Author Topic: Back Again  (Read 1647 times)

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Offline Alan

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Re: Back Again
« Reply #30 on: 30 September 2016, 10:27:29 PM »
G'day again

Moving away from problems with medical staff, do you mind if we re-examine your diet and regimen?

You said you test eight times daily. When, related to your meals, are those tests? Are any at your peak after meals?
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.
What numbers do you generally see ONE hour after breakfast? Does it vary depending on whether it included toast or porridge or baked beans?
Quote
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.
Same question; does it vary when you have crackers compared to a sandwich?
Quote
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.
And again. What are your typical post-meal numbers, especially after rice. Do you have bread with those dinnners? What do you wash it down with?

Do you remember reading this last time you were here: Test, Review, Adjust:)
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)

Offline Lucy

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Re: Back Again
« Reply #31 on: 30 September 2016, 10:30:16 PM »
I may have missed it somewhere but your signature says gliclazide. Are you on the maximum dose of that? There are other tablets that could be tried before insulin, some examples off the top of my head being januvia or forxiga unless they disagree with you. Alternatively have you considered trying to adjust diet to get the levels down? Perhaps a change of diet could reduce your blood sugars to the point you don't need insulin? If you are seeing bgs of 8-9 now they arent all that high, a feww less carbs and a bit more exercise could possibly improve your levels without needing insulin or tablets.
Type: Lucy. A1C 44 / 6.0% Jan17.
Lantus, Victoza and Apidra. Metformin XR, Bisoprolol (for SVT). Dexcom G4 with xdrip and nightscout.

Online Pattidevans

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Re: Back Again
« Reply #32 on: 01 October 2016, 09:16:37 AM »
Lucy


He is on canagliflozin which is the same class of drug as Forxiga (same mechanism) and it would appear tha that drug was the cause of the problem, not the Metmormin.
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 #33 on: 01 October 2016, 10:20:50 AM »
Thanks Patti, I know you are quite busy at the moment. All your points are registered and I will give some serious thought to it all.
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Offline Agincourt

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Re: Back Again
« Reply #34 on: 01 October 2016, 10:52:49 AM »
Hi there, sorry for the delayed response.

Quote
You said you test eight times daily. When, related to your meals, are those tests? Are any at your peak after meals?

Test times are flexible dependent upon what I am doing and where I am but overall it looks like this - 30 minutes after rising then about every two hours thereafter until I go to bed. However it is flexible in that I do sometimes miss one or alternatively insert one. I really depends on my day and what I am doing.

Quote
What numbers do you generally see ONE hour after breakfast? Does it vary depending on whether it included toast or porridge or baked beans?

After rising mt first one is usually in the range 8.9 - 9.1 and it seems to be pretty regular. I do not usually have breakfast but if I do [like today] it will be either 2 x hard boiled eggs or porridge made with water and nothing else added and the volume is exactly 26 table spoons to eat.  ::) I test before and then about two hours later. There is no variety to this meal. This last week I have not had breakfast on three occasions.

Quote
What numbers do you generally see ONE hour after breakfast? Does it vary depending on whether it included toast or porridge or baked beans?

I do not test one hour after so cannot answer the question. More often than not I will go through until about 1030.

Quote
Same question; does it vary when you have crackers compared to a sandwich?

Yes it would do almost definitely however there is a type of bread I can get which is very good for diabetics and when I do have a slice of that the effect seems very reduced. But we don't always have it.

Quote
And again. What are your typical post-meal numbers, especially after rice. Do you have bread with those dinners? What do you wash it down with?


Post meal [evening] at 2 hours would be around 9.0 sometimes 11/12. I don't wash it down but do have a mug of tea about an hour afterwards.

Quote
Do you remember reading this last time you were here:

Errr to be honest no. But.......I can ask at my GP's on Monday when I go I am sure they will have at least a Hba1c from then. I used to keep that stuff for reference but gave up after a while.

