Very high H1ac levels practical help

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These official documents also say you should test before driving on gliclazide (as well as the one for medical professionals I posted above who should be passing this information along). Should you have a driving incident and be found to be hypoglycaemic then you are potentially liable for driving whilst unfit due to drugs (the gliclazide), careless or dangerous driving as a result. I agree it could and should be clearer on the leaflet you posted but that makes no mention of testing one way or other. Please don’t encourage people to take the risk (legal and moral) of driving when on hypoglycaemic medication without testing.

Driving and diabetes

For most people with diabetes, driving isn’t a problem, and they can hold a driving licence and carry on driving. Here you’ll find everything you need to know about diabetes and driving. "As someone with diabetes, it's really important that I'm aware of the rules around driving in the UK" - Mim...
www.diabetes.org.uk www.diabetes.org.uk
https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes/driving/driving-licence#hypomeds (says to ask your medics if you are at risk of hypos and they are advised to tell you to test as above)

sulphonylurea and driving - General Practice notebook

gpnotebook.com gpnotebook.com
https://www.nhs.uk/medicines/gliclazide/common-questions-about-gliclazide/ (makes clear the onus is on you to be safe and the only way to know if you are is to test).
 
Lucyr said:
Agreed, but with a hba1c of 107 and a1c always around 100 it’s more likely false hypos than actual hypos, so it’s more important that OP takes into account how they feel when deciding whether to drive rather than just test and assume if it’s not hypo I’ll drive.
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Agreed, anyone who feels unwell (false hypo or any other cause) obvious shouldn’t drive if their ability to do so safely is impaired. But that is a separate issue to testing for real hypos on hypoglycemic drugs.
 
HSSS said:
Please don’t encourage people to take the risk (legal and moral) of driving when on hypoglycaemic medication without testing.
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There isn’t a legal risk, some of the links you posted are out of date, you used to have to test in the past. That last one doesn’t even mention testing when feeling low, it just says don’t drive until you’re feeling better.
 
Lucyr said:
There isn’t a legal risk, some of the links you posted are out of date, you used to have to test in the past. That last one doesn’t even mention testing when feeling low, it just says don’t drive until you’re feeling better.
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Your advice is both wrong and dangerous. Why, despite numerous official documents showing otherwise?

There most definitely is a legal risk. If you take a medication that potentially can make you unfit to drive and you drive whilst unfit then you are liable. S4 Road traffic act 1988 driving a motor vehicle whilst unfit through drink or drugs. https://www.drinkdriving.org/drink_driving_laws_drivingwhileunfit.php. This includes legal and prescription drugs. The law changed about how to test (ie fmg and cgm became allowed) but there has been nothing to remove the need to ensure you are not driving whilst hypo on sulfonylureas.

The last link says
“But if your blood sugar levels become too low, this can reduce your concentration. If this happens to you, do not drive, cycle or use machines or tools until you feel better.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking gliclazide.”
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So both confirms it is a legal offence and that the responsibility is yours. And a dr should advise you to test as per their instructions. How else do you suggest someone ensure they are safe?

Which links are outdated and where is the more updated information?
 
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I find the wooliness about exactly which medications ‘count’ and which don’t in DVLA guidance very frustrating @HSSS and @Lucyr :(

And it doesn’t help that different leaflets/sources from the same organisation give a distinctly different impression.

One would have thought it would be straightforward enough to provide a list of currently prescribed meds which require the same level of monitoring as insulin and those (like Metformin) which don’t. o_O 🙄 :(

Either way, I believe healthcare professionals should prescribe monitoring equipment to keep people safe who take a medication which can cause hypoglycaemia - and Glic is one of those!
 
Thank you for merging my posts i can see its all getting a bit muddled bit like my state of mind i guess. i am due a call from the nurse tomorrow where i will go through the issues as i see them currently.

