Hello from newbie

[Spikey Plant]

I was diagnosed as type 2 in March 2021 with an HbA1c level of 89. My weight was 15.5 stone and I did not display any classic symptoms as such. I was prescribed 2000mg Metformin and decided on a dietary and lifestyle change.
I did not get any immediate dietary advice so decided to keep my carb intake to around 120g a day. In June 2021 my weight had dropped to 12 stone and my HbA1c level had dropped to 47. My GP and diabetic nurse said this was fantastic and have been told to get another HbA1c test in Dec 2021. I am continuing with the low carb diet.
However, from April, as the months went by, I began developing shooting pains and some skin sensitivity in many areas of the body, particularly in the feet and back, sometimes in the groin area, but anywhere on the body can be affected. These pains come and go but are always worse at night and the feet issue interferes with my sleep quite considerably. The feet can come on after lying in bed for a couple of hours, only to disappear after I’ve walked around a bit, to then return after going back to bed for an hour. ☹️
GP and diabetic nurse have said that this may be my body adjusting to the lower HbA1c level and these symptoms should subside after around 6 months.
Well it’s now September and these pains are showing no signs of improvement, if anything they seem worse. I cannot get much help from GP and the diabetic nurse repeats the HbA1c level change theory. Had several blood tests and all are normal. Had feet checked twice and no issues there. Of course I’ve trawled the internet but can’t find any situation which matches my symptoms.
Any thoughts or similar experiences from the forum members?

 

[ianf0ster]

Hi @Spikey Plant and welcome to the forum.
If it's any reassurance, your GP and diabetic nurse are correct about similar symptoms sometimes (rarely) occurring when Blood Glucose drops quickly because it takes the body time to adjust to it.
How long this can last and whether this is what it is in your case, I don't know.

 

[trophywench]

You know when they check your feet, does whoever checks them check the pulses in your ankles with either a stethoscope or a Doppler scanner? - I'm just wondering if it's more a circulation thing, like your foot/lower leg going dead when you've been sitting with one leg folded under your bum for too long ? Not rocket science to realise that if the blood flow all the way through the teensy veins to the nerves wherever isn't constant, the nerves complain, painfully! Hence why when you get out of bed and walk about, your tootsies go 'Aaaah - thanks mate!' Certainly it's very easy (for 'them') to check with a stethoscope the difference between the pulse in the groin and the ankle for starters.

 

[everydayupsanddowns]

Welcome to the forum @Spikey Plant

I wonder if the GP and DN are describing ‘treatment induced neuropathy’ (previously called insulin induced neuritis). This is a painful, bit thankfully transient/temporary form of neuropathy which can develop when BG levels have reduced dramatically after an extended period of them being high.

The amount and speed of A1c reduction seem to correlate with the severity of discomfort.

See: https://academic.oup.com/brain/article/138/1/43/337923

And this paper suggests that pain improves in the vast majority over the course of 18 months

Treatment-induced diabetic neuropathy: a reversible painful autonomic neuropathy - PubMed

Treatment-induced neuropathy is characterized by acute, severe pain, peripheral nerve degeneration, and autonomic dysfunction after intensive glycemic control. The neuropathy occurred in parallel with worsening diabetic retinopathy, suggesting a common underlying pathophysiological mechanism...

pubmed.ncbi.nlm.nih.gov

Hope you begin to see some improvement in the pain soon - it must be really difficult for you

 

[Jo.davis]

I was diagnosed as type 2 in March 2021 with an HbA1c level of 89. My weight was 15.5 stone and I did not display any classic symptoms as such. I was prescribed 2000mg Metformin and decided on a dietary and lifestyle change.
I did not get any immediate dietary advice so decided to keep my carb intake to around 120g a day. In June 2021 my weight had dropped to 12 stone and my HbA1c level had dropped to 47. My GP and diabetic nurse said this was fantastic and have been told to get another HbA1c test in Dec 2021. I am continuing with the low carb diet.
However, from April, as the months went by, I began developing shooting pains and some skin sensitivity in many areas of the body, particularly in the feet and back, sometimes in the groin area, but anywhere on the body can be affected. These pains come and go but are always worse at night and the feet issue interferes with my sleep quite considerably. The feet can come on after lying in bed for a couple of hours, only to disappear after I’ve walked around a bit, to then return after going back to bed for an hour. ☹️
GP and diabetic nurse have said that this may be my body adjusting to the lower HbA1c level and these symptoms should subside after around 6 months.
Well it’s now September and these pains are showing no signs of improvement, if anything they seem worse. I cannot get much help from GP and the diabetic nurse repeats the HbA1c level change theory. Had several blood tests and all are normal. Had feet checked twice and no issues there. Of course I’ve trawled the internet but can’t find any situation which matches my symptoms.
Any thoughts or similar experiences from the forum members?

