The dilemma continues

Newbie777

Newbie777

Well-Known Member
Relationship to Diabetes
Type 2
Been to see a different GP today to discuss my recent HBa1c results of 76 down from 113.

This new GP was happy. I explained thatt I have now stopped Trajenta as getting very low BG reads and only taking 1 Glicizide 80mg and 1000mg Metformin and 100mg Invokana.

Looking at my Libre reads the low reads of 3.8 today, yesterday and over the last few weeks, convinced the GP that leaving the high dosage was fine.

I fact I can't believe what the GP said next, STOP taking Glicizide, wow, can't ever remember doing that before. GP said that low BG and hypo are not acceptable and my BG needs to be lower than 14 or 15 before looking at taking Glicizide again. GP advised can start taking Trajenta as it is only mild at BG control. Will be seeing Diabetic Nurse in two weeks.

Next need to tackle high proteins in my urine, last sample was done mid afternoon, new sample will be done as fasting so first thing in the morning.

Finally, not so good news, kidney function has gone down from eGFR 58 now 48, but this is understandable as not eating the right foods for CKD as low carb is not beneficial. Scan will be done soon.

Let see how the new changes work.
Leaving you all with a smile, my 4 weekly average on CGM is 8.3 mmol last 2 weeks down to 7.2 and last week down to 6.6 so my new target HBa1c of 60 or below should be achievable.
 
What great results @Newbie777 , down from 113 to 76. I can't comment on stopping the glicizide as I'm only on metformin, but you are doing really well. I hope you've given yourself a big pat on the back!
 
Thank you very much @Vonny.

Looking forward to some proper food one day like pizza, lasagne, bread and jacket potatoes, not all once though
 
I had the same Gliclazide experience some years ago. I was on Gliclazide at the beginning and was encouraged to stop after 6 months. HbA1c stayed at the 48-50 level for a few years and then went bonkers back to 96 this year. Back to Gliclazide again (Metformin also - new) and now HbA1c down to 39.

Sugars now fall quickly in the PM and after mild exercise - so might be time to stop G again and just go with M. Am seeing consultant in two weeks, I'll raise it.

Hope things work out for you.
 
Thank you very much.
Wow well done for going to 39 and keeping it down when it got difficult for you, what an inspiration to us all 🙂

I have a theory that Glicizide works with carbs in the diet, so when carbs are restricted it becomes slow release and so when I take one in the morning, I do not expect to get hypo in the evening or the next day but only Glicizide remaining in the body can do this, as I can't see Metformin or Inovokana making much of a difference.

Also you when you went back, did you take 40mg or 80mg Glicizide?

I can't believe I was on 240mg Glicizide, max Metfirmin and invokana and facing insulin, but luckily I made it through and what a great bunch of helpful people and a great forum
 
I've managed to avoid hypos but the reaction to exercise can be quite draining. Fortunately I've got a CGM and that can tell me in time to much on a few jelly babies. Doesn't happen at night thankfully. I went back to 40mg G (what I was on originally). I'm going to resist any increases in this for as long as possible - slippery slope towards Insulin injections IMO.
 
Newbie777 said:
Next need to tackle high proteins in my urine, last sample was done mid afternoon, new sample will be done as fasting so first thing in the morning.

Finally, not so good news, kidney function has gone down from eGFR 58 now 48, but this is understandable as not eating the right foods for CKD as low carb is not beneficial.
Click to expand...
Could you explain what you mean by low carb not being beneficial? When I was diagnosed with CKD three years ago I did some research and what it said was bad for kidney health was high BG, high BP, too much salt and too much protein. First three not an issue for me but guilty as charged on the protein. I cut my protein intake to the recommended grams-per-kilo-of-body-weight amount and my eGFR has not dropped any further, and all the time I've stuck with low carb.
 
I think it is the food you can and can't eat and cutting back on potassium and sodium. Also my low carb diet is high fat and high protein. Also the diets recommended for CKD are typically fruits vegetables and whole grains, which are very limited for me on my low carb diet.

