Author Topic: Back Again  (Read 1648 times)

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Offline Agincourt

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Back Again
« on: 25 September 2016, 01:43:37 PM »
Hi,
Well here I am again, I first joined this group in 2005 and stayed for quite a while before deciding to depart and just get on with me life. Well all went well really, no big issues or anything out of the ordinary. Medication remained pretty much the same except there has been an addition of Blood Pressure pills. [Please see end of post] Things have been fine really, well that is up until a few weeks ago. The short version is that I had just finished me evening meal and had gone into the kitchen to put the dirty stuff into the dishwasher. I bent down put me plate in and stood up. Well that was the last I remember until the missus came to see what the banging about was. She made me stay sat on the floor until the ambulance arrived. The crew took my BG and it was 8.2 they then did a heart thing and took some blood [Vein] but I was so out of it and confused they decided to send me to the Hospital which is where I stayed for 48 hours kept awake and undergoing tests which involved them taking venal and arterial blood every hour. I now have a damaged Coxix [is that spelt right?] two massive cuts and bruises to my scalp, and my Metformin stopped.

The long and short of it is that they think I have damage from Metformin in that there is Lactic Acid in my Blood. However, before all of this I had been in the pub and had two large Red wines which contain Lactic Acid. But they tested me continually for a long time so unless they are doing it wrong or I drank five gallons of Red it looks like Metformin is not going to be of further use to me. I was on 2 x 500mg twice a day so you might understand my concern right now. None of this explains my keeling over but now its all over I do remember feeling close to fainting a few times before this but not close to drinking or eating times. So in my mind I think it's not that simple.

Anyway that is my story so far. Patti might remember me but I cannot for the life of me remember my previous log in name etc.  :banghead: [It's an age thing]
Current Medication [Less the Metformin] is;

Glicklazide 80 mg            x 2 am and x2 pm
Lisinopril                         x 1 am
Amlodipine                      x 1 am
Canagliflozin                   x 1 am

I have been doing blood tests x 8 per day for 8 days and the daily average is 9.4 Patti might remember me doing this a lot. So we shall see when my HBA1c comes back. The so called 'Diabetic Nurse' at my group practice reckons I'm going to go on Insulin because Metformin has to stop..........for the record I am not happy about that.

Sorry this has been so long but I though it best to get it all out right off.

TQ
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Offline heather1957

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Re: Back Again
« Reply #1 on: 25 September 2016, 02:18:09 PM »
Firstly welcome back, secondly NIGHTMARE!!!!

I totally sympathise with you about having to take insulin, Metformin can be so easy for many people but obviously you have to consider your long term health.

Hopefully the hospital can pin point what caused the faint, it could be as simple as just standing up too quickly but it always helps to know.

I am afraid I have very limited knowledge but if I can help in any way please ask.
T2 since 8/12 HbA1c HIGH!!
Medication 4 x 500mg Metformin SR at tea time

Online Pattidevans

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Re: Back Again
« Reply #2 on: 25 September 2016, 03:52:52 PM »
Hi there TQ

I probably would remember you, but only with your original log in name.  Sadly we have lost our original forum with all it's messages as it was based on a platform which was no longer supported and it became a security issue.

I wonder whether you fell because of low BP?  Someone else I know, having been on a low dose of BP meds had a similar experience and broke a rib.  Still, if you had Lactic Acidosis from Metformin then it could have been that.  We are finding out that the so-called harmless pill has some nasty side effects (in addition to the tummy probs many experience).  I have just stopped it due to Vitamin B12 deficiency which is caused by Metformin blocking absorption of that vitamin from the stomach.  You were on quite a conservative dose at 2 x 500mg though.  There are other diabetes medications before insulin.  It would definitely be worth asking your nurse or GP about those, if you don't like the idea of insulin.

I mean I am T1 and have no choice about insulin and it's not at all terrible (I put on some weight and was taking Met because I'd developed some resistance as well).  However as a T2 they do tend to try to save money by putting you on horrid old fashioned insulin regimes like mixed insulin which requires you to eat to feed the insulin and to eat at set times.  To be resisted at all costs!  LOL!

