SGLT2?

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happydog

happydog

Well-Known Member
Relationship to Diabetes
Type 2
The DN telephoned today to say that she has decided that I should try SGLT2 in order to get my blood glucose levels back in control. They have been up to 13.3 at times and never lower than 7.0 at present. I don't know why this is happening as I am not doing anything different to what I normally do, except taking Letrozole since my breast cancer. She says this does not raise blood glucose levels, Macmillan Cancer Information and drugs website say that it can do, so difference of opinion there. I have had 10 years (just had my anniversary of diagnosis) controlling it with diet and exercise. Is anyone else on this drug? What are the side effects? Am I being unreasonable in thinking that I would have liked a doctor to prescribe this if necessary rather than a nurse in whom I do not have a lot of confidence? She says that I have 'got away with it for years' and need to face up to the fact that it is a progressive disease and that I will deteriorate as I get older. I find that a very negative approach.
 
That is not a helpful response from her, sorry she said that. Also they can't know everything so I would get a second opinion off my doctor if I was you.
Sorry no experience with SGLT2.

Take care
 
You might feel like it’s a negative response from her, but if you’ve not changed anything and your blood sugars have worsened then it does seem like your diabetes has progressed. If there’s no lifestyle, diet, exercise changes you could reasonably make to improve things then it would be worth trying the SGLT2 medication since it is really important to get your blood sugars down.

Here’s a page of information about them. The main things to know are that it’s important to drink plenty of water whilst taking them, and be extremely careful if following a low carb diet whilst taking them. It’s best not to go too low carb on these. https://www.diabetes.org.uk/guide-t...betes/tablets-and-medication/sglt2-inhibitors


happydog said:
The DN telephoned today to say that she has decided that I should try SGLT2 in order to get my blood glucose levels back in control. They have been up to 13.3 at times and never lower than 7.0 at present. I don't know why this is happening as I am not doing anything different to what I normally do, except taking Letrozole since my breast cancer. She says this does not raise blood glucose levels, Macmillan Cancer Information and drugs website say that it can do, so difference of opinion there. I have had 10 years (just had my anniversary of diagnosis) controlling it with diet and exercise. Is anyone else on this drug? What are the side effects? Am I being unreasonable in thinking that I would have liked a doctor to prescribe this if necessary rather than a nurse in whom I do not have a lot of confidence? She says that I have 'got away with it for years' and need to face up to the fact that it is a progressive disease and that I will deteriorate as I get older. I find that a very negative approach.
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Hiya @happydog. It looks like you dug your heels in and got the nurse to at least suggest other medications. Well done. 🙂 If you do end up taking this drug, I hope it doesn't give you problems, like metformin did. And hopefully, you can get your BG figures back where you want them. Good luck.
 
Whilst your nurse's response would have had my blood boiling, it would be good to get your numbers down a bit. If the Letrozole is your only change, I would tend to side with MacMillan, who know a thing or two and conclude that could well have impacted your blood sugars.

If you do decide to go down this route, please do read up on Euglycaemic Acidosis, so that you are familiar with the symptoms and steps you should take should you find yourself unfortunate enough to be impacted.

There is a school of though that suggests not using a low carb diet with this class of drug, due to the slightly increased chance of acidosis.

Happydog, there are many, many combos of oral meds to help with T2 and it's important you are comfortable with your treatment, or the stress will be in play, and I doubt you need any more stress in your life.

Good luck with whatever you decide to do.
 
Thank you everyone for your replies. I am researching and attempting to decide what to do. Sadly my BG is not behaving anymore so I may have to give this a try. I have even tried not eating for a day to see if that would help. It was a bit lower but still 7.5 which is too high. I am very fortunate to have had 10 years without medication so I may have to accept it now. Wondering about doing the Newcastle diet. I am not overweight and never have been. Also wondering if my pancreas is just not working as well as it was, apparently it has some atrophy, a tail and an enlarged duct which I was told can be the precursor of cancer. As both my parents had pancreatic cancer that was not good news. Thanks again for your help. This forum is so good. 🙂
 
It is possible your pancreas isn't working as effectively then, which would potentially explain why your diabetes is misbehaving.
 
happydog said:
Thank you everyone for your replies. I am researching and attempting to decide what to do. Sadly my BG is not behaving anymore so I may have to give this a try. I have even tried not eating for a day to see if that would help. It was a bit lower but still 7.5 which is too high. I am very fortunate to have had 10 years without medication so I may have to accept it now. Wondering about doing the Newcastle diet. I am not overweight and never have been. Also wondering if my pancreas is just not working as well as it was, apparently it has some atrophy, a tail and an enlarged duct which I was told can be the precursor of cancer. As both my parents had pancreatic cancer that was not good news. Thanks again for your help. This forum is so good. 🙂
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To be honest @happydog, in your shoes, as someone living in a recovery period from the Big C, I would want to be feeding myself nutritionally dense foods, not putting myself into a period of starvation, even short term. My feeling (and it can only be a feeling) is that your Letrozole has impacted your blood sugars, but a mechanism we don't necessarily understand.

