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Should I be worried?

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Berniegoldfish

New Member
Relationship to Diabetes
Type 2
Hi, I’m new to Diabetes and trying to grasp managing it. I’m really struggling with controlling my BS. I was diagnosed in December with daily BS readings between 20mmol to off the scale (which I think the reading limit on my device is 33mmol).

I take my BS readings a few times a day and it doesn’t seem to be reducing.
I started on 500g of metformin a day, then increased to 2000g, now I’m on Gliclazide 60mg. My BS remain exceedingly high. I’m worrying why there is no change.
My diet wasn’t too bad pre diagnosis as I’m Coeliac, which already restricts my diet.
I’ve also tried to cut out as much Sugar, Alcohol and Carbs as I can to try and get some control but it doesn’t seem to be happening. I’m also doing 15k steps a day to get the exercise in, but nothing appears to be working.

Am I missing anything, Is there anything else I can try?. I’d be grateful for any advice or help as I’m worried about the impact of having consistently high readings.

Thanks in advance.
 
Hi @Berniegoldfish One thing leapt out at me there - you have coeliac disease. Has it actually been considered that you might be Type 1?

You say your meds and diet changes aren’t working and your blood sugar remains very high, and you already have one auto-immune disease (coeliac).

If you’re Type 1 you’ll need insulin. I suggest you speak to your GP asap and get some clarification.
 
Hi Inka, I didn’t realise that could be a factor to be honest. I have however asked for a LADA blood test as I was reading a case study that ‘rang bells’ with my own. I’m still waiting for the test at the moment.
 
You can get Type 1 at any age @Berniegoldfish Type 1 in adulthood is often misdiagnosed as Type 2. Many Type 1s are diagnosed as adults.

There are no LADA tests to my knowledge - just the Type 1 tests. There are two of those: the antibodies tests and the C Peptide test. LADA is just a form of Type 1.

But with your blood sugar “exceedingly high”, I’d be going back to the GP and getting some help now, not waiting for tests and their results (the results take a while). There’s no reason at all why you can’t have insulin now if you need it, and Gliclazide isn’t recommended for Type 1 anyway as it only hastens the demise of the remaining beta cells whereas insulin can help them go on for longer. Personally I’d prefer insulin for that reason if there’s any doubt about diagnosis.

Whatever your Type, very high blood sugar can be dangerous and needs attention.
 
Thanks again. I’m due a phone call from the nurse so I will ask to be booked in for a Type 1 blood test ASAP. Thanks for the advice @Inka
 
Wow, that’s scary!. If a prescribed medication was going to work, how long would you expect it to take before seeing any results?
 
Just for the record, I totally agree with @Inka This is a serious situation if your levels have been in the 20s since December. Metformin would have had an effect in a few weeks and gliclazide in a few days if they were going to work. You are on the minimum Glic dose and they may want to try increasing that but I think you need to be really pushing for insulin NOW if your levels have been consistently that high since December. Testing can be done later and will likely need to be authorized by a consultant but you need to be seeing a slow steady reduction in those readings even just down to mid teens initially and then gradually aiming to get mostly below 10. I imagine the current pandemic situation is meaning that there is less input from specialist nurses who would have spotted this.... My practice nurse had case conferences with the DSN and consultant in the 6 week run up to me being started on insulin and whilst, like you, it was people on this forum who alerted me to my misdiagnosis, there were at least question marks already flagged with my HCPs. My Type 1 testing didn't happen until 2 months after I started on insulin.

Good luck getting something sorted and please do not delay as those persistently very high levels are not doing you any good..... but be aware that reducing your levels slowly and steadily is equally important to reduce the risk of damage to small blood vessels in the eyes.
 
@Inka I was in the process of Typing as you mentioned me.
 
Metformin doesn't directly reduce BG - if you reduce the amount of carbohydrate you eat (not just actual sugar) and take more exercise, those 2 things help reduce it and with the Met assisting your body to use the insulin you produce more efficiently, then you see reductions in BG.

Gliclazide enables your pancreas to produce more insulin - so that does it more directly.

If your pancreas is not producing enough insulin - Glic is flogging a dead horse!

Hence the C-peptide test to find out how much insulin your pancreas IS actually producing.
 
The things to emphasize with your HCP is that your levels are not showing any reduction despite 2 lots of Type 2 oral medication and they have been persistently dangerously high for 2 months despite following a low carb diet and increased exercise, both of which should have had a significant impact. It is therefore clear that you are not producing enough insulin to keep you safe and need additional insulin.
Have they given you any means of testing for ketones? If not, they certainly should have with levels that high so do ask for that too... it might just be a pot of Ketostix to test your urine but you really should be testing when your levels are regularly mid teens or above.
 
Sorry to hear about your elevated BGs @Berniegoldfish - despite all the changes you have made.

Hope you and your Dr can get to the bottom of things.

Let us know how you get on.
 
rebrascora said:
The things to emphasize with your HCP is that your levels are not showing any reduction despite 2 lots of Type 2 oral medication and they have been persistently dangerously high for 2 months despite following a low carb diet and increased exercise, both of which should have had a significant impact. It is therefore clear that you are not producing enough insulin to keep you safe and need additional insulin.
Have they given you any means of testing for ketones? If not, they certainly should have with levels that high so do ask for that too... it might just be a pot of Ketostix to test your urine but you really should be testing when your levels are regularly mid teens or above.
Click to expand...
Hi @rebrascora. Thanks for your advice.
I have been in touch with 1 of the general nurses at my doctors. She has said that my urine sample was clear. She has also told me that I’ve now got to take 2 x 500grams metformin with the Glicazide to see if that makes a difference. I did mention the type 1 test but she’s asked me to start taking the extra tablets and she said that it will be reassessed at my next appointment in March.
 
You can buy pots of Ketostix over the counter at a pharmacy (you test your urine with them, instructions on tub) and last lot I bought were around £5. Please invest in some and use em!
 
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