Chemotherapy and diabetes

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happydog

happydog

Well-Known Member
Relationship to Diabetes
Type 2
`i had my first chemotherapy session on the 23rd September. No one told me that it would send my Blood glucose way up, 21.5. When the hospital contacted me there was some talk about sending me to hospital. Fortunately it came down when I finished the steroids. Phew! The hospital want me to get the GP to prescribe medication as evasive action for the next session. He phoned me after several days and calls to the surgery to say that he would prescribe metformin. The hospital had gliclazide in mind. GP said to take metformin for three days before the next chemotherapy session, hospital said only on the day. I am finding this conflicting information confusing and stressful. Surely I am not the only person who has type 2 diabetes and cancer? My levels are better but not completely down. Will they stay up? I asked the GP who said "I don't know". Sorry just having a rant
 
So sorry to hear that your levels went that high but good that they have come down a bit.
In my opinion your GP is not being helpful prescribing Metformin, which usually takes weeks to build up in the system and even then would have minimal impact on levels that high. So taking them 3 days before your chemo is a waste of time and could potentially upset your stomach which is the last thing you need when you are also having chemo. I don't think it would be unreasonable for them to give you insulin to tide you over this very difficult time. Pregnant women with gestational diabetes get prescribed insulin short term to manage levels. The hospital should have instructed the GP to prescribe Gliclazide rather than just "had it in mind" and that would certainly be middle ground that you should definitely push for. Maybe get back onto your hospital team and see if they can sort it from their end or challenge your GP about the action and timescale issues with Metformin for your situation..... really difficult I know. Is there a diabetes trained nurse at your practice who might be able to advocate for you? Or push your GP for a diabetes clinic referral. Timescales wise that is probably not going to be helpful because of the waiting time for appointments, but maybe your oncology team could recommend you being fast tracked.

Sending you (((HUGS))) and really hoping you can get something more effective to help you through this very difficult time.
 
When I was receiving chemo the steroids sent my BG into the low 30s but I was on insulin and able to pump myself full for the duration - a week per month if I recall. My diabetes consultant warned me so maybe worth you taking it up a notch or two from your GP.

Good luck.
 
happydog said:
`i had my first chemotherapy session on the 23rd September. No one told me that it would send my Blood glucose way up, 21.5. When the hospital contacted me there was some talk about sending me to hospital. Fortunately it came down when I finished the steroids. Phew! The hospital want me to get the GP to prescribe medication as evasive action for the next session. He phoned me after several days and calls to the surgery to say that he would prescribe metformin. The hospital had gliclazide in mind. GP said to take metformin for three days before the next chemotherapy session, hospital said only on the day. I am finding this conflicting information confusing and stressful. Surely I am not the only person who has type 2 diabetes and cancer? My levels are better but not completely down. Will they stay up? I asked the GP who said "I don't know". Sorry just having a rant
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I completely agree with @rebrascora in relation to the Metformin. I can't see you benefitting at all, or absolutely minimally if you do. Gliclazide (or it's ilk) is a much more immediate impact. Does the hospital communication stipulate Gliclazide? If this is so, it's naughty of you GP to do something different.

To be honest, I'd want to talk to the hospital diabetes team about all of this. They'll at least know what they're talking about.

Good luck with the ongoing treatment.
 
Ah sorry you’ve had such a tough time with the chemo and steroids @happydog

Steroids do have a real reputation for causing havoc with Bg levels sadly.

Glad to hear things have started to settle a little for you. It’s the last thing you need on top of the rigours of the chemo itself isn’t it?!

Hope you find a meds strategy that works for next time. You may have to put on your assertive hat when discussing with your GP?
 
That is part of the prob though surely - that the OP does not get to see anyone higher up the diabetes scale than her GP and the surgery nurse who appears utterly clueless about the effects of trauma/other illness etc on BG - so cannot escalate herself upwards unless she wants to attach rockets to her feet. Her oncologist is not going to be of any help - he only knows about cancer and they no longer overstep their job description or even appear to speak to each other socially or seem to know their names even, these days.

Ring the oncologists secretary and ask them to get him/her to write to the GP saying that they suggested Glic in the knowledge that Metformin was not suitable for the job required.
 
