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Hi I’m looking for some advice I was on metformin for a while but I didn’t like all the side effects . I felt worse taking them than I did before I started on them so I went to see my GP to tell him that I didn’t want to carry on with metformin and I’d like to try Ozempic after reading lots of good articles and reviews but he said I’d have to try two other types of medication (i.e tablets)before he would consider prescribing Ozempic . I’d like to know is that a NHS guild line that you have to try two or three other medication before they will prescribe Ozempic or is it my GP just trying to watch the Penny's ?
 
Yeah that’s normal, there will be a flow chart for your area. Here’s the nice guidelines which say if you’re on metformin and a1c still high then add other tablets. Once you’re on metformin and 2 other tablets, if a1c is still high then consider switching one tablet for a GLP-1 (eg ozempic) if you meet the criteria. IMG_2352.png
 

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Hi and welcome.

There is a NICE guidance pathway with diabetes meds I believe, so whilst a GP can probably make a special case in some circumstances they would have to be justified.
I think the bigger problem here would be obtaining Ozempic as there is a worldwide shortage and there are people already prescribed it who can't get it and have been changed onto other oral medication, so it would be extremely unlikely that anyone new would be prescribed it at the moment and the shortage has been ongoing for some time and is set to continue throughout most of this year I believe.

What dietary and lifestyle changes have you tried so far? Medication is only a small part of managing diabetes and dietary changes are much more powerful than almost all meds. In fact some Type 2s have managed to come off insulin thorough changing their diet and it doesn't have to be all sack cloth and ashes, but understanding which foods cause your body a problem and reducing or eliminating them from your regular diet can have a massive impact. Do you have much/any weight to lose?

Are you aware that Ozempic effectively works by making you feel sick if you eat too much. Some people find it makes them vomit, others just feel nauseous. Some people say they can't face food for 2 days after injecting they feel so rough. It certainly isn't without it's side effects and it is only effective whilst you are using it, so if you stop, you normally regain the weight it helped you lose. Far better to find a way of eating which effectively manages your diabetes and is sustainable, or the other main option which is to try to reverse your diabetes through weight loss via the likes of the Newcastle diet. There is an NHS referral for that through Oviva I think, where meal replacement soups and shakes are provided along with a support system to help you transition back onto real; food at the end of the program to help maintain the weight loss.
 
Hi thanks for that info I thought it was him just fobbing me off on to the cheaper stuff . I’m still not taking anything and I don’t feel any worse. I try to eat well not easy when you have a sweet tooth and the feeling you’re always hungry but I feel ok .I do about 8-12 miles a day walking at work I could do with losing a stone ozmepic would have helped with that but never mind. I’ll have my once a year appointment in December and see what he has to say

Thanks again for your help
 
Are you eating low fat products? Fat is satiating without affecting BG levels, so low fat and higher carb foods lead to hunger especially when combined with diabetes as carbs spike blood glucose levels higher than a non diabetic person, but then insulin is released too late and levels then drop sharply from a high level causing you to feel hungry about 2 hours after eating. If you eat less carbs and more fat and protein, then you stop that rollercoaster and you don't feel hungry all the time.

I was a sugar addict and chocoholic pre-diagnosis. Following a low carb, higher fat way of eating has really helped me get on top of my cravings and gain control of my eating. I am actually Type 1, so could go back to normal eating and just inject insulin for whatever I wanted but there have been so many health benefits to eating low carb that I choose to stick with it. The main reason is that it helps me to manage my previous craving for sweet stuff and stops the hunger.

To a large extent we have been sold a lie about fat making us fat and being bad for us and causing high cholesterol and in fact the low fat dietary advice we have been given all these years may in part be why obesity and diabetes has risen, because we have eaten more carbs to compensate. I feel satisfied with less food when I eat more fat and less carbs. Of course it is important to eat plenty of low carb veggies as they provide extra micronutrients and particularly fibre which is good for our gut, cholesterol and also helps us to feel full and slows down the digestion of any carbs we do eat. Many of us allot ourselves a carb allowance for the day. You can either spend that on a tiny portion of carb rich food or avoid the carby foods and spend our allowance on larger portions of things which will actually fill us up and give us slow release energy and not spike our BG.