Can I ask about your diet?  I mean what do you eat in a typical day?  You might be able to control the BGs better if you could adopt a low carb diet.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Online Pattidevans

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Re: Back Again
« Reply #3 on: 25 September 2016, 04:16:41 PM »
PS.  I had to look it up, it's coccyx. :) :) :)
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline nytquill17

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Re: Back Again
« Reply #4 on: 25 September 2016, 04:34:00 PM »
Have done a cursory bit of reading. It appears that lactic acidosis can cause low blood pressure, which may have been what caused you to feel faint / lose consciousness, especially as it came on when you stood up (which points to a blood pressure issue in many cases). So there is in fact a decent possible link between Metformin and you fainting.

The other possibility to consider is low blood sugar. You take gliclazide, which will lower your blood sugar whether it actually needs to be lower at the moment or not. Depending on when you take it, when you eat, and how much you eat, gliclazide can definitely cause low blood sugar (hypoglycemia). You mention that the ambulance crew tested your BG and it was 8.2, which is not hypoglycemic at all. However, your body can sometimes (though not reliably) raise BG on its own after a low, especially since you fell and were injured - stress and injury can raise BGs in and of themselves. So a BG taken something like 30 minutes (I presume?) after your fall tells you nothing in fact about what your BG was when you actually fell and whether or not low BG from gliclazide might have been the culprit.

Going forward, if you feel faint again, it would be a good idea to test your BG immediately and again 10-15 minutes afterwards, to see whether that might be the cause.

But if it was low BP or other consequences of lactic acidosis from the Metformin, then that at least will be solved now! But you still might want to ask about getting a 24-hour BP test just to verify that your BP is stable. You may have a tendency to low BP to begin with, that should be treated, and the Metformin just made it worse, rather than being the real cause of it.
T1 DX 1995
Levemir + Novorapid
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Alan

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Re: Back Again
« Reply #5 on: 26 September 2016, 12:57:16 AM »
Hi,
Well here I am again, I first joined this group in 2005 and stayed for quite a while before deciding to depart and just get on with me life. Well all went well really, no big issues or anything out of the ordinary.

Welcome back :)
Quote
Medication remained pretty much the same except there has been an addition of Blood Pressure pills. [Please see end of post] Things have been fine really, well that is up until a few weeks ago. The short version is that I had just finished me evening meal and had gone into the kitchen to put the dirty stuff into the dishwasher. I bent down put me plate in and stood up. Well that was the last I remember until the missus came to see what the banging about was. She made me stay sat on the floor until the ambulance arrived. The crew took my BG and it was 8.2

That tends to rule out a hypo as the problem.
Quote
they then did a heart thing and took some blood [Vein] but I was so out of it and confused they decided to send me to the Hospital which is where I stayed for 48 hours kept awake and undergoing tests which involved them taking venal and arterial blood every hour. I now have a damaged Coxix [is that spelt right?] two massive cuts and bruises to my scalp, and my Metformin stopped.

The long and short of it is that they think I have damage from Metformin in that there is Lactic Acid in my Blood. However, before all of this I had been in the pub and had two large Red wines which contain Lactic Acid. But they tested me continually for a long time so unless they are doing it wrong or I drank five gallons of Red it looks like Metformin is not going to be of further use to me.  I was on 2 x 500mg twice a day so you might understand my concern right now.

I doubt that was the wine; very unusual for low dose metformin. I doubt the cessation of the metformin will have much effect on your blood glucose levels in the short term.
Quote
None of this explains my keeling over but now its all over I do remember feeling close to fainting a few times before this but not close to drinking or eating times. So in my mind I think it's not that simple.
Anyway that is my story so far. Patti might remember me but I cannot for the life of me remember my previous log in name etc.  :banghead: [It's an age thing]
Current Medication [Less the Metformin] is;

Glicklazide 80 mg            x 2 am and x2 pm
Lisinopril                         x 1 am
Amlodipine                      x 1 am
Canagliflozin                   x 1 am

I have been doing blood tests x 8 per day for 8 days and the daily average is 9.4

I have a suspicion a hospital "diabetic diet" may have something to do with that. What dietary regimen do you follow when home? Low-fat, low-carb or something else?
Quote
So we shall see when my HBA1c comes back. The so called 'Diabetic Nurse' at my group practice reckons I'm going to go on Insulin because Metformin has to stop..........for the record I am not happy about that.

I hope they work out the true cause of your collapse.

