Metformin, Canagofloxin and Trulicity

M

manlyp

New Member
Relationship to Diabetes
Type 2
About a year ago, after being pre-diabetic for 3 or 4 years, my HbA1c crept up and I became fully diabetic. Since then I’ve been prescribed various tablets. Ordinary Metformin to start with and then slow acting Metformin but I didn't get on with either and I was prescribed Canagofloxin 100mg in February and 300mg a month later.
In February my HbA1c was 61 and it is now 63 and my doctor has stopped the Canagofloxin on the grounds that it is not working and today put me on to weekly self injectable Trulicity 0.75mg.
Over the last few months I have become nauseous, sometimes dizzy, tired and thirsty which I assume is because my blood sugar level is not under control. Are there members out there who have had a similar experience and does Trulicity work?
 
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Hi and welcome to the forum.

Sorry to hear that your levels are gradually creeping up. You mention a lot of different medication, but have you made any dietary changes as well as they can actually be more powerful than most oral medication?

Unfortunately, many medical professionals have no idea of just how effective the right dietary changes can be and it usually has a lot less side effects than the medication they prescribe. Many people are under the impression that diabetes is all about sugar because people talk about blood sugar being high, but what most people don't realize is that all carbohydrates get broken down into glucose by our digestive system and absorbed into the blood stream where as diabetics we are unable to efficiently metabolise them, so they build up making our blood thick and syrupy. If we eat less carbs (starches and sugars) then we are putting less glucose into the system and that enables our bodies to better cope with what is in our blood. If you are not sure what foods are high in carbohydrates, then the obvious ones are sweets, cakes and biscuits but also all grain products including bread, pasta, couscous, breakfast cereals, pastry, batter, rice and potatoes and potato products (crisps/chips/hash browns etc) And of course fruit is also high in natural sugars some ore than others, so generally berries like rasps and strawberries and blackberries and black currants are low carb but the sweeter fruits like grapes and bananas and mangoes are much higher. Most of us restrict ourselves to a small daily portion of berries as our fruit intake and verry occasionally treat ourselves to perhaps half a banana or an apple.
That may all sound rather restrictive but actually it can be really enjoyable once you get your head around it. The difficulty lies in the fact that many of us have piled our plates up with spuds and bread most of our lives and the idea of not having toast or cereal for breakfast is a bit mind boggling or not having a sandwich for lunch, until you learn all the other lovely foods that you can eat. Anyway, just thought I would mention dietary changes, since you hadn't and it might perhaps be something to consider before you start yet more medication.
 
Thankyou Barbara,
Re your first paragraph. I have made many dietary changes to control diabetes and followed an exercise regime for years. I’m also familiar with the connection between carbohydrate intake, glycemic indices and the excellent works of Michael Moseley. You are right, restricting carbohydrate input works but not for everyone forever, hence my question about controlling diabetes with Metformin, Canagofloxin and Trulicity! I am interested in hearing about other people’s experience. I didn’t get on with the first two medications and the third one has just been prescribed by a doctor who specialises in diabetes who appears to me to know what he is talking about.
 
Welcome to the forum @manlyp

We’ve had many more forum members asking about trulicity over recent years as their use has widened.

There are some threads with other people’s experiences here:

As with many medications, it seems to work really well for some people, and are less successful or well tolerated by others.

It’s a GLP-1 agonist, which encourages the beta cells in the pancreas to release more insulin. There is also a possible weight loss effect. It is not recommended in T1 because of an increased risk of DKA.

Have you been given a BG meter to monitor progress yourself? Or will you be relying on HbA1c checks every few months?
 
Mike, thank you for your comments. I will be relying on HbA1c checks every few months as they seem to be the gold standard for measuring sugar levels but I’ve also been given a BG monitor. It’s early days but I’m a bit sceptical about how to use it to judge how my meds are working. I’ve seen how tests before and 2 hours after meals show spikes of varying degrees and how exercise can induce troughs, but for the last few days I’ve taken a reading first thing in the morning after 10 to 12 hours of fasting and they are most erratic - anything from 8.1 to 10.4! I was hoping to record a stable base figure which over time would change from which I could deduce trends. I tested a Freestyle Libra a few months ago and I was impressed and I can see how one can deduce a trend from that. Unfortunately I’m not eligible for a NHS funded device and it is beyond my personal budget.
 
manlyp said:
I’ve seen how tests before and 2 hours after meals show spikes of varying degrees and how exercise can induce troughs, but for the last few days I’ve taken a reading first thing in the morning after 10 to 12 hours of fasting and they are most erratic - anything from 8.1 to 10.4! I was hoping to record a stable base figure which over time would change from which I could deduce trends.
Click to expand...
8.1 to 10.4 are quite stable baseline readings for fasting levels within the error margins of testing and variation in BG levels.

Whilst food and exercise and medication (if applicable) are the main players when it comes to BG levels, there are something like 42 factors which impact BG many of which are beyond your control, so variation is a part of the system. Stress, how well or poorly you slept as well as how long you slept, ambient temperature, hormones etc.
When you tested in the morning is also very important. If you tested after you got up and got washed and dressed, you may very well have a higher reading than when you first woke up in bed. Most of us test as soon as we wake up because as soon as we swing our legs out of bed and stand up, our BG levels start to rise as our liver releases glucose into our blood stream to give us energy for the day. This sometimes starts before we get up (referred to as Dawn Phenomenon) but the longer we are up and about before we eat, the more the liver pumps out glucose (Foot on the Floor Syndrome). They are all part of the same process but consistently testing before you get out of bed when you wake up should give you slightly more consistent readings. Eating shuts down this morning liver glucose dump, so skipping breakfast is not always a good idea, but again it depends on the individual's biology and we are all different.
 
manlyp said:
and they are most erratic - anything from 8.1 to 10.4! I was hoping to record a stable base figure which over time would change from which I could deduce trends.
Click to expand...

I wouldn’t be too concerned about those variations in fasting readings. Blood glucose levels naturally vary from day to day, and while a fully functioning metabolism is able to keep levels within very tight tolerances, some variation is perfectly natural.

Additionally there is a degree of in built variation in the meter readings themselves, which are permitted a certain degree of difference from a lab test as suggested on the table below.

1664136492554.png

That doesn’t mean that results from BG meters aren’t helpful, but it is also worth remembering that they are a bit more ‘ish’ than their decimal point readings might suggest :)
 
I understand the reasons for the variation in readings from BG meters (I‘m a scientist) but I don’t really see how a BG meter will help me in the treatment of my T2? By way of an example, I can get on the scales and weigh myself every morning and quite easily observe the trend over time - scales have in-built measurement variation and my weight fluctuates daily - but what number do I use as a base figure for a BG comparison when there is so much daily variation? I’m on some new meds and it appears to me that I’ll have to wait three months for an HbA1c test to tell me if it is working. Since this is the third med I’ve been prescribed in a year it seems to be rather a long process to work out how the new med is working!
 
There are several reasons people with Type 2 use a blood glucose monitor to help them manage their condition.
They will do a morning reading and hopefully see a downward TREND on a daily, weekly or monthly basis.
They will test before meals and 2 hours after to see if they have tolerated the amount of carbohydrates in that meal, an increase of no more than 2-3mmol/l will indicate the meal is OK, as levels come down then a 2-hour post meal reading of no more than 8-8.5mmol/l is again a good indication the meal is OK.
They will also test if they feel unwell.
This will help people to know if they are on the right track with their dietary changes and medications rather than bumbling along for at least 3 months and finding lo and behold that they are still having too many carbs for their body to tolerate when their HbA1C hasn't changed much.
Many find this is key to them having control over their condition.
 
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