1) I thought i was being referred to a diabetic clinic in an effort to help with my high BG 107 and review my medicine. Instead i was put on Glizlazide which i took one dose and felt awful very quickly light headed and very wonky. So as someone said i need someone to take me seriously and offer a framework i can work with.
2) I would like to talk to a nutrioniist who can help provide me with help on what i should and shouldnt be eating. As has been said diet rather than medication is key for me. I am currenlty on metformin, ramipril,fprxiga and trajenta.
3) The reason i need to take care of my BG is my gneral wellness and also my eyes. I know high BG means worse macular degeneration. The lower the better of course. The eye hospital said my struggles are direcly because of my high BG and i need to improve my excercise.

Thanks
 
Berksps said:
Thank you for merging my posts i can see its all getting a bit muddled bit like my state of mind i guess. i am due a call from the nurse tomorrow where i will go through the issues as i see them currently.

1) I thought i was being referred to a diabetic clinic in an effort to help with my high BG 107 and review my medicine. Instead i was put on Glizlazide which i took one dose and felt awful very quickly light headed and very wonky. So as someone said i need someone to take me seriously and offer a framework i can work with.
2) I would like to talk to a nutrioniist who can help provide me with help on what i should and shouldnt be eating. As has been said diet rather than medication is key for me. I am currenlty on metformin, ramipril,fprxiga and trajenta.
3) The reason i need to take care of my BG is my gneral wellness and also my eyes. I know high BG means worse macular degeneration. The lower the better of course. The eye hospital said my struggles are direcly because of my high BG and i need to improve my excercise.

Thanks
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Great stuff @Berksps,

Perhaps consider asking for a meter and strips to be prescribed. I can see there might be an argument from your Surgery nurse that you are not entitled - but my interpretation from the hot discussion earlier was that Glic can cause hypos and so you are entitled. Without a test capability you are making changes with zero point of reference and that makes little (=no) sense. Prescribing test meters and strips is permitted by NICE Guidance notes and is within the gift of all GPs - they just need to do it, particularly in support of patients clearly trying to help themselves.

Also for nutrition advice the broad experience of people on this forum is that we all react differently to any particular food stuff. So you can only confidently know if cutting something out or not is ACTUALLY right for YOU after testing. Normally T2s test immediately before starting to eat then 2 hrs later to see how they managed that particular meal. If your request for a meter and strips falls on deaf ears I would encourage you to buy your own - there are cost effective suggestions made in this forum, as well as fuller testing processes and test objectives.

Consider booking your next HbA1c at the 3 month point to find out how you are doing after your various recent changes in lifestyle. Whatever that reveals, you need to know. Good luck with tomorrow.
 
Spoke to dcotor who advised to not take the glizlazide anymore and he will refer me back to clinic to see me in person. I am very scared of going onto injections. I also spoke to a helpful nurse at my practice who i am going to see and review everything. I feel my best chance is a controlled diet.

I have ignored this too long i feel i am too late and that my eyes will only get worse. Feeling very low today because of my stupidity and ignorance.
 
You can't change what is gone but you can change today and tomorrow. Use those negative feelings to give you motivation and determination to do better now. That is what I did when I was diagnosed and I felt so embarrassed and guilty that I had done this to myself. I decided that I was going to do my utmost to do better now and not only is my diabetes under really good management now and I feel confident that I now understand it and it won't get the better of me again, but also that in changing my diet, many other health issues have also improved, like I no longer suffer regular debilitating migraines which caused me to lose a day of my life about once a month but also better gut health and until recently when my diet started to slip a bit, better joint health. I am addressing that slip and getting myself back on the low carb wagon. I am not going to beat myself up about letting my diet (and exercise) slip a bit but I am going to do something about it. That is all you can do too. Work on today and just take it one step at a time and stop looking back and regretting. Move forward and be proud of the accomplishments you achieve, one day at a time.
 
Berksps said:
I have ignored this too long i feel i am too late and that my eyes will only get worse. Feeling very low today because of my stupidity and ignorance.
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Sorry to hear you are feeling low @Berksps :(

It’s never too late! Slowing progression even just a little can make a significant difference. No improvement is wasted.

Hope you feel a little brighter in the morning.

Be kind to yourself. You are moving things in the right direction.
 
i think the enormity of having diabetes for so long basically not checked has hit home. The struggles with my eyesight seem irreversible and also i seem to be hurtling towards having to inject myself which i desperately want to avoid. You reap what you sow as they say.
 