I am stuck.
If I increase my carbs my BG increases and my weight.
If I increase my protein my kidneys will continue to suffer.
If I increase the fats, my triglycerides remain high.
If I decrease my salt and just drink water, I may get dehydration.
So just need to find a balance.
My priority is BG control and will then focus on my kidneys.
 
victorhamesse said:
I've managed to avoid hypos but the reaction to exercise can be quite draining. Fortunately I've got a CGM and that can tell me in time to much on a few jelly babies. Doesn't happen at night thankfully. I went back to 40mg G (what I was on originally). I'm going to resist any increases in this for as long as possible - slippery slope towards Insulin injections IMO.
Click to expand...
Yes and well done, exercise for me is always very light, I like the idea of going down to 40mg G too, also am glad you also like me do not want to go near the insulin injections route 🙂
 
Newbie777 said:
I think it is the food you can and can't eat and cutting back on potassium and sodium. Also my low carb diet is high fat and high protein. Also the diets recommended for CKD are typically fruits vegetables and whole grains, which are very limited for me on my low carb diet.

I am stuck.
If I increase my carbs my BG increases and my weight.
If I increase my protein my kidneys will continue to suffer.
If I increase the fats, my triglycerides remain high.
If I decrease my salt and just drink water, I may get dehydration.
So just need to find a balance.
My priority is BG control and will then focus on my kidneys.
Click to expand...
There are lots of vegetables which fit your low carb and berries which are low carb, people need some salt to maintain their electrolyte balance. You could just go for normal rather than high fat and just avoid low fat products.
As you say it is finding a balance with the foods you enjoy and find imaginative ways of using low carb veg which may be more unusual.
 
Newbie777 said:
I think it is the food you can and can't eat and cutting back on potassium and sodium. Also my low carb diet is high fat and high protein. Also the diets recommended for CKD are typically fruits vegetables and whole grains, which are very limited for me on my low carb diet.

I am stuck.
If I increase my carbs my BG increases and my weight.
If I increase my protein my kidneys will continue to suffer.
If I increase the fats, my triglycerides remain high.
If I decrease my salt and just drink water, I may get dehydration.
So just need to find a balance.
My priority is BG control and will then focus on my kidneys.
Click to expand...
There are lots of vegetables which fit your low carb and berries which are low carb, people need some salt to maintain their electrolyte balance. You could just go for normal rather than high fat and just avoid low fat products.
As you say it is finding a balance with the foods you enjoy and find imaginative ways of using low carb veg which may be more unusual.
 
I eat strawberries and blueberries. Occasionally 1 piece orange or an apple. Vegetables I have cauliflower, zucchini, green beans, mushrooms. I also have red lentils. I have full fat Greek yogurt. I have French butter, full fat cream cheese, cheddar cheese. For snacks all day I eat walnuts, almonds and sometimes unsalted peanuts, however my main source of food is chicken and fish everyday, so high animal protein, at the moment I think am around 70g of carbs a day, so not keto, but not the ideal 120g a day I would like to be on.
 
I've never thought that the majority of people whether or not they happen to have diabetes, needed to eat 'high' fat - just a normal amount of fat and definitely not low fat.

OTOH I've never liked eg great swathes of butter on my bread - except when it's hot from being baked and has a crisp crust - and then I regret it for hours after cos it's pretty instant heartburn !
 
trophywench said:
I've never thought that the majority of people whether or not they happen to have diabetes, needed to eat 'high' fat - just a normal amount of fat and definitely not low fat.

OTOH I've never liked eg great swathes of butter on my bread - except when it's hot from being baked and has a crisp crust - and then I regret it for hours after cos it's pretty instant heartburn !
Click to expand...
I think it is not about high fat, just need it as natural as possible, so less ingredients and less additives. I eat more cheese than I used to, more yogurt etc, so that's what I mean by high fat. Anything diet I avoid.

My favourite food would also be hot crusty bread with some french butter,easily eat the full stick. Lol
 
trophywench said:
What's 'ideal' about 120g carb?
Click to expand...
Personally I think keto is too low at less than 50g and something like 200g is too high as it will affect BG and you will not be able to lose weight, unless you exercise rigorously.
I think 120g is the right balance, keeping your BG under control, do light exercise, also lose weight and importantly enjoy your food a bit more.

I am on a out 70g to 80g once I my BG levels normalise will try 120 to 130g per day.
 
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