Hi I have the same issues as you with my feet and legs it’s so bad occasional I am up all night. I have found it is worse if I don’t drink enough water in the day . I am unable to take normal metformin or jardiance as I have a dairy intolerance and most of the diabetic meds are in a lactose carrier . I started sukkarto today at 6 pm it’s now 1.30am and I’m up with a rolling belly and burping like a beast .The issue I have had before with any meds for diabetes is crippling pancreatic pain and stomach upset . So I just feel that if this doesn’t work I don’t know what next . Seeing my consultant Monday I also now have high BP which seems to be settling with telmisartan no side effects and high cholesterol but the statins cause such severe muscle pain and cramps I just can’t tolerate them .I’m trying hard to loose weight . No health care professional is interested at my GP surgery in fact I had to beg them to explain the blood monitor . I currently run at 7/8.5 on waking and after a meal it can be 11/12 .

 

[everydayupsanddowns]

Hi I have the same issues as you with my feet and legs it’s so bad occasional I am up all night. I have found it is worse if I don’t drink enough water in the day . I am unable to take normal metformin or jardiance as I have a dairy intolerance and most of the diabetic meds are in a lactose carrier . I started sukkarto today at 6 pm it’s now 1.30am and I’m up with a rolling belly and burping like a beast .The issue I have had before with any meds for diabetes is crippling pancreatic pain and stomach upset . So I just feel that if this doesn’t work I don’t know what next . Seeing my consultant Monday I also now have high BP which seems to be settling with telmisartan no side effects and high cholesterol but the statins cause such severe muscle pain and cramps I just can’t tolerate them .I’m trying hard to loose weight . No health care professional is interested at my GP surgery in fact I had to beg them to explain the blood monitor . I currently run at 7/8.5 on waking and after a meal it can be 11/12 .

Sorry to hear you are having such a tricky time with meds Jo.

Your BGs are elevated, but don’t seem to be horrifically high from a T1 perspective. Have you reduced the amount of total carbohydrate you are eating (not just sweet and sugary things)?

I wonder if a more low-moderate carb approach might allow your body to deal with the carbs you are eating without needing the Metformin/Sukkarto that doesn’t seem to suit you well?

Several members here have managed to alter their diet and reduce or remove the need for meds with a lower carb approach. It doesn’t work for everyone, but I wonder if it would be worth trying in your case, as you seem to have quite strong reactions to things?

 

[ianf0ster]

Hi @Jo.davis and welcome to the forum.
You are very lucky as a Type 2 to get a Blood Glucose meter if you live in the UK. We are usually told not to test and just wait for the HbA1C (blood draw tests) which are every few months.
Since Blood Glucose can spike much higher after just a single high carb meal, this is rather like using speeding tickets to gauge your speed when driving.

The Blood Glucose figures you mention seem low enough that reducing some of the higher carbohydrate foods from your normal diet should have a large effect. Indeed in general for a Type 2 what we eat has a bigger effect than either exercise or any diabetes med apart from insulin.

Since you have problems with the medication then a Low Carb way of eating seems just right for you. You need to measure BG before a meal and the 2hrs after your first bite. aiming for an increase of 2mmol or less.

The meal that most get wrong is Breakfast, since cereals are high in carbohydrates as are fruit juices, bread and even skimmed milk (in fact full fat milk is better than skimmed).The best food for breakfast is eggs - boiled, fried, poached, scrambled etc, of meat, cheese or fish. Though a few (very few) Type 2 diabetics are OK with oats/porridge for breakfast, but most are not - the problem is that we all react slightly differently, hence the need to test for yourself!