Berksps said:
You reap what you sow as they say.
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Then start sowing something positive and begin to turn things around or at least slow things down. Beating yourself up is not achieving anything. We have all made mistakes and have regrets about how we handled things, but it is how we move forward which is important. You can make a difference if you start now, so things are really not as bleak as you are seeing them. There is lots they can do treatment wise for your sight these days, but now is the time to change direction and start managing your diabetes better. It is never too late to do that and we are here to help you.

Berksps said:
The struggles with my eyesight seem irreversible and also i seem to be hurtling towards having to inject myself which i desperately want to avoid.
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Many of us wanted to avoid injecting ourselves, but the fact of the matter is that it keeps us alive and in good health and the reality is not a big deal, it is the thought of it which is frightening. The needles are teeny tiny (like 4mm long and not much more than the thickness of a human hair) and a lot of the time you don't even feel them. But it may not be necessary for you yet if at all if you can sort out your diet and do some exercise.

I can assure you that you can feel so much better than you do now if you put a bit of effort in because high BG levels make you feel rough and emotional and anxious and negative. Once levels become stable and in range and you get into a routine with managing your diabetes, you will feel lots better, but you do have to just take it one step at a time and try not to look beyond each step and certainly stop looking backwards. There are people here who have lost 5 stones in weight which seemed like a massive achievement and some had been trying for years and not been successful, but one day at a time is how you do it and give yourself credit for each successful day. You can do this and we are here to help you.
 
super rebrascora you should go into counselling. my GP surgery is very odd you get a very mixed response from them. my sight issues have woken me up finally to the situation i am in. i am seeing one of the practice nurses next Wednesday so i am going with a clear plan. i need to know my numbers on a regular basis. i know how high i was last test about 6 weeks ago i need to change my diet and exercise plan now.
 
Berksps said:
super rebrascora you should go into counselling. my GP surgery is very odd you get a very mixed response from them. my sight issues have woken me up finally to the situation i am in. i am seeing one of the practice nurses next Wednesday so i am going with a clear plan. i need to know my numbers on a regular basis. i know how high i was last test about 6 weeks ago i need to change my diet and exercise plan now.
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You have had plenty of suggestions from people here on the forum, it is now time to put those into practice. Knowing you numbers for your HbA1C is important so you know where your starting point is but also on a 3 monthly basis to make sure the measures you are taking are working.
Between times a home monitor will guide you on a meal to meal basis and help you make better choices.
 
what do people think of the libre 2 system
 
I love it and you would likely qualify for a free 14 day trial... ie. 1 sensor if you have a suitable phone to scan it, but it is important to be able to finger prick too because Libre isn't always as accurate as finger pricking and there are times when you need to double check it against a finger prick. It is also really important to understand it's limitations, but it is a game changer in my opinion, for the huge amount of data it provides. The important thing of course is what you do with the data, what you learn from it and the adjustments you make as a result of that data. The Libre is not a magic fix, it just shows you what is going on so that you can make better choices.
 
It is also about £40 per sensor which lasts 2 weeks so you have to take that into consideration. But it is a game changer for those on insulin.
 
is it of any use for someone who isnt currently but wants to monitor their levels
 
Berksps said:
is it of any use for someone who isnt currently but wants to monitor their levels
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I think you are better to get used to doing some finger prick testing first because as mentioned the Libre has limitations on accuracy at extremes of blood glucose levels so unless you are finger pricking it would be hard to judge.
 
Berksps said:
is it of any use for someone who isnt currently but wants to monitor their levels
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It can be and the free trial will cost you nothing, so you can get 2 weeks worth of data from it for free but I personally think that having a base understanding of testing with finger pricks before you use sensors gives you a framework of basic data and understanding of how testing works and your body responds, otherwise you risk being overwhelmed and unable to see the wood for the trees with Libre. I would get your self a basic reliable test kit like the Gluco Navii or Spirit Tee2 and apply for the Libre whilst the free trial offer is still on. Put the free Libre to one side for a month or two and start finger pricking to give yourself some time to get the hang of testing and then use the Libre later to fine tune things once you have got the hang of the basics.
 
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