What are the medications available to treat diabetes type 2

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JasMBird

JasMBird

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Type 2
Hi, wanted to introduce myself and say hello

Jason here. I’ve had type 2 diabetes since 2015 and for a long time it was well controlled. Then the pandemic hit and things have got hey wire since.

im hoping to get some support and update my knowledge regarding medications available to help bring my sugar levels back to a more controlled range than they have been since 2020.
 
Hey Jason and welcome!

You say you were well controlled, has your diet changed to account for the higher numbers? What kind of numbers are you seeing and have you had a hba1c recently ?

I can’t advise on meds but I’m sure others will be along shortly on that note.
 
Hi,

I’m having difficulties with my GP listening to me and have a phone appointment with the GP surgery pharmacist on Monday, so was hoping to get some information about what medications options are available on the NHS.

I’ve been taking Metformin since I diagnosed in 2015 and up until 2020 it seemed to be doing a good job. With my blood sugars remaining at 6.

Since then unfortunately my blood sugar levels have been elevated. Starting at 12 and have very slowly an stubbornly come down to 9.2.

Since 2020, I have started taking slow release Metformin and a number of additional drugs. Starting with Sitaglipin, then dapagliflozin, which was stopped and replaced by Gliclazide. Yet despite all these changes my blood sugar has remained elevated.

I’ve noticed the slow release Metformin tablets have been passing through me and appearing in my stools since I first started taking it. Yet my GP still refuses to accept this is possible. I’ve also had very bad diarrhoea often. I’m told this is a common side effect of Metformin.

My question is, what other medications are available as an alternative to Metformin that i should be aware of for my call with the GP Practice Pharmacist this coming Monday.

I can’t find any resources on the Diabetes UK website which lists medication options available and there pros and cons.

Thanking you in advance for any advice anyone might be able to provide me with.

Jason
 
It’s just the shell of metformin that passes through, it’s normal. There’s so many medications available that no one can really give you a list, you’d need to discuss with your doctor on what’s right for you.

What diet and exercise changes have you made to support reducing your blood sugars?
 
JasMBird said:
Hi,

I’m having difficulties with my GP listening to me and have a phone appointment with the GP surgery pharmacist on Monday, so was hoping to get some information about what medications options are available on the NHS.

I’ve been taking Metformin since I diagnosed in 2015 and up until 2020 it seemed to be doing a good job. With my blood sugars remaining at 6.

Since then unfortunately my blood sugar levels have been elevated. Starting at 12 and have very slowly an stubbornly come down to 9.2.

Since 2020, I have started taking slow release Metformin and a number of additional drugs. Starting with Sitaglipin, then dapagliflozin, which was stopped and replaced by Gliclazide. Yet despite all these changes my blood sugar has remained elevated.

I’ve noticed the slow release Metformin tablets have been passing through me and appearing in my stools since I first started taking it. Yet my GP still refuses to accept this is possible. I’ve also had very bad diarrhoea often. I’m told this is a common side effect of Metformin.

My question is, what other medications are available as an alternative to Metformin that i should be aware of for my call with the GP Practice Pharmacist this coming Monday.

I can’t find any resources on the Diabetes UK website which lists medication options available and there pros and cons.

Thanking you in advance for any advice anyone might be able to provide me with.

Jason
Click to expand...
This link goes to the NICE table for recommended treatment options to be considered for Type 2 so will show you most of the available medications
 
Welcome to the forum
It does sound as if you have tried a number of options all the usual suspects, in terms of oral medication but what about your diet. Medication can only do so much and if you are still having more carbohydrates than the medication and your body can deal with then blood glucose will likely increase.
If medication and diet are not being effective then one thing to consider is that you may have a late onset Type 1 (LADA) rather than Type 2 and that would then require insulin.
This may be something to ask your GP about and ask for some of the tests to check for antibodies (GAD) and c-peptide which can check how much insulin you are producing.
 
EmmaL76 said:
Hey Jason and welcome!

You say you were well controlled, has your diet changed to account for the higher numbers? What kind of numbers are you seeing and have you had a hba1c recently ?

I can’t advise on meds but I’m sure others will be along shortly on that note.
Click to expand...
Hi, no change in dieT, maybe less active during lockdown, however back up to my old levels now.
My hba1c went from 6 to 12, and has since come down to 9.2 (my last test a few weeks ago). However VERY slowly and despite me having started taking 2 additional medications in addition to Metformin.

The first change was to switch me to slow release Metformin (more about that later). Then Sitaglipin was added to the mix.. followed by Dapaglifozin. The Dapaglifozin was switched to Gliclazide in December after a stint in hospital for a burn that went infectious and developed into an abscess. One operation later I was told my hba1c was 26!! And was put on intravenous insulin for 3 days to bring it down.

Despite this, I feel I’m hitting a brick wall with my GP as he doesn’t believe me that since starting the Slow Release Metformin, I’ve been seeing these tablets passing through me in my stools ( they are far larger than any of the other medications I take and can only be the Slow Release Metformin. Nothing else I take is that shape or size.

I’m desperate to know what alternative medications are available in place of Metformin as I’m 100% sure it is not being fully absorbed and this is why I’ve seen such dismal reductions in my hba1c.
 
Leadinglights said:
Welcome to the forum
It does sound as if you have tried a number of options all the usual suspects, in terms of oral medication but what about your diet. Medication can only do so much and if you are still having more carbohydrates than the medication and your body can deal with then blood glucose will likely increase.
If medication and diet are not being effective then one thing to consider is that you may have a late onset Type 1 (LADA) rather than Type 2 and that would then require insulin.
This may be something to ask your GP about and ask for some of the tests to check for antibodies (GAD) and c-peptide which can check how much insulin you are producing.
Click to expand...
Diet hasn’t changed. The only difference was being less active during lockdown, however that has since returned to normal.

thank you for the advice re Type 1 (LADA) not heard of this at all and just done a Google search to find out more.

thanks again
 
Hi @JasMBird and welcome 🙂

This information is from Diabetes UK website and lists the types of medication that may be appropriate/available for Type 2 and how they work.