 

[Jo.davis]

Hi @Jo.davis and welcome to the forum.
You are very lucky as a Type 2 to get a Blood Glucose meter if you live in the UK. We are usually told not to test and just wait for the HbA1C (blood draw tests) which are every few months.
Since Blood Glucose can spike much higher after just a single high carb meal, this is rather like using speeding tickets to gauge your speed when driving.

The Blood Glucose figures you mention seem low enough that reducing some of the higher carbohydrate foods from your normal diet should have a large effect. Indeed in general for a Type 2 what we eat has a bigger effect than either exercise or any diabetes med apart from insulin.

Since you have problems with the medication then a Low Carb way of eating seems just right for you. You need to measure BG before a meal and the 2hrs after your first bite. aiming for an increase of 2mmol or less.

The meal that most get wrong is Breakfast, since cereals are high in carbohydrates as are fruit juices, bread and even skimmed milk (in fact full fat milk is better than skimmed).The best food for breakfast is eggs - boiled, fried, poached, scrambled etc, of meat, cheese or fish. Though a few (very few) Type 2 diabetics are OK with oats/porridge for breakfast, but most are not - the problem is that we all react slightly differently, hence the need to test for yourself!

Hi there thank you so much for your reply. I find it so hard to get my head around diet I have been in pain since midnight last night after taking sukkarto at 6 with a meal roasted veg and chicken .pain is pancreatic and intense with bloating and nausea. I don’t think I can take another sukkarto .seeing my consultant Monday. I just think metformin is not for me .I have been given th opportunity. To loose weight and I do but it creeps back on no matter how I eat .I don’t want insulin what else can I try .

 

[ianf0ster]

I lost weight (as a side effect) from eating a Low Carb way of eating to reverse my T2 diabetes, I didn't absolutely need to lose weight as was only 2lbs into the overweight BMI.
However their are a whole host of improvements that eating traditional real food (minimal processed stuff) and keeping it Low Carb can bring for :
Blood Glucose
Weight
Blood Pressure
Water Retention
PCOS
even in some cases Depression

 

[rebrascora]

Well I spoke with Diabetic Nurse and when describing my symptons of areas of skin being over sensitive and shooting pains around the body she believes this may be medication induced. The A1c drop can cause discomfort but she believes it has been too long to be a factor and the fact my symptons are getting worse. I had no symptoms until around 5 weeks after starting meds. She has suggested stopping the statin for cholesterol for four weeks. My cholesterol was always normal anyway. If no change then stop metformin for four weeks. I have decided to stop both for four weeks and then, if symptoms improve, go back on metformin and see what happens. Today is day three without meds. No change yet.

I believe that it can take quite a while for the side effects of statins to wear off. Hope you see some improvement soon. So annoying that they prescribed them when your cholesterol levels were normal and didn't warrant them.

As I was reading this thread, I did wonder if it might be due to vitamin B deficiency which can occur as a result of eating low carb because we often get most of our Vit B from grains and when we cut out bread and breakfast cereals, it can leave us short. Added to that Metformin can inhibit the absorption of the Vit B that you are ingesting, so might be worth asking if they checked your Vitamin B levels.

Good luck getting to the bottom of it and getting it resolved and well done on the fantastic weight loss and HbA1c reduction.

 

[Lucyr]

Well I spoke with Diabetic Nurse and when describing my symptons of areas of skin being over sensitive and shooting pains around the body she believes this may be medication induced. The A1c drop can cause discomfort but she believes it has been too long to be a factor and the fact my symptons are getting worse. I had no symptoms until around 5 weeks after starting meds. She has suggested stopping the statin for cholesterol for four weeks. My cholesterol was always normal anyway. If no change then stop metformin for four weeks. I have decided to stop both for four weeks and then, if symptoms improve, go back on metformin and see what happens. Today is day three without meds. No change yet.

Why did you stop the metformin as well when she only said to stop the statin? You’ll have to go back to the start of slowly building up the metformin to tolerate the side effects again if you stop it for 4 weeks