It doesn't have to be all sack cloth and ashes. I have real double cream in my morning coffee which is my daily luxury (cream is lower carb than milk), and creamy Greek Style natural yoghurt with mixed berries and mixed seeds and a good sprinkle of cinnamon or a 2 egg omelette with mushrooms and onion and cheese and whatever else I have that needs using up with a large side salad usually dressed with balsamic vinegar and a big dollop of cheese coleslaw. That latter will keep me going until my evening meal, so I don't have to think about lunch. There are plenty of options for evening meal including steak if you like it but instead of potato chips, use celeriac instead, cut into fingers and parboiled and then deep fried, again with salad and full fat coleslaw and mushrooms are low carb, so feel free to have those if you like them. High meat content sausages (cheap sausages contain rusk which is carbs) work well with broccoli and cauliflower cheese.... cauliflower par boiled and then coated in cream cheese and grated cheese and then finished off in the oven.... as oppose to a cheese sauce made with flour and milk (both contain extra carbs) Cabbage is incredibly versatile and I have a real thing for curried cabbage in the form of cabbage bhaji (very different to onion bhaji), but lots of other ways to cook it. Mostly I do it for 2-3 mins in the microwave with a knob of butter and have it with gammon or bacon because cabbage and bacon go so well together or with chops but sometimes I use it as a bed for chilli instead of rice or a baked potato or for bolognaise or to soak up the sauce from a meat curry and if I have bacon and eggs I serve the eggs on shredded cooked cabbage to soak up the runny yolk. Savoy is my staple but just coming into spring greens season which I love for it's meaty flavour.

Anyway, just wanted to give examples of the sort of meals you can have where you really don't need those carby accompaniments. Bread particularly is a carrier for so many foods that it was something I really struggled to get around when I started eating low carb, but now I really don't miss it at all.
 
rebrascora said:
Are you eating low fat products? Fat is satiating without affecting BG levels, so low fat and higher carb foods lead to hunger especially when combined with diabetes as carbs spike blood glucose levels higher than a non diabetic person, but then insulin is released too late and levels then drop sharply from a high level causing you to feel hungry about 2 hours after eating. If you eat less carbs and more fat and protein, then you stop that rollercoaster and you don't feel hungry all the time.

I was a sugar addict and chocoholic pre-diagnosis. Following a low carb, higher fat way of eating has really helped me get on top of my cravings and gain control of my eating. I am actually Type 1, so could go back to normal eating and just inject insulin for whatever I wanted but there have been so many health benefits to eating low carb that I choose to stick with it. The main reason is that it helps me to manage my previous craving for sweet stuff and stops the hunger.

To a large extent we have been sold a lie about fat making us fat and being bad for us and causing high cholesterol and in fact the low fat dietary advice we have been given all these years may in part be why obesity and diabetes has risen, because we have eaten more carbs to compensate. I feel satisfied with less food when I eat more fat and less carbs. Of course it is important to eat plenty of low carb veggies as they provide extra micronutrients and particularly fibre which is good for our gut, cholesterol and also helps us to feel full and slows down the digestion of any carbs we do eat. Many of us allot ourselves a carb allowance for the day. You can either spend that on a tiny portion of carb rich food or avoid the carby foods and spend our allowance on larger portions of things which will actually fill us up and give us slow release energy and not spike our BG.

It doesn't have to be all sack cloth and ashes. I have real double cream in my morning coffee which is my daily luxury (cream is lower carb than milk), and creamy Greek Style natural yoghurt with mixed berries and mixed seeds and a good sprinkle of cinnamon or a 2 egg omelette with mushrooms and onion and cheese and whatever else I have that needs using up with a large side salad usually dressed with balsamic vinegar and a big dollop of cheese coleslaw. That latter will keep me going until my evening meal, so I don't have to think about lunch. There are plenty of options for evening meal including steak if you like it but instead of potato chips, use celeriac instead, cut into fingers and parboiled and then deep fried, again with salad and full fat coleslaw and mushrooms are low carb, so feel free to have those if you like them. High meat content sausages (cheap sausages contain rusk which is carbs) work well with broccoli and cauliflower cheese.... cauliflower par boiled and then coated in cream cheese and grated cheese and then finished off in the oven.... as oppose to a cheese sauce made with flour and milk (both contain extra carbs) Cabbage is incredibly versatile and I have a real thing for curried cabbage in the form of cabbage bhaji (very different to onion bhaji), but lots of other ways to cook it. Mostly I do it for 2-3 mins in the microwave with a knob of butter and have it with gammon or bacon because cabbage and bacon go so well together or with chops but sometimes I use it as a bed for chilli instead of rice or a baked potato or for bolognaise or to soak up the sauce from a meat curry and if I have bacon and eggs I serve the eggs on shredded cooked cabbage to soak up the runny yolk. Savoy is my staple but just coming into spring greens season which I love for it's meaty flavour.

Anyway, just wanted to give examples of the sort of meals you can have where you really don't need those carby accompaniments. Bread particularly is a carrier for so many foods that it was something I really struggled to get around when I started eating low carb, but now I really don't miss it at all.
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Hi i do try to eat the right things i have good days and bad days and then i have really really bad days but you have to have some in life and you only live once
 
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