Would you mind going into some details on your usual daily regimen in terms of diet (carbs, fats, protein), meds doses and timing, and test timing and results? It may help us offer ideas to reduce your meds load.
Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: Small New York Baked Low Carb Cheesecake)
Born Under a Wandering Star (Latest:Dambulla, Sigiriya and Polonuwarra, Sri Lanka)

Online Pattidevans

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Re: Back Again
« Reply #6 on: 26 September 2016, 09:22:40 AM »
When someone posts their meds I usually look them all up if they are unfamiliar but I was on the verge of going out last night.  However, I had the opportunity this morning and found this regarding your canagliflozin:


Dizziness may occur while you take canagliflozin. This effect may be worse if you take it with alcohol or certain medicines. Use canagliflozin with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Canagliflozin may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects



  • This is from. https://www.drugs.com/cdi/canagliflozin.html. It also particularly states that it can interact badly with  Lisinopril - Sorry the formatting is all over the place, it's quite difficult on my iPad.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Agincourt

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Re: Back Again
« Reply #7 on: 26 September 2016, 11:52:09 AM »
Patti,

Stupid me  :banghead: I have been puzzling myself over this for ages and with not so much luck. Duh ! You seem to have got what I was after all along. Now I do feel dozy -  ;D

Canagliflozin may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects.

Well that seems to be a damn accurate description of all the circumstances. It was a hot day at about 28c in me garden and I was working reasonably hard cutting back bramble by hand and had been doing so for about an hour. Definitely 'light headed' - although I thought I was on the verge of fainting. This was about 1600 and so had not been to the pub.

The whole thing is pretty odd, I have been on my medication for quite a long time although the Canagliflozin will have been the last addition to my pill package. Coincidentally and now thinking about it, since starting that med I do not think I have been in a circumstance to produce the nasty effect. Until  now.

It seems to fit the bill with all other things taken into account. I think the only way to prove it is to run a test. I get my HbA1c results back on Wednesday so will wait until then to make a choice. If my blood results come back and show no Lactic Acid then one of three things is true [1] They should have tested Arterial Blood [2] The Red Wine was responsible and since stopping the Lactic Acid problem has receded. [3] There was no Lactic Acid problem at all. My money is on [3] and here is why;

For a very long time now, I ceased drinking beer. Once in a blue moon I might have a few lagers but that is it. I cannot stand the bloated belly I get with it and cannot stomach more than a few pints anyway. It goes flat before I finish a glass. I usually drink Red Wine only and to be honest I can go through three bottles a week quite easily though not always. I only go to the pub twice a week and often only once then I have two large ones [250] then the missus sends a text telling me to get my arse home...... :'( On top of that I sometimes have 1 glass [250 ish] every other day if the weather is ok and I can sit on me garden bench. Then there is 2 x 250 glasses with my Sunday Diner on alternate Sunday's when we have my brother in law around.

I was unaware of the Lisinopril issue.

Well what to do? Since stopping my Metformin I have ceased drinking Red Wine and have had perhaps 3 lagers overall, my diet has gone to rats as has my BG readings. I am hardly eating to be honest and have lost about 5 lbs in two weeks. I walk about 5 to 7 miles a day [deliberate routes but not all in one go] and there is little else I can do at the moment. I have not felt dizzy or giddy at all or even close since the initial event. We shall see. I have a suspicion that this whole business is something to do with me starting retirement.

Patti, I cannot remember what my handle was when I was last on this group but it was the old one and you organised a meeting for the group near Nuneaton ? Cannot remember the name but know where it was, used to drive past all the time. By the lakes, you had a good turn out and there were quite a few decent photos you published if I remember right.
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Online Pattidevans

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Re: Back Again
« Reply #8 on: 26 September 2016, 12:06:04 PM »
I am pleased to shed a little light on the matter.  I wouldn't have thought your alcohol intake was an issue with the amount you drink. Though lager and beer can push BGs up, red wine will often reduce them or have a neutral effect.

I do wonder sometimes when the Dr prescribes some drugs, whether they are actually familiar with some of the interactions they may have with other pills the patient is on.  I also note you are on Amlodipine as well as Lisinopril - the information says nothing about Amlodipine interacting with Canagliflozin, but it could certainly react with the Lisinopril to cause low BP.  Maybe you reacted on that day in such a way that all the drugs together caused the problem?

