Metformin+gliclazide+sitagliptin?

[RJN123]

I was diagnosed in early June and put on metformin, and my Hba1C was 64 and rose to 80 after just a few weeks. After surgery which required me to take daily steroids, gliclazide was added. For three weeks, I have monitored blood sugar and diet, and although I still have a daily spike, my blood sugar is now 7 average, and 85% TIR on the libre (which also puts my estimated Hba1C at 43). However, they have now added sitagliptin. It seems a bit overkill to be on 3 medications when my blood sugars are heading in the right direction. I have an appointment with the clinic Tuesday, so would be interested in views from here?

 

[Leadinglights]

They may be taking a belt and braces approach as steroids have a reputation for increasing blood glucose so it may depend on how long you are expected to need them for.
The trauma of surgery can also increase blood glucose and it depends on what surgery you had as well.
You say 'other type' in your profile, is that as a result of the surgery ?

 

[RJN123]

Thank you. I put “other” as my official diagnosis is type 2, but all the specialists think that it has probably been induced by my ongoing immunotherapy (for cancer). I have no risk factors and the elevated glucose came on in a matter of weeks, which apparently isn’t normal. I had both my adrenals removed in the surgery so will be on steroids for life. I’d really like to see if I can’t get the diabetes under control with minimal medication, since I have so much going on already, hence my question. But you are probably right that they are being extra cautious.

 

[Leadinglights]

Thank you. I put “other” as my official diagnosis is type 2, but all the specialists think that it has probably been induced by my ongoing immunotherapy (for cancer). I have no risk factors and the elevated glucose came on in a matter of weeks, which apparently isn’t normal. I had both my adrenals removed in the surgery so will be on steroids for life. I’d really like to see if I can’t get the diabetes under control with minimal medication, since I have so much going on already, hence my question. But you are probably right that they are being extra cautious.

Have a look at this link it may explain the sudden onset. https://www.diabetes.org.uk/diabetes-the-basics/other-types-of-diabetes/steroid-induced-diabetes

 

[RJN123]

Thank you, but the diabetes began before I started before I started on steroids. Mine may be immunotherap-induced and hence closer in nature to Type 1, according to my endo. But frankly all knowledge around immunotherapy is still quite new, so even the specialists are learning day by day.

 

[trophywench]

Well ...... it appears that all forms of treatment for this 'type' of diabetes - being as it is so new since not all cancers respond to it - but since I am no expert myself I'll be interested in what/how the experts respond to the very query you have raised about it in your first post! It sounds to me like they might be attempting to preserve your own output of insulin rather than assuming your beta cells have already popped their clogs (or will do anyway = more or less Type 1) and therefore just prescribing exogenous insulin jabs sooner rather than later.

So, one question I'd be prompted to ask were it I, is what they hope my body to achieve on its own by taking these 3 drugs? - and whether I'll just land up on insulin like a normal Type 1 anyway ?

What sort of diet are you achieving those blood glucose results on?

 

[RJN123]

Sorry @trophywench I missed your post. Different DNS’s are saying different things (and I have only had a brief informal encounter with an endo). But they just seem to throw the kitchen sink at me to make sure my glucose is stable. Maybe it is because I am used to being molly-cuddled at the cancer clinic, but definitely don’t feel particularly supported. The last nurse offered a nutritionist, but given the improvements I have achieved by myself (and extremely good knowledge of nutrion already), I didn’t feel that would make a difference. I would love to have a libre on an ongoing basis, as this has helped me immensely plan my diet. My plan has so far consisted of 4-5 smaller meals a day, and cutting out any sugar/carb’s which didn’t feel “necessary“ - so out with crisps, sugar in tea, sandwiches, but allowing myself a half pizza, 2-3 small potatoes etc every few days. I have been on Keto before and I absolutely detested it and gave me nausea. I don’t want to lose too much weight, as I am in ongoing cancer treatment and have adrenal insufficiency, so being underweight isn’t a smart move. My BMI is 22, so just right.