Type 2 (advanced?) - Thoughts/Advice Please

[Lucy H]

Hello, I am contacting on behalf of my Dad, who is Type 2. He is 59 years old and his sugars are constantly 15 or more despite multiple medications and strict adherence to the diet. They were even that way after 24 hours of fasting for a gastroscopy and then again for a colonoscopy.

He takes Aspirin, Atorvastatin, Duloxetine, Metformin, Bisoprolol, Sitagliptin, and Pioglitazone. Some of the medications do give him side effects, so we question the point of taking them if they aren’t controlling his sugars or making him feel better.He has tried other medications in the past such as Bendroflumethiazide, Gabapentin & Amitriptyline but they gave him awful side effects, particularly on his heart, one in particular (the first I think) kept causing him to black out!

He’s always been a healthy eater really and never been one for fatty sugary treats etc, so we were all really surprised he developed the condition in the first place. My Mum was far more the likely candidate heehee.

However like a typical guy, he did wait until his feet felt odd before going to the GP, despite me saying I thought it was Diabetes for some time, so he was probably diagnosed late. He was diagnosed around May 2011 I think, and his just felt worse and worse ever since. We just feel like we are passed from pillar to post with Nurses & GPs etc and not getting anywhere.

His main symptoms are:

- Extreme dryness, particularly in his mouth. No amount of drinking seems to change this. Sucking on an ice cube or sugar free/homemade ice lollies seem to be the only thing that helps. His lips continuously stick to his teeth when he’s trying to talk. It’s worst in the mornings.

- Exhaustion as he’s only getting 2-4 hours sleep a night due to neuropathy pains in his legs. Much of his lower legs are now numb too, so he can be unsteady walking. He is still working full time too so being exhausted can be embarrassing. He naps whenever he is able.

- They have recently discovered he is anaemic which is of course contributing to the exhaustion, and there’s also an issue with his liver – non alcoholic fatty liver/fibrosis I think. Hence the endoscopy’s which we are still waiting for results on.

- He has also developed what the dermatologist believes to be Discoid Eczema which is of course also driving him mad! Despite allergy testing, they haven’t found a cause as to what suddenly caused the Eczema as he’s never had any problems with his skin. He’s on the usual emollients and steroid creams as treatment. We are now wondering if it’s because he is so dry with the Diabetes.

All in all I just feel sorry for my dear old Dad. He's a shadow of his former self! They keep saying his BMI classes him as overweight but he has never looked overweight and these days is literally skin & bone!

I do have Coeliac, so I did request they take a biopsy for that when they did the camera’s – as I say we are waiting on results. Just to see if perhaps that was contributing to how he feels, and possibly account for not absorbing the medications properly hence why his sugars are still so high? Who knows!? I know Coeliac is usually only connected to Type 1 though.

I’m not sure if any of you are able/allowed to give medical advice and of course you haven’t seen him as a medical professional and had access to his notes, but do you have any thoughts or suggestions?

Is there somewhere or someone you could recommend we be referred to privately or NHS? Ideally within North West England as we live near Preston, Lancashire, but we are happy to travel further if it means getting things under control.

Thanks for reading and any help will be most gratefully received.

 

[Owen]

Hello, I am contacting on behalf of my Dad, who is Type 2. He is 59 years old and his sugars are constantly 15 or more despite multiple medications and strict adherence to the diet. They were even that way after 24 hours of fasting for a gastroscopy and then again for a colonoscopy.

He takes Aspirin, Atorvastatin, Duloxetine, Metformin, Bisoprolol, Sitagliptin, and Pioglitazone. Some of the medications do give him side effects, so we question the point of taking them if they aren’t controlling his sugars or making him feel better.He has tried other medications in the past such as Bendroflumethiazide, Gabapentin & Amitriptyline but they gave him awful side effects, particularly on his heart, one in particular (the first I think) kept causing him to black out!

He’s always been a healthy eater really and never been one for fatty sugary treats etc, so we were all really surprised he developed the condition in the first place. My Mum was far more the likely candidate heehee.

However like a typical guy, he did wait until his feet felt odd before going to the GP, despite me saying I thought it was Diabetes for some time, so he was probably diagnosed late. He was diagnosed around May 2011 I think, and his just felt worse and worse ever since. We just feel like we are passed from pillar to post with Nurses & GPs etc and not getting anywhere.

His main symptoms are:

- Extreme dryness, particularly in his mouth. No amount of drinking seems to change this. Sucking on an ice cube or sugar free/homemade ice lollies seem to be the only thing that helps. His lips continuously stick to his teeth when he’s trying to talk. It’s worst in the mornings.

- Exhaustion as he’s only getting 2-4 hours sleep a night due to neuropathy pains in his legs. Much of his lower legs are now numb too, so he can be unsteady walking. He is still working full time too so being exhausted can be embarrassing. He naps whenever he is able.

- They have recently discovered he is anaemic which is of course contributing to the exhaustion, and there’s also an issue with his liver – non alcoholic fatty liver/fibrosis I think. Hence the endoscopy’s which we are still waiting for results on.

- He has also developed what the dermatologist believes to be Discoid Eczema which is of course also driving him mad! Despite allergy testing, they haven’t found a cause as to what suddenly caused the Eczema as he’s never had any problems with his skin. He’s on the usual emollients and steroid creams as treatment. We are now wondering if it’s because he is so dry with the Diabetes.