Thank you so much for your reply Rebrascora. What you have said makes a lot of sense to me. I had a feeling that the GP and the hospital were trying to put the responsibility for this onto each other. It took the GP 5 days to phone me. Sadly the GP has had it in for me ever since I refused to have medication in 2012 and is annoyed that I have managed to get it under control by myself. I am saying this because he actually said "you will have to have medication now and probably for the rest of your life whether you want it or not". He dismissed the hospital's suggestion by saying "that is not an appropriate medication in this case". So solid brick wall there. The nurse has no idea and suggested the other day that I should eat more bananas. I will go back to the hospital today, thanks for your help. 🙂
 
Thank you Andbreathe. I am going to have a go at the hospital today. I do feel that everything is such a struggle at my surgery although it is reckoned to be the best one in the area. 🙂
 
Thank you for your message Everydayupsanddowns. The book on mindfulness that you recommended has been brilliant, thank you. I have been extremely fortunate to not have severe side effects from the chemo although I have 5 more cycles yet :(. The blood glucose thing scared me as I did not realise that it would be affected and when they started to talk about putting me in hospital that was not good. I hope that I can get it resolved. 🙂
 
Thank you for your reply. It made me chuckle. I will try to get something sorted today. It all seems to be such a struggle. I cannot fault the cancer treatment that I have had and I am so grateful that other than a sore throat and mouth and the BG issue I have not had a problem with side effects so far. This forum is utterly brilliant! Thank you. 🙂
 
happydog said:
Thank you Andbreathe. I am going to have a go at the hospital today. I do feel that everything is such a struggle at my surgery although it is reckoned to be the best one in the area. 🙂
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It will be scant, if any, comfort to know there are many feeling the same out their GPs at present.

Fingers crossed you feel more comforted after your hospital visit.

Keep on keeping on. We're rooting for you.
 
I wonder if PALs would be of any help. It is a patient advocacy organization I believe and might be able to put your case across better than yourself, especially if you have a difficult relationship with your GP.... or maybe bash medical heads together until they see sense.
I feel like I want to start a protest on your behalf and come and wave placards and shout "INSULIN FOR HAPPYDOG" outside your GP surgery. Anyone care to join me??

It might be useful to contact the diabetes helpline above and see if they have any other suggestions.
 
Sorry to hear that you are not getting the support with managing your diabetes along with all that you are coping with.

I hope that you can get a referral to the diabetes team to help you with this, possibly switching to using insulin during this time. Steroids do make things very hard to manage without the extra flexibility of insulin.

Let us know how you get on.
 
I spoke to PALS once years ago about something - and they said they didn't deal with GP complaints, you have to raise GP complaints with the GP surgery itself.
 
Do you have a Macmillan nurse or similar? My husband found that his was particularly good at banging heads together when Oncology didn't seem to know what ENT were doing, and vice versa.
 
... many MacMillan nurses are indeed lovely - my husband's wasn't very helpful at all - though sometimes he got to speak to a colleague one - and they were. If your husband had an appt letter telling you to see the nurse a fortnight after you underwent a total prostatectomy, which said the appt was for TWOC - would he or you know what that was? I commented at the time that the only time I'd heard 'TWOC' was on police programmes on telly being Police shorthand for 'Taking without consent' ie theft of a car without owner's permission - and hence didn't think you'd need to go to a hospital in order to resolve it.

How utterly thick must we be - the person was totally amazed neither of us knew it meant 'Trial without catheter' - and when I told her what TWOC means to the Police Force, she practically fell about laughing. (Clearly it's hilarious after you've got up early specially to get there to see her on time, driven miles to the hospital and paid to park in order to see her ..... or are accused of stealing a car - or just that we're peculiar and clearly don't share her sense of humour)

Let's all hope she was the SOLE exception!

- and I apologise profusely to @happydog for not thinking of that way of hopefully getting round your problem and nipping it in the bud (though perhaps you can understand now why I didn't) - because they do normally short circuit 'stuff like this' and get things sorted out properly - so it's the best idea yet @JJay !
 
happydog said:
Thank you Andbreathe. I am going to have a go at the hospital today. I do feel that everything is such a struggle at my surgery although it is reckoned to be the best one in the area. 🙂
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Good luck, my surgery is not as good as it used to be, but it much better than the one nearest to me.
 
Firstly thank you all for taking time to reply and make suggestions. I spoke to the hospital today. They were very nice but said that I will have had my second chemo before they would be able to offer an appointment with the diabetes clinic. (It is on 14th October.) She suggested that I could "give it a go" with the metformin and see what happens. Conflicting advice again in that she said I should start 3 days before the chemo, (I was told day of the chemo last week.) I said that i am concerned about nausea with the metformin and she said you will not know until you take it. Everyone is different.
My BC nurse has been completely unsupportive. She had a brief conversation with me on the day that I was diagnosed and I have never seen or heard from her since. I have left her a couple of messages but she never contacts me or returns my calls. :( not good.
 
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