Still got high blood sugars

[Titch 91]

Hi,

So I am taking highest dose of glicazide and metformin..my blood sugars are still between 16 and 21! On waking sometimes they are 9 or 10 but often higher. I am seeing the diabetes nurse in about 3 weeks. What should I be asking for?

I have completely changed my diet too and largely eat protein with green veg and

 

[rebrascora]

Hi. Really sorry to hear your levels are persistently so high still as that will be doing your system no good and must be making you feel pretty rough! It sounds to me like you need insulin, if max strength Gliclazide is not working. If the nurse is reluctant to prescribe insulin, I wonder if a C-peptide test might be helpful to ask for as that will show how much or little insulin you are managing to produce yourself. Do make sure to stress that you have stripped your carbs right back, so the nurse knows there is no real dietary wriggle room left and perhaps take a few days worth of food diary with you so that the nurse can see what you are eating.

Good luck with your appointment and I hope you get a satisfactory result from it. You cannot afford to carry on with levels that high for months on end, so do be prepared to be politely pushy to get a more effective treatment.

 

[gll]

looking at this flowchart
https://www.sign.ac.uk/assets/diabetes_algorithm.pdf

They would class you as line 3 if you need another thing added (metformin is line 1, glic is line 2)

Note it says:

IF NOT REACHING TARGET AFTER 3−6 MONTHS, REVIEW ADHERENCE: THEN GUIDED BY PATIENT PROFILE ADD EITHER AN ADDITIONAL ORAL AGENT FROM A DIFFERENT CLASS
OR AN INJECTABLE AGENT

So they will likely offer you another tablet or talk about insulin.
Do you have a preference one way or another what path you would be happier with?

 

[ajax]

My HbA1c decreased from 108mmol/mol to 64mmol/mol over 25 months ..via a stepwise escalation of medication ..although I now have the luxury of looking through the 'rearview mirror' ..I could have done with ✻reassurance✻ that the therapy would work eventually.