Letrozole and T2 diabetes

[happydog]

I have had treatment for breast cancer over the last year. I now have to take Letrozole which suppresses oestrogen production. I have just had my annual diabetes review by telephone. I had to go to the hospital for a blood sample to be taken for the HbA1c. Sadly my blood glucose levels are raised from 42 to 54 . The DN at the surgery says that I will have to have another blood test at the end of June and may have to go onto tablets etc. I had a lot of steroids and a major reaction to the chemotherapy that put me in hospital for almost a month with ulceration of the entire digestive tract. I pointed out to her that the Letrozole is know to increase blood glucose levels and she said that she had never heard of that. The oncologist says "choose your battles, diabetes is the least of your problems at present, concentrate on getting well again". Currently my BG is between 7 and 8. I have tried very hard to control my diabetes and I am hoping that it will improve. So my query is does anyone else have experience of Letrozole and it's influence on blood glucose? People on this forum have been very kind and helpful over the years (diagnosed Sept 2012). Any advice is welcome 🙂

 

[Leadinglights]

Welcome back, you certainly have been through the mill and hopefully you are on the road to recovery.
An HbA1C in the circumstances is not all that high, yes it is disappointing that it has gone up. Steroids are well known for increasing blood glucose so that had probably played a big part.
You really just have to do your best and watch your carbohydrate intake as that will have to most impact in trying to get blood glucose down.
I think I agree with your consultant and at the glucose levels you are seeing it is not a priority.

 

[happydog]

Thank you Leadinglights. I do try not to eat much carbohydrate. I can only try. I am really not keen on medication as metformin made me have bad stomach cramps and diarrhea. Gliclazide made my blood glucose go too low (less than 4). I am not keen on needles although I was given insulin in hospital because of the steroids. I feel that I have had a bit of a bashing this last year so I am hoping that as my general health improves that will do so too. ;😉

 

[rebrascora]

So good to read a post from you again @happydog. I have been wondering how you were getting on and been meaning to PM you but didn't want to intrude. So pleased to hear they eventually gave you insulin to manage your levels through the cancer treatment. I hope you are winning that battle.

I agree with your oncologist that the diabetes isn't a battle you need to actively engage in other than through your current dietary management. If your levels were a lot higher it would be another matter, but the way I look at it, I am achieving HbA1c's of low 50s and my diabetes consultant is extremely happy with that. Ok I am Type 1 but surely an HbA1c result is the same for all of us and no one is suggesting I start taking extra medication to try to bring it down further. Many Type 1s don't achieve even as good a result as that and can spend most of their lifetime with higher HbA1c levels. In an ideal world, it would be nice if we could all maintain our BG levels in the normal range but I don't think being a bit higher is a great risk and I would say the risk from medication for you with your other health issues might be higher than slightly elevated BG levels.

I know you already have your head around low carb eating so I doubt there is much wriggle room in that (but alwaus worth a re-assessment and I think it is also important not to deny yourself a little treat occasionally, as long as you are eating well the majority of the time.

I really wish you well with your health battles and I think in the circumstances you are doing incredibly well with your diabetes and don't forget you do have the right to reject the offer of diabetes medication at this time if you feel it will negatively impact your health in other ways. Maybe negotiate a 3 monthly HbA1c test rather than medication, so that you can re-evaluate the situation if things change too much in the wrong direction. That said, if you are testing reasonably regularly you will have a good idea if things are ticking along OK or if your levels are starting to rise.

Considering everything you have been through I think you are doing brilliantly. Good luck!

 

[happydog]

Thank you so much Rebrascora for your encouraging reply. Yesterday I was signed off for a year by the cancer team that have been looking after me. They have been absolutely brilliant. The DN keeps saying that I do not need to test my BG as I am a type 2. Fortunately my GP has supported my request for test strips and I get 25 per month which does the job. (I remember when she said that I was very overweight which I have never been. I am 1.65m and weight 60 kg.) I will continue to try everything that I can to control my diabetes without medication, frankly unless it goes a lot higher I will refuse tablets etc. I feel very hopeful that as my body gets back to 'normal' I will find better control. I know that Letrozole also increases cholesterol and the nurse is very keen for me to have statins, but as my last test was 3.2 I have refused. This forum has been a life saver for me as I was never given much information about diabetes and how to control it. The instant reaction at diagnosis was medication. I have had to fight hard but I have done it with the support of kind people like you helping and giving advice from people who really know what it is like to have this condition. Thank you to everyone 🙂