Type 2 confusion

[Flnnrs]

Well 59, to my non-medical opinion, is not so bad for age 67. There is a gently growing view that as we age our ability to keep our blood in good order slows down a bit PLUS the longer term risks to us from elevated BG long term diminish.

However T2 in a wheel chair might reasonably be considered that it makes you more vulnerable to many other ailments. What date was the 59 result and how does that compare to the one before (and when were each)? What was your HbA1c when you were first diagnosed 3 yes ago and were you wheelchair bound then? I apologise for this "interrogation", I'm just trying to get a sense of the bigger picture.

Manual

Are those numbers from random testing or are you following a regime, eg testing on waking (fasting test), just before a meal and then again 2 hours later?

Yes before meal and two hours after I've eaten

 

[Martin.A]

Yes before meal and two hours after I've eaten

Do you keep a food diary, recording your meals against your readings so that you can see what foods give you numbers higher than you'd like? I knocked lots of things on the head when I started doing so.

 

[Proud to be erratic]

Well manual, ie self-propelled, is a recognised good way of maintaining upper body strength and a natural way of exercising to help one's kidneys and liver stay in good shape.

I'm tempted to say ask your GP to clarify why Dapagliflozin is necessary and at least make sure you are directly informed in accepting the decision. There can be side effects, most of which are more in the category of inconvenient rather than desperately problematic. But all these would be exacerbated when wheelchair confined. Back ache is unpleasant but worsened when you can't stand up, move around and generally seek a more comfortable posture; increased need to pee; thrush or mild skin rashes are harder to treat, calm or moderate; and I would think dizziness in a wheelchair could be most unpleasant. I'm not saying that all or any of these side effects can occur, but they are quoted as 1: 100 risk - so not rare. Also, get to the bottom of the hypo risks: understand what hypo symptoms might be for you and make sure you have a suitable hypo response treatment with you at all times. It all feels a bit "haphazard" prescribing without fully explaining, when someone is confined to a wheelchair.

However this aspect pans out, @Flnnrs, some review of your food choices could be a great help to you. I say food choices because I'm presuming there is not much extra you can take on in exercise or activity. If you can ease your HbA1c down a bit, then that will help a lot and reduce your medical vulnerability accordingly. But I still suggest small changes gradually and choices that are easy to sustain beyond any 1st rush of enthusiasm.

 

[everydayupsanddowns]

Welcome to the forum @Flnnrs

Hope you are able to find a balance between your meds and your menu, to gently ease those numbers a little closer to your target range, without putting yourself at increased risk of DKA. 🙂

Do you have a pharmacist at your GP surgery that you could have a telephone appointment with to ask how best to balance Dapagliflozin and a moderate carbohydrate menu.

 

[Leadinglights]

Welcome to the forum @Flnnrs

Hope you are able to find a balance between your meds and your menu, to gently ease those numbers a little closer to your target range, without putting yourself at increased risk of DKA. 🙂

Do you have a pharmacist at your GP surgery that you could have a telephone appointment with to ask how best to balance Dapagliflozin and a moderate carbohydrate menu.

This seems to be a conundrum about what is a safe amount of carbs when taking Dapagliflozin, it seems that low carb or keto is not recommended and yet there are some people @Felinia in particular who most days is having less than 100g per day which obviously is low carb.
I assume there must be some individual guidance as to what is safe for each individual taking into account other medications.

 

[Felinia]

This seems to be a conundrum about what is a safe amount of carbs when taking Dapagliflozin, it seems that low carb or keto is not recommended and yet there are some people @Felinia in particular who most days is having less than 100g per day which obviously is low carb.
I assume there must be some individual guidance as to what is safe for each individual taking into account other medications.

When I was switched to Dapagliflozin last September, I was never told to stop following my lower carb eating pattern. I am at the higher end of of low carbs. Although I try and stay 75-90gm per day, I am often above that, although still less than 130gm.

 

[everydayupsanddowns]

This seems to be a conundrum about what is a safe amount of carbs when taking Dapagliflozin, it seems that low carb or keto is not recommended and yet there are some people @Felinia in particular who most days is having less than 100g per day which obviously is low carb.
I assume there must be some individual guidance as to what is safe for each individual taking into account other medications.

I think the picture is still emerging, but reduced insulin output, reduced food intake seem to have been noted among other things?

SGLT2 inhibitors: updated advice on the risk of diabetic ketoacidosis

Test for raised ketones in patients with ketoacidosis symptoms, even if plasma glucose levels are near-normal.

www.gov.uk

It should not be used in T1.

 

[Bloden]

I can't get my results on NHS app! I assumed because I can order medication I would be able to!! Perhaps it's a Wales thing??

Snap! Yep, I think it’s a Wales thing, like you say. The app’s pretty useless (IMHO!).

 

[brucie]

Snap! Yep, I think it’s a Wales thing, like you say. The app’s pretty useless (IMHO!).

I think it's GP dependant as I'm in SE UK and the only thing I can do with the app is order repeat prescriptions.

 

[Lucyr]

I think it's GP dependant as I'm in SE UK and the only thing I can do with the app is order repeat prescriptions.

Have you asked your GP for access to test results through the app? Usually you have to request the access it’s not automatic.