Help please

[Scottie Lottie]

As previous posts I was taken off metforman 1000SR several weeks ago as having issues with constant toilet visits. Was asked by GP to stop my metforman for Two weeks and problem has mostly gone. 5 weeks ago I started on 40mg Gliclazide morning and evening 30 minutes before meals. My BG was average betweeh 13-16.9. Increased last week to 80mg morning and 40mg before evening meal, my BG has gone between 12.7 Lovett to 15.7 highest.
I have had no issues with my BG and my Hbc1 annual checks until these past weeks. The metforman obviously worked for me keeping my BG controlled. I am concerned as I have not experienced these high BG in 9 years of Type 2. The gliclazide first seem to be working.

 

[Scottie Lottie]

Meant to write “ the gliclazide doesn’t seem to be working.”

 

[trophywench]

You were originally asked if you'd tried eating less carbohydrate, to which question you didn't reply. So - have you tried that?

 

[Scottie Lottie]

Sorry ! I have reduced my carbohydrates especially bread. No difference to my BG. When I was taking 1000mg metformin and 40mg Gliclazide for several years had no issue with my BG levels. This has just happened coming off metformin.

 

[trophywench]

ok - you're on nowhere near the highest dose available of gliclazide as yet so no need to panic either as yet. Just contact the surgery first thing on Monday and tell them.

Metformin does nowt to reduce the BG - what it does do though is assist your body in using the available insulin more efficiently so in the absence of it, perhaps a higher dose of Glic (which encourages your pancreas to produce more insulin than it currently does) might do the trick?

 

[Eddy Edson]

Metformin does nowt to reduce the BG

People say this, but it's quite misleading.

The typical effect of Metformin in T2D is to reduce the amount of BG produced by the liver via "gluconeogenesis". This is the process by which the liver constructs glucose from fats and proteins, when it thinks the bod doesn't have enough BG. In T2D the liver gets this wrong, because fat around the liver reduces its sensitivity to insulin, and the liver uses insulin as a signal to tell it whether there's enough glucose in the blood. So the liver chugs out too much glucose, especially overnight. Metformin improves the liver's insulin sensitivity, and so reduces the amount of glucose it produces via gluconeogensis.

Rule of thumb: if you have high waking BG, but taking Metformin for a few days improves things, then it could well be that you have too much fat around your liver (as is typical in T2D). Losing weight can reduce this amount of fat, improve the liver's insulin sensitivity, resolve the gluconeogensis dysfundtion, and reduce waking and general background BG.

 

[SB2015]

Sorry ! I have reduced my carbohydrates especially bread. No difference to my

Any carbs you eat will become glucose once inside you. Do you know how many carbs you are eating at each meal. If you can find a way of reducing this total number it will reduce the amount of glucose going into you. Have you tried keeping an honest food diary alongside the carb content.

We all react differently to different foods and testing before and again 2 hours after a meal can help you to identify how different foods impact your levels and/or what portions size your body can manage. It takes a bit of workout it can be worth it.

 

[Scottie Lottie]

ok - you're on nowhere near the highest dose available of gliclazide as yet so no need to panic either as yet. Just contact the surgery first thing on Monday and tell them.

Metformin does nowt to reduce the BG - what it does do though is assist your body in using the available insulin more efficiently so in the absence of it, perhaps a higher dose of Glic (which encourages your pancreas to produce more insulin than it currently does) might do the trick?

Thank you. My DN made an phone appointment (which is what I think will be the norm for the future sadly) with me for 18th to see how this meds are working or if they are not but has said if I am concerned and not a big change in my BG levels to contact her before then. Which I will do.
I think I got so comfortable with my diabetes over the past 9 years and not had any issues and know i have found this sudden change it has made me anxious and insecure with my treatment with this recent sudden change.

 

[Scottie Lottie]

Any carbs you eat will become glucose once inside you. Do you know how many carbs you are eating at each meal. If you can find a way of reducing this total number it will reduce the amount of glucose going into you. Have you tried keeping an honest food diary alongside the carb content.

We all react differently to different foods and testing before and again 2 hours after a meal can help you to identify how different foods impact your levels and/or what portions size your body can manage. It takes a bit of workout it can be worth it.

I have been much more aware of this over these past weeks and have been more diligent and being careful. The food diary along with carbs is a good idea and will start doing that. Thank you.

 

[everydayupsanddowns]

Hope you fond a new balance of meds and menu that work to successfully manage your blood glucose @Scottie Lottie

It can be very disconcerting when your diabetes suddenly changes the rules and starts behaving differently, but that does seem to be part and parcel of things unfortunately.

Hope your appointment goes well 🙂

 

[Scottie Lottie]

Hope you fond a new balance of meds and menu that work to successfully manage your blood glucose @Scottie Lottie

It can be very disconcerting when your diabetes suddenly changes the rules and starts behaving differently, but that does seem to be part and parcel of things unfortunately.

Hope your appointment goes well 🙂

Thank you. I do really appreciate all your thoughts and information. It really helps especially from others who experience some issues being a diabetic. I don’t feel so alone since joining this forum and it helps any anxiety I’m experiencing at this time.