was better off in the NHS system and the diabetes support has been first class since.
Good luck with the job hunting and again my employer has been totally supportive during my pancreatitis and diabetes diagnosis and in fact it has helped given me an insight into explaining how our diabetes products work.

Thank you very much Wendal. I'm very grateful indeed. I will definitely keep you informed about my job hunting.

 

[Wendal]

Thank you very much Wendal. I'm very grateful indeed. I will definitely keep you informed about my job hunting.

No worries and wish you much luck in your quest to find another job

 

[Annette&Bert]

I absolutely agree but sometimes things labelled as low sugar can be lower carb but not necessarily so.
I use Lizi's low sugar granola but have been puzzled by the fact that the carbs vary between ones labelled as low sugar depending on where you buy from e.g from Costco 45g carbs per 100g, but elsewhere 56g per 100g. They also do others high protein at 40g per 100g.
So you do need to look carefully and not assume.

I do agree, I have tried with different food groups and I have seen this.

 

[a live]

I joined this forum a few weeks ago, after being diagnosed with diabetes. I've started using my Freestyle Libre 2 yesterday and I'm learning to read my BG. This morning, after breakfast having eaten my favourite Alpen cereal, I was shocked to see a spike on my Libre (21.3).

View attachment 30501

The pack does say 'no added sugar' and my BG shot up!

I'm slim but I LOVE eating because I'm always hungry. I'm a sweet-toothed, especially chocolate.

But, can anyone please suggest the best cereal to eat without spiking?

Thank you awry

oll cereals are possible to control it could be that the milk gives a bigger push to the sugar you should speak to your doctor about it or it could be that in the morning the liver gives you more sugar in the morning so it could be just the long term insulin that needs more just speak to your diabetes care taker

i hope you'll be able to continue eat your cereal

 

[Proud to be erratic]

i hope you'll be able to continue eat your cereal

That's a kind thought @a live (and welcome by the way).

I understand that @Busdriver60 is currently in an uncertain position since he has pancreatic damage from pancreatitis and hence potentially T3c, but that diagnosis is still not confirmed. Meanwhile he has a 1x daily basal insulin which is helping him but he still goes too high quite often, which he can see from his Libre2. So it seems that he needs to eat more as if T2 with a lowish carb diet - just to keep his BG in a reasonable place. Right now it's all evolving and confusing - but I think cereal probably might not a helpful solution at the moment!

 

[a live]

oh understand so for the future after its settled if it could still be problematic to eat cereal
I think time will tell and for now hope it will settle easily
just need to not get bored of it and keep to it it will be fine

 

[Busdriver60]

You already have risks of possible hypos from your basal insulin so the Gliclazide doesn't really change that in my view.
I don't know if you need to declare your diabetes and possible hypos other than to say you have a Medically Restricted Driving Licence and elaborate if they ask more. I would maybe contact the DUK helpline to see if you even need to declare that unless it is on the application form or you are asked, although I imagine it would be if it is a driving job. So it may ask if you hold a full UK driving licence and assuming you have informed DVLA about your insulin usage which you must do, then you would have to answer that you have a 3 year medically restricted licence.

I get the idea that maybe I should consider non driving work instead, as I really need the income. What do you think?

 

[rebrascora]

I think non driving work might ease the potential strain on you at a time when you have a lot to learn about managing your diabetes. I can't say how an employer might view employing you to drive. I am not saying that you shouldn't apply for driving jobs or that you are not able to do driving jobs but you do need to be able to manage your diabetes reasonably well to ensure you don't get stuck somewhere twiddling your thumbs in the middle of the day because you are "timed out" for an hour or so with a hypo, but 6 months or a year down the line, when you have a bit more experience of balancing your levels with insulin and food, you might manage a driving job a lot better.

 

[Busdriver60]

Hi rebrascora
Thank you for sharing that with me. I have had a long hard think about my future job hunting and now looking for any non driving job I am capable of doing. I have decided that, even when I do get my class 2 licence back, I won't be driving coaches or buses as I don't want to run the risk of being responsible of any accident, with passengers on board as a diabetic. I would also be required to take regular finger prick tests, which I don't want either. So instead, I have two interviews lined up for next week, both are for warehouse jobs, and will endeavor to continue job hunting until I'm successful. I do worry though, that some employers unfairly age discriminate. I will try not to be put off by that and also know this won't be easy. Hopefully, I will have some good news soon!
Thank you for your advice, I am very grateful.

 

[Leadinglights]

Hi rebrascora
Thank you for sharing that with me. I have had a long hard think about my future job hunting and now looking for any non driving job I am capable of doing. I have decided that, even when I do get my class 2 licence back, I won't be driving coaches or buses as I don't want to run the risk of being responsible of any accident, with passengers on board as a diabetic. I would also be required to take regular finger prick tests, which I don't want either. So instead, I have two interviews lined up for next week, both are for warehouse jobs, and will endeavor to continue job hunting until I'm successful. I do worry though, that some employers unfairly age discriminate. I will try not to be put off by that and also know this won't be easy. Hopefully, I will have some good news soon!
Thank you for your advice, I am very grateful.

B & Q seem to have a policy of recruiting more mature folk so there may be opportunity there if you have a store near you.

 

[SB2015]

I was very pleased when my diagnosis of T1 precluded me from driving the school minibus (at the time). I did not want the responsibility.
At the interviews if asked why you have changed from driving you could make a big positive of your responsible attitude as well as the positives of your effective management of your T1.
Let us know how you get on.

 

[Busdriver60]

Thank you for that, there isn't actually a B & Q in my town, the nearest one is 12 miles away. But worth exploring other DIY places.

 

[Busdriver60]

I was very pleased when my diagnosis of T1 precluded me from driving the school minibus (at the time). I did not want the responsibility.
At the interviews if asked why you have changed from driving you could make a big positive of your responsible attitude as well as the positives of your effective management of your T1.
Let us know how you get on.

Hi SB2015,
yes, I will do! Thank you!