All in all I just feel sorry for my dear old Dad. He's a shadow of his former self! They keep saying his BMI classes him as overweight but he has never looked overweight and these days is literally skin & bone!

I do have Coeliac, so I did request they take a biopsy for that when they did the camera’s – as I say we are waiting on results. Just to see if perhaps that was contributing to how he feels, and possibly account for not absorbing the medications properly hence why his sugars are still so high? Who knows!? I know Coeliac is usually only connected to Type 1 though.

I’m not sure if any of you are able/allowed to give medical advice and of course you haven’t seen him as a medical professional and had access to his notes, but do you have any thoughts or suggestions?

Is there somewhere or someone you could recommend we be referred to privately or NHS? Ideally within North West England as we live near Preston, Lancashire, but we are happy to travel further if it means getting things under control.

Thanks for reading and any help will be most gratefully received.

An option would be insulin, it would get rid of some his meds and is actually quite painless.

 

[Ljc]

Hello Lucy . I'm sorry to hear about your dad , what a worry for you all. Owen is right, insulin is an option . I went onto it earlier this year and haven't looked back.
One thing that does concern me is, you say dad has always been a healthy eater, what sort of things does your dad eat the reason I'm asking is that many of us have found by cutting down on carbohydrates (its carbohydrates that our bodies can't handle too well, we turn some of them into glucose dead easy.) that we gain better control.

 

[grovesy]

Welcome!

 

[Greyhound Gal]

Hi Lucy. I also have problems with my liver plus psoriasis. Both the liver disease and the diabetes made me very tired, and before diagnosis I put it all down to the liver problems. Since I've been on insulin, the tiredness has got better. It's not gone and there are probably a couple of days a week that I am exhausted and need a nap (and it's not so much wanting a nap as cannot keep my eyes open and MUST have a nap). I don't know whether there is any correlation between the psoriasis and diabetes but any stress, loss of sleep etc does make my psoriasis much worse. I'm on quite a heavy duty drug for it plus I have a good emollient called Doublebase gel which I apply 4x a day which helps.
I'm also in the NW in Cheshire and although my care has been generally OK, I have found that no team will look at the overall 'me' and try and coordinate treatments, so everything is very siloed and I find that,with the exception of the dermatology team, I have to pay close attention to what the are suggesting I take/do to ensure it won't impact on another area of my health.
I have found that since my BG have been reasonably under control that I feel better so I'm sure that if your Dad can get the required treatment for his diabetes then he will start to feel better.
If you or your dad want to PM me, please do. As you mentioned above, I can't give you medical advice but I can let you know what affects me, what has helped, what I use etc.

 

[graj0]

Hello, I am contacting on behalf of my Dad, who is Type 2. He is 59 years old and his sugars are constantly 15 or more despite multiple medications and strict adherence to the diet.

Welcome Lucy, there's a lot going on there with your dad and I can understand how much of a worry dad can be, my type II father is exactly the same. His afternoon readings would regularly be 17 and over and his solution was to ignore them and not even bother to note them. Curiously he would still take readings, I sneaked a look at his meter.

I have been type II since 1997 and it was only 4 years ago that I did something that my GP at the time had told me not to do. I cut my carb intake despite being told not to and it was the best thing I have ever done. I cut out bread, pasta, rice and potato, as well as cereal, although now and again will have toast and maybe rice once in a while. My Hba1c s are always commented on by my present GP who actually puts "well done" in my notes. I had avoided going onto insulin (not against it, but I don't need to now), threw away the gliclazide, januvia and the atorvastatin. My BG and total cholesterol had dropped enough for me to manage on metformin only. I did pay for my own c-peptide test that shows that my pancreas is producing enough insulin to be considered normal but my body isn't using the insulin the way it should.

Going back to my dad, it took 3 years to persuade him to cut back on carbs which he has now done. He tells everyone that eating raw red onion has brought his BG down, not cutting out the chocolate he used to eat or the potatoes. He's 90 and I'm not disagreeing, bless him.

You're are quite right in saying that people on this forum do not give medical advice not even if medically qualified. I would suggest seeing if you can get a c-peptide test, at least you would then know what the pancreas is doing and it might be that going on to insulin might be the answer. Cutting carbs is recommended as well. However, I believe rapid weight loss can be a sign of type I, I know that an old pal of mine discovered his type I that way. If your dad's BMI is high, yet you say he's "skin and bone", that's a bit confusing, but if cutting carbs, be careful of weight loss and low BG.

One thing I will say and it may not be true in your father's case, but sometimes the side effects of these drugs are worse than the condition and just to make life more interesting, they don't affect us all in the same way. Even eating the same carbs can affect people's BG differently.

 

[DaveB]

Hi. It sounds likely that your Dad is not T2 but Late onset T1 (LADA); misdiagnosis is common. He almost certainly needs to go onto insulin. I suspect his HBa1C is above the level that NICE says insulin is needed? Do discuss this with the GP and ask what his last HBa1C was. BTW pioglitazone has some side effects and is no longer a preferred treatment. I'm surprised he isn't taking Gliclazide which is useful for a while when insulin levels are suspected as being low (I was on full dose for years before insulin)