Taking medication isn't a failure, and taking medication isn't necessarily a forever status. If taking medication helps your body work more efficiently, and be spared the (potential) impacts of sustained elevated blood sugars, the it is a good thing.

Your body had been under assault, firstly from your cancer, and then from the impacts of what we sincerely hope is a cure. Perhaps a little respite could be a good thing?

To be clear; I hate taking any medication and growl my way through my weekly top up of my pill pots, but sometimes for whatever reason our bodies just need a bit of help - sometimes for a while, and sometimes for longer.

Whatever you choose, you have to be comfortable with it.
 
happydog said:
Also wondering if my pancreas is just not working as well as it was, apparently it has some atrophy, a tail and an enlarged duct which I was told can be the precursor of cancer. As both my parents had pancreatic cancer that was not good news.
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If your pancreas is damaged by disease or surgery or an accident, then you are Type 3c not Type 2 and should be treated like a Type 1. They should be offering you insulin now if you are unable to manage your levels with diet and oral meds and I know you have been very strict about your diet. The fact that you are not overweight should be an additional flag that this is not Type 2 and needs a different approach. Please push for a referral to a specialist diabetes clinic.
 
Sorry to hear your pancreas is showing some signs of wear and tear @happydog :(

Did you have a scan for them to check for the atrophy and enlarged duct?
 
42istheanswer said:
It is possible your pancreas isn't working as effectively then, which would potentially explain why your diabetes is misbehaving.
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This is quite possible but no one seems to want to know. I am going to give SGGT2 drug a try and see if that makes a difference as I have tried everything including a lot more exercise and so far have not found a solution. Thank you for your reply
 
Thank you for your response Everydayupsanddowns. I have had 4 CT scans and all show the same result regarding the state of the pancreas. No one seems to be taking much notice. I have pointed it out to the DN who said she would speak to a doctor and eventually phoned back this week. I think it will give the SGLT2 a go and see if it makes any difference
 
Thank you for your reply Andbreathe. I think that you are probably correct that the rather drastic Newcastle diet may not be the solution. I am only just within the guidelines for BMI and weight for my height. When I asked the Oncologist about what I should eat she said that in her opinion I need to choose my battles and getting better from the Cancer etc is the most important thing at present. She felt that anything under 10 was acceptable and even the odd reading over that. She could well be correct as I really have tried everything and all I have done is loose 2 kg and my jeans won't stay on now without a belt. Lol. BG remains stubbornly higher that the nurse wants. Maybe time to give SGLT2 a whirl.
 
Thank you for your reply rebrascora. I have decided to give the SGLT2 a try and see if it makes any difference. I really have done my best and I can't think of anything else to try. BG is between 7.5 and 13.0 but that is higher than it was. Don't know exacly how much in in HbA1c terms as they have not released my results, said they would send them about two weeks ago but nothing has come and they are considering my application to access my medical records. Be interesting to see what happens. Thanks again for always being encouraging. 🙂
 
happydog said:
Thank you for your reply Andbreathe. I think that you are probably correct that the rather drastic Newcastle diet may not be the solution. I am only just within the guidelines for BMI and weight for my height. When I asked the Oncologist about what I should eat she said that in her opinion I need to choose my battles and getting better from the Cancer etc is the most important thing at present. She felt that anything under 10 was acceptable and even the odd reading over that. She could well be correct as I really have tried everything and all I have done is loose 2 kg and my jeans won't stay on now without a belt. Lol. BG remains stubbornly higher that the nurse wants. Maybe time to give SGLT2 a whirl.
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I'm firmly in the Oncologist's camp on where you focus your resources at the moment. You need to heal and to do that most efficiently, you need to be eating well.

I'll cross my fingers for you on the drugs. Let's face it, you may be able to ditch it a bit down the line.
 
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