New Member, looking for advice

[EssexSimon]

Hi, first post here and have a question about my diabetes.

I'm Type 2, and also have high blood pressure and high cholesterol. For the blood pressure I take Bendroflumethiazide and Lisinopril, a Statin for Cholesterol and Metformin for diabetes.

I had my annual review last September and my HbA1c had gone up from 56 to 65 from the year before. My GP increased my dose of metformin from 1 to 2 tablets a day, with a further HbA1c test in Dec / Jan. My HbA1c has now gone down to 55 but my GP wants this to decrease further so has increased my Metformin to 3 tablets a day. She has also advised I stop taking Bendroflumethiazide as this can have an effect on blood sugar levels.

Has anyone else had similar advice or been in a similar position? For the first time I'm doubting the advice of my GP as I'm wary of taking 3 metformin per day, feels a bit excessive. I'm also wondering why I've been prescribed Bendroflumethiazide and Metformin together for around 10 years but now it's not a good combination.

Any thoughts welcome

 

[Lily123]

Welcome to the forum. I can’t offer any advice on the medication but do you have a BG meter? Most GPs will discourage Type 2s from testing their blood glucose. Having a BG meter will allow you to see the effects that foods have on your BG

 

[Leadinglights]

Hi Welcome
The fact that your HbA1C went up suggests that you are having too much carbohydrate in your diet for your body to tolerate, metformin will only help the body use the insulin it produces more effectively but will only be able to reduce blood glucose with dietary control as well.
As you have had diabetes for some time it maybe that you need to review your diet, as ideally you should be trying to get your HbA1C down to nearer normal levels of below 42mmol/mol
What would typical meals be for you as that is most likely to be where the problem will be.
Do you have a home blood glucose monitor so you can test the effect of various meals and make some adjustment to better choices.

 

[ianf0ster]

Hi @EssexSimon
Both your Blood pressure medication and your Statin can be raising your Blood Glucose. several medications can do that but statins (and steroids) tend to do it the most.
However the good news is that if you reduce your carbohydrate intake (and increase the protein and fat , the only essential macronutrients) then as well ad reducing your Blood Glucose your Blood Pressure is likely to reduce for just that dietary change alone. It may also reduce your weight too - it does with most even if they don't consciously cut calories.

There are several different views, but in my opinion speaking as someone who has achieved medication free remission from Type 2, self funding a BG meter and, keeping a food diary and testing the BG spike from each meal (trying to keep it down to 2.0 mmol or less) is the easiest way to Type 2 remission. test just before eating then 2hrs after 1st bite.
Though if your HbA1C is over 60 then it may be a good idea to reduce the carbohydrates in stages so that the rapid change in BG doesn't affect your vision. People who have a BG over 100 who drop it to 50 or so within 3 weeks or so sometimes suffer a few weeks of blurred vision until they adjust to more normal BG levels.

 

[EssexSimon]

Thanks for the comments!

 

[everydayupsanddowns]

Welcome to the forum @EssexSimon

1500mg of metformin is not at all unusual, but it is generally considered best to increase the dose in stages at this can reduce the chances of side effects.

Metformin: a medicine to treat type 2 diabetes

NHS medicines information on metformin – what it's used for, side effects, dosage and who can take it.

www.nhs.uk

If you get a bit of gastric upheaval from the increased dose you might find slow release met gentler on the tum?

Metformin doesn’t work directly on blood glucose levels from food, it builds up in your system and helps to improve sensitivity to your insulin, while also limiting glucose released from the liver - so it helps in the background to improve your BG levels.

Tweaking your menu, and moderating your carb intake will help the Met work most effectively.