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Trouble at Mill...

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Reptile

Active Member
Relationship to Diabetes
Type 2
A couple years ago my hba1c was 52 and blood sugar was controlled by metformin and diet. I refused re-testing through fear of covid but I've just come in at 102. My doc is starting me on glipizide and will mri scan my pancreas. I've inexplicably lost 15 kg in the period too.

I'm feeling pretty scared and bruised now. Has anyone turned a situation like this around. Is there any advice based on experience of starting glipizide?

Thanks in advance for your advice.
 
Welcome @Reptile 🙂 You mention weight loss - was that intentional weight loss or was it unexpected? The reason I ask is because unexpected weight loss can be a symptom of Type 1 diabetes. Contrary to what some people think, Type 1 can develop at any age. Older adults are not uncommonly assumed to be Type 2, but are actually Type 1.
 
Hi, the weightless was not expected though it was over a two year period. In that time, I have also stopped drinking alcohol. Could that explain it over two years? Perhaps I have crossed the line into type 1?
 
No - you don't 'cross the line' into Type 1 - if this is what has happened - you have actually had a different type of diabetes all along!

It is called LADA (Latent Autoimmune Diabetes of Adults) which can behave like Type 2 for sometimes years and also responds to normal Type 2 medical treatment - ie pills, diet etc - rather than solely to injected insulin like normal Type 1 - but as Type 1 is always caused by an autoimmune attack, it still isn't Type 1 even though in the finish - it also can only be treated with injected insulin, although it often still helps to also continue with the Metformin.

It's quite confusing, so don't worry if you can't get your head round it.

In any event - there is a blood test which can establish how much insulin your pancreas is actually producing called a C-peptide test although not every single Lab has the wherewithal to undertake it, so the blood sample has to be sent away to one that does, plus it takes some time, it's not a quick overnight job wherever it's done. Usually takes a couple of weeks to get the answers, instead of PDQ like most other tests.

In any event, the glipizide is again a tablet and this encourages your pancreas to produce more insulin and hence you are usually told to take it with a meal in the hope the extra insulin will deal with the increase in BG from the meal. Which is your pancreas is still capable of producing insulin may be fine - but if it isn't - it won't work! and in which case you most likely do have LADA.
 
Hi, the weightless was not expected though it was over a two year period. In that time, I have also stopped drinking alcohol. Could that explain it over two years? Perhaps I have crossed the line into type 1?

There’s no line into Type 1. Type 1 and Type 2 diabetes are different conditions not grades of seriousness. They’re both serious. Type 1 is an auto-immune condition where your own immune system mistakenly kills off the insulin-producing cells in your pancreas. I have Type 1.

It’s good you’ve got an MRI scan being arranged. I know that must be scary but getting as much information as you can will really help.
 
Thanks to you both. I thought I understood how this disease works but I see there is a lot more to it. BTW, I miss-spelled the new drug I'm starting on. It's actually Gliclazide...
 
That’s ok - I assumed it was gliclazide anyway 🙂 Yes, there’s a lot to learn about diabetes. I still learn things even now decades after diagnosis. It’s a nuisance of a condition but you’ll gradually get the hang of it as time goes by. Getting your scan will help you and your doctor plan the best way to move forward. Whatever your scan shows, you’ll get a lot of support here. Never be afraid to ask any question you want. Nothing is ‘silly’ or too trivial.
 
Thanks. I'm feeling pretty annoyed with myself for letting my diet slip. I had been controlling it quite well before covid. I'm fasting for the rest of today to help get the blood glucose down. My new drugs should arrive tomorrow and I'll take them with food but drastically cut the carbs...
 
Thanks. I'm feeling pretty annoyed with myself for letting my diet slip. I had been controlling it quite well before covid. I'm fasting for the rest of today to help get the blood glucose down. My new drugs should arrive tomorrow and I'll take them with food but drastically cut the carbs...
I don't think that is a good idea - to change two things at the same time is not good experimental procedure - and the Gliclazide is to help you deal with the carbs - so if you aren't having them you could hypo.
Do you have a glucose testing device? The doctor should have made sure that you can test yourself if you are taking that type of medication.
If you have stopped drinking beer or cider they are high carb/calorific so it might account for the weightloss - but your liver might well respond to fasting by throwing out glucose - mine does, or did when I was testing, so it is as well to check. I eat every 12 hours as that seems to keep things well controlled.
 
I agree with @Drummer Dont cut the carbs. Get settled on the Gliclazide first over a period of weeks at least and then gradually reduce the carbs if needed. Two reasons: firstly, Gliclazide can cause hypos; secondly, drastically reducing your blood sugar very quickly can potentially cause damage.
 
Thanks for the advice. I'll do as you both suggest.

The alcohol was mostly Cognac or Rum. About three quarters of a bottle, roughly once a month. A couple of years ago I just stopped liking it so stopped drinking it. I don't miss it.
 
Please can anyone tell me what units the doctor's figure of "102" for the hba1c are in and what that equates to as an average blood glucose figure? My fasting blood glucose this morning was 13.9 mmol/l (I think).

I recall on one occasion when I hadn't been monitoring, my vision started to blurr quite badly. I checked and my blood glucose was 26! I fasted for a couple of days and went back on the wagon and it came down over a couple of weeks. The vision also returned to normal.

I find it a bit embarrassing admitting to this but I think getting it off my chest is somehow going to help with doing better going forward.
 
102 is in the new IFCC units and is 11.5% in the old units. It’s equivalent to a blood sugar of 15.7.
102 is pretty high but people here have had higher and made great improvements.
 
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