Diabetes tablets and medication

There are several types of diabetes medications available, which all work in different ways. Not all diabetes treatments are suitable for everyone, so don’t be disheartened if you find yourself needing to change or stop certain medications. Your GP or healthcare team can help you find a...
www.diabetes.org.uk www.diabetes.org.uk
 
Wow this sound rough, when you say hba1c of 26 do you mean in % (the old way) as that would be well over 200 ! Thai seems a bit drastic for a bit of decreased activity. Have you been on any steroids at all ?

I’m not sure I can be too helpful other than to suggest if you haven’t been already …. Get tested for type 1 antibodies !
 
JasMBird said:
he doesn’t believe me that since starting the Slow Release Metformin, I’ve been seeing these tablets passing through me in my stools
Click to expand...
Think you may have two threads and I’ve explained this on the other one but will explain again here in case you haven’t see it. This is completely normal and should be explained in the leaflet. It is only the shell that passes through. The active ingredient is absorbed.
 
Extract from the leaflet below explaining the remains you are seeing. It’s important to always read the leaflet so that you don’t worry about things like this that are totally normal
 

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JasMBird said:
Hi,

I’m having difficulties with my GP listening to me and have a phone appointment with the GP surgery pharmacist on Monday, so was hoping to get some information about what medications options are available on the NHS.

I’ve been taking Metformin since I diagnosed in 2015 and up until 2020 it seemed to be doing a good job. With my blood sugars remaining at 6.

Since then unfortunately my blood sugar levels have been elevated. Starting at 12 and have very slowly an stubbornly come down to 9.2.

Since 2020, I have started taking slow release Metformin and a number of additional drugs. Starting with Sitaglipin, then dapagliflozin, which was stopped and replaced by Gliclazide. Yet despite all these changes my blood sugar has remained elevated.

I’ve noticed the slow release Metformin tablets have been passing through me and appearing in my stools since I first started taking it. Yet my GP still refuses to accept this is possible. I’ve also had very bad diarrhoea often. I’m told this is a common side effect of Metformin.

My question is, what other medications are available as an alternative to Metformin that i should be aware of for my call with the GP Practice Pharmacist this coming Monday.

I can’t find any resources on the Diabetes UK website which lists medication options available and there pros and cons.

Thanking you in advance for any advice anyone might be able to provide me with.

Jason
Click to expand...
There are no medications available to 'treat' diabetes. The ones that are used are designed to manage the symptoms rather than 'treat' the condition. It might be time to consider Insulin.
 
Flower said:
Hi @JasMBird and welcome 🙂

This information is from Diabetes UK website and lists the types of medication that may be appropriate/available for Type 2 and how they work.

Diabetes tablets and medication

There are several types of diabetes medications available, which all work in different ways. Not all diabetes treatments are suitable for everyone, so don’t be disheartened if you find yourself needing to change or stop certain medications. Your GP or healthcare team can help you find a...
www.diabetes.org.uk www.diabetes.org.uk
Click to expand...
Thanks this is exactly what I’ve been looking for
 
Hi @JasMBird - as the regulars on here will know, I like to get the numbers straight.

You say your HbA1c went from 6 to 12. Was that 6% to 12%? If that is so then you must be with a practice that has not caught up with current best practice which quotes the HbA1c in mmol/mol. 6% and 12% translate to 42 mmol/mol and 108 mmol/mol. 9.2%, your last measurement translates to 76 mmol/mol. If your surgery has not caught up with HbA1c units, you wonder what else they have not caught up with.

The 26 cannot be an HbA1c quoted as a percentage - if it was then it would likely be a world record for somebody still standing! I'm guessing that actually was a blood glucose measurement measured measured either with a finger prick or on a full blood test where a result of 26 mmol/l would cause concern.

Are you measuring your blood glucose levels with a hand held meter? That would help to give some sort of idea about where your blood glucose levels generally are and whether anything you are doing is effecting them.
 
JasMBird said:
I’m hoping not
Click to expand...
Don't be afraid of Insulin. And don't resist it for too long once the palliatives/ medication begin to fail . Many if not most T2s who go onto it sigh with relief and say 'this makes control so much more straightforward'. '
 
Would you mind telling us what your diet normally consists of?

I appreciate you say it hasn't changed and your BG levels have gone up, but if you didn't adjust your diet in the first place or just cut sugars but didn't reduce all carbs then, it is not unreasonable for your levels to increase. Things like bread, rice, pasta and potatoes and breakfast cereals will all increase your BG levels as well as the more exotic fruits like bananas because they are high in carbs as well as the obvious cakes, biscuits, sweets and sugar. If you haven't made adjustments to your diet in this respect, that that is something to consider before looking at increasing meds, but it is somewhat concerning if Gliclazide is not working because that stimulates the pancreas to produce more insulin and if it isn't working then that suggests it might be starting to run dry and you may need insulin. Glic is probably the most powerful oral med.

Do you have much weight to lose?

That is another angle to approach it from. The Newcastle diet or Fast 800 which is a short term 8-12 week 800calorie shakes based diet has been effective at putting about 50% of participants into remission. I think this can be particularly effective if you are carrying weight around your middle and lower rib cage where the liver and pancreas are situated as visceral fat build up in and around these organs damages their efficiency at balancing your BG levels. The Newcastle diet is designed to help burn off that visceral fat and ideally enable a return to better function of those organs.
 
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