Ah, a meeting at Kingsbury Water park.  We've had 6 or 7 there altogether.  Did you attend?  If you can recall the year I could see if I can find a photo you might be in and from that deduce what your original nick was. :)
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Agincourt

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Re: Back Again
« Reply #9 on: 26 September 2016, 12:17:40 PM »



Would you mind going into some details on your usual daily regimen in terms of diet (carbs, fats, protein), meds doses and timing, and test timing and results? It may help us offer ideas to reduce your meds load.

Ok before this incident this was my regime but please take into account that I have been T2 since 2005 and so the so called 'honeymoon' dietary phase is long gone in my case. Also please bear in mind that I retired at the beginning of July so things have gotten a little different from what was my normal routine. This is how it was before this incident;

Rise about 0830 [mainly to give the missus priority in the bathroom  ;D ] get sorted then downstairs for 2 x 500 Metformin + 2 x Glicklazide 80 + Lisinopril + Amlodipine + Canagliflozin. Breakfast is one of the following - 2 x Hard Boiled Eggs + 1 x Slice Brown Bread + Coffee. Or, 1 x small bowl porridge made with water, no milk [allergic] no sweetener + Tea. Or, 2 x Slices Brown Bread as toast with margarine and Marmite. Once a week usually Sunday - 1 x boiled egg, 3 rashers of bacon, tomatoes, baked beans and mushrooms and that has to last until 1900 that day for Sunday Dinner.

Lunch - well this is a bit of a problem because there is no particular regime in that I only eat if hungry otherwise I do not. If I do its usually a tin of fish and a few crackers or 1 x meat sandwich or something from the previous days evening meal left over.

Evening meal - usually 1800 - 1900 consists mainly 3 or 4 veg and some form of meat or stew but no potatoes. Or, a basic rice dish such as Chili Con Carne or a Salad with just about everything but no rice or potato products. Puddings are either a Yogurt [ I know !!!!!] or a piece of fruit.

That boring list is pretty much it oh.....once every other Sunday its a full Sunday dinner, well that's what we call it but I do not get potatoes or Yorkshire Puds. Instead I have a large red onion and more veg than anyone else.

I do not eat confectionery at all, no baking of any kind and definitely no fast food types.

Since being taken off Metformin my BG's are not at all good and I do not think you would believe how little I eat. Before sitting down to write this I walked 2 miles into town had a coffee 3 slices of bacon and then walked back. Going to test in half an hour but it was 9.2 when I set off.
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Offline Agincourt

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Re: Back Again
« Reply #10 on: 26 September 2016, 12:23:46 PM »
I am pleased to shed a little light on the matter.  I wouldn't have thought your alcohol intake was an issue with the amount you drink. Though lager and beer can push BGs up, red wine will often reduce them or have a neutral effect.

I do wonder sometimes when the Dr prescribes some drugs, whether they are actually familiar with some of the interactions they may have with other pills the patient is on.  I also note you are on Amlodipine as well as Lisinopril - the information says nothing about Amlodipine interacting with Canagliflozin, but it could certainly react with the Lisinopril to cause low BP.  Maybe you reacted on that day in such a way that all the drugs together caused the problem?

Ah, a meeting at Kingsbury Water park.  We've had 6 or 7 there altogether.  Did you attend?  If you can recall the year I could see if I can find a photo you might be in and from that deduce what your original nick was. :)

You have made me think hard now, I thank you for that.  :-* Nope I did not attend the do, I had intended to but at the time I was working and it was a no chance. Not sure what the year was but a guess might be 2007 I have been desperately trying to remember my username at the time but so far no luck. However there are only a few possibles I will private message to see if one rings a bell.
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Online Pattidevans

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Re: Back Again
« Reply #11 on: 26 September 2016, 03:12:19 PM »
I know what it was!  I will PM you.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Online Pattidevans

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Re: Back Again
« Reply #12 on: 26 September 2016, 03:25:04 PM »
Sorry, you can't PM or receive them as a new member until you have done a certain amount of posts.  I have emailed you.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Agincourt

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Re: Back Again
« Reply #13 on: 26 September 2016, 04:33:03 PM »
 ::) Yup you got it right.......I might like to go back to using my other but to be honest I am not sure I can remember the password I used etc. I will try though. Anyhow you will know eh?

Cheers
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Agincourt

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Re: Back Again
« Reply #14 on: 26 September 2016, 04:43:58 PM »
Ok got it