Confusion

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PWWiddyT2

PWWiddyT2

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First of all I would like to say hello...
I am a 45yo chap and was diagnosed with Type 2 around the beginning of March.
I, like I presume, many others on diagnosis sat light a rabbit in the headlights in the GP’s room when listening to my blood results and beginning the first day of my new life..

I went to see the practice nurse for these results (117 HbA1c) and told that was very high, was given a prescription for Metformin, and told to more or less go straight to 2000mg a day, a monitor and test strips and then given another appointment to see dietician the following week.

To be honest I learned more from her than either the GP or practice nurse, however, a coupe of days ago I had a phone appointment with a different GP, due to stomach issues with the Metformin, and he has told me to just cut down Metformin to 500mg a day and that I shouldn’t even bother with testing!!

I’ve been testing twice daily and have seen my levels come down to around 6-7 average from over 20. Took the GP’s advice and lowered my Metformin, but still tested and now levels are higher than they have been in weeks!!

Does anyone else have conflicting information from GP’s, practice nurses, etc?
 
PWWiddyT2 said:
First of all I would like to say hello...
I am a 45yo chap and was diagnosed with Type 2 around the beginning of March.
I, like I presume, many others on diagnosis sat light a rabbit in the headlights in the GP’s room when listening to my blood results and beginning the first day of my new life..

I went to see the practice nurse for these results (117 HbA1c) and told that was very high, was given a prescription for Metformin, and told to more or less go straight to 2000mg a day, a monitor and test strips and then given another appointment to see dietician the following week.

To be honest I learned more from her than either the GP or practice nurse, however, a coupe of days ago I had a phone appointment with a different GP, due to stomach issues with the Metformin, and he has told me to just cut down Metformin to 500mg a day and that I shouldn’t even bother with testing!!

I’ve been testing twice daily and have seen my levels come down to around 6-7 average from over 20. Took the GP’s advice and lowered my Metformin, but still tested and now levels are higher than they have been in weeks!!

Does anyone else have conflicting information from GP’s, practice nurses, etc?
Click to expand...
Hi @PWWiddyT2, welcome to the forum 🙂 Sorry to hear about your diagnosis :( You've certainly learned quickly that the quality of care and advice can vary considerably in the field of diabetes! 😱

The nurse who prescribed the strips and meter has the right idea - testing is the only good method of discovering whether you are making good food choices i.e. eating meals that your body can tolerate well and don't have a big impact on your blood sugar levels. I would recommend reading Test,Review, Adjust by Alan S in order to understand how to test efficiently and effectively. The aim is to test before eating, then test one or two hours after eating to see how much your blood sugar levels have risen do to the carbohydrate content (both amount and type of carb) in your meal. Record what you ate in a Food Diary, alongside your before and after meter readings, and eventually you will begin to recognise patterns which will help you to decide whether you need to perhaps replace or reduce certain carbs in the meal, or if you tolerate it well 🙂 Everyone's tolerances can be different, so whilst there are some basic rules, you do need to discover your own situation 🙂

I'd also recommend reading the excellent Maggie Davey's letter for a good overview of an approach to managing your diabetes well, and also get a copy of Type 2 Diabetes: The First Year by Gretchen Becker which will encourage and guide you through these early weeks and months 🙂 In my opinion, all newly-diagnosed Type 2s should be given this information then they would be off to a fine start! 🙂

As for the metformin, the advice is usually to build up to the full dose, rather than have it hit you all at once from the beginning, so the nurse was wrong in that respect and the second one got it right - side-effects should be much reduced if your body can adapt to it gradually. If side-effects are still too bad after a few weeks there is a modified release version which many people tolerate better, so you should ask for it if problems persist 🙂

Please let us know if you have any questions and we will be more than happy to help! 🙂
 
Hi @PWWiddyT2 ,
Im fairly new here myself, but I wouldn't let the increased bg levels persist for long periods I suggest asking about the modified release version of Metformin as @Northerner suggests or discuss other treatments with your GP.
I also wonder what advice you had from your dietician regarding your diet, what has been working for me, so far, is following a Low Carbohydrate Higher Fat diet, keeping carbohydrates to around a maximum of around 50g per day and substituting them with proteins and healthy fats. I am aware however that what works for one person may not work for another.
Hope you manage to get your situation resolved soon and it certainly doesn't help when you're getting conflicting advice..
 
Thanks for the reply. My dietician had some really good advice, including this website...
Low carb diet she told me yeah, but I don’t think a specific amount was noted. Just the usual about whole meal stuff instead and less of them.
I think on the diet side I am doing ok, as well as my exercising, which I am enjoying once again after a 7-8 year rest!!
I just found it a little confusing when the GP told me to lay off the testing and quarter the amount of my Metformin dosage.
I agree with Northerner regarding testing. It’s a window into everything you ear and drink.
Thanks again for your advice.
 
Northerner said:
Hi @PWWiddyT2, welcome to the forum 🙂 Sorry to hear about your diagnosis :( You've certainly learned quickly that the quality of care and advice can vary considerably in the field of diabetes! 😱

The nurse who prescribed the strips and meter has the right idea - testing is the only good method of discovering whether you are making good food choices i.e. eating meals that your body can tolerate well and don't have a big impact on your blood sugar levels. I would recommend reading Test,Review, Adjust by Alan S in order to understand how to test efficiently and effectively. The aim is to test before eating, then test one or two hours after eating to see how much your blood sugar levels have risen do to the carbohydrate content (both amount and type of carb) in your meal. Record what you ate in a Food Diary, alongside your before and after meter readings, and eventually you will begin to recognise patterns which will help you to decide whether you need to perhaps replace or reduce certain carbs in the meal, or if you tolerate it well 🙂 Everyone's tolerances can be different, so whilst there are some basic rules, you do need to discover your own situation 🙂

I'd also recommend reading the excellent Maggie Davey's letter for a good overview of an approach to managing your diabetes well, and also get a copy of Type 2 Diabetes: The First Year by Gretchen Becker which will encourage and guide you through these early weeks and months 🙂 In my opinion, all newly-diagnosed Type 2s should be given this information then they would be off to a fine start! 🙂

As for the metformin, the advice is usually to build up to the full dose, rather than have it hit you all at once from the beginning, so the nurse was wrong in that respect and the second one got it right - side-effects should be much reduced if your body can adapt to it gradually. If side-effects are still too bad after a few weeks there is a modified release version which many people tolerate better, so you should ask for it if problems persist 🙂

Please let us know if you have any questions and we will be more than happy to help! 🙂
Click to expand...

Thank you for your reply and advice... It is much appreciated.
I will check out the reading you have noted and will find them a great help I am sure.
I do agree with you regarding the testing as I find it the most helpful tool I have, and cannot understand why the GP would say it’s a waste of time to be honest. I am back to see them in a couple of weeks and I will be asking about the slow release version as I think my stomach (which is dodgy at the best of times) will cope with those better!!
Thanks again..
 
Hi and welcome 🙂
Testing for me has been Essential so definitely continue as it’s how you will see what your body reacts to. Personally I followed the low carb option by cutting out all rice, pasta, potatoes, veg that grows underground and anything else starchy. I do eat Burgen bread for toast or if I need to take a sandwich with me, it’s a soy and linseed low carb bread. I found it helpful to keep a food diary and track my bg levels, I soon started to see patterns and that helped me adapt my meals :D
 
Welcome PWWiddy.

Good to hear how you are getting to grips with your management of Diabetes.
As others have said, testing gives you information on which you can act and adapt what you choose to eat.
 
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