Patti might remember that at that time I had a very clear method of how I was going to manage myself. That became second nature though over time I have just slipped a few times. Well to be fair it has been a long time. ;D







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

Offline Agincourt

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Re: Back Again
« Reply #35 on: 01 October 2016, 11:04:35 AM »
I may have missed it somewhere but your signature says gliclazide. Are you on the maximum dose of that? There are other tablets that could be tried before insulin, some examples off the top of my head being januvia or forxiga unless they disagree with you. Alternatively have you considered trying to adjust diet to get the levels down? Perhaps a change of diet could reduce your blood sugars to the point you don't need insulin? If you are seeing bgs of 8-9 now they arent all that high, a feww less carbs and a bit more exercise could possibly improve your levels without needing insulin or tablets.

Hi Lucy,

Unfortunately, my existing diet is pretty diabetic friendly and coincidentally, my missus has  lost over three stone over the years I have been a T2. [See there is always a bit of good round the corner] I doubt that diet adjustment will do it completely, I am sure I can 'smarten' my diet up because I have gotten a tad too relaxed about it but that's because of complacence over the years. I am 65 and lucky enough to be physically fit and strong enough to do many miles a day with ease as well as other stuff and have been doing so but the big issue now is that I am not convinced the medics have got it right. Not yet. So for now I am doing what I can without diabetic medication except for the Glicklazide 2 x 80 morning and the same evening.
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Offline Lucy

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Re: Back Again
« Reply #36 on: 01 October 2016, 01:44:33 PM »
I may have missed it somewhere but your signature says gliclazide. Are you on the maximum dose of that? There are other tablets that could be tried before insulin, some examples off the top of my head being januvia or forxiga unless they disagree with you. Alternatively have you considered trying to adjust diet to get the levels down? Perhaps a change of diet could reduce your blood sugars to the point you don't need insulin? If you are seeing bgs of 8-9 now they arent all that high, a feww less carbs and a bit more exercise could possibly improve your levels without needing insulin or tablets.

Hi Lucy,

Unfortunately, my existing diet is pretty diabetic friendly and coincidentally, my missus has  lost over three stone over the years I have been a T2. [See there is always a bit of good round the corner] I doubt that diet adjustment will do it completely, I am sure I can 'smarten' my diet up because I have gotten a tad too relaxed about it but that's because of complacence over the years. I am 65 and lucky enough to be physically fit and strong enough to do many miles a day with ease as well as other stuff and have been doing so but the big issue now is that I am not convinced the medics have got it right. Not yet. So for now I am doing what I can without diabetic medication except for the Glicklazide 2 x 80 morning and the same evening.

I was asking after reading your other thread really, if you added some one hour tests you may find that some of your foods spike you and that there are some adjustments you could make. E.g. You say you have either eggs or porridge with water for breakfast. Do both of those meals have the same impact on your blood sugar?
Type: Lucy. A1C 44 / 6.0% Jan17.
Lantus, Victoza and Apidra. Metformin XR, Bisoprolol (for SVT). Dexcom G4 with xdrip and nightscout.

Online Pattidevans

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Re: Back Again
« Reply #37 on: 01 October 2016, 03:51:10 PM »
Agincourt

Ideally (at least for a day or two) test as close as possible after you wake, then again before breakfast.  BGs can rise a lot in that time.

Also test before a meal and at one and two hours after your last bite. Then post, along with what you ate, those results should tell a story.  Good idea to use a day with porridge and a day with eggs.

I don't know what you mean by diabetically friendly... if it's the low fat and carby diet that is suggested by what you've mentioned previously, then it's not really diabetically friendly, but it IS the advice often pushed by the medical profession.

The following foods are what we should ideally avoid (leaving out the obvious like sugar), baked goods, cereal, porridge, bread, rice, potatoes, pasta, or what is known as "starchy carbs".  Also beware of fruit.  Berries are usually better tolerated than other fruits. Though we all vary in our tolerances and you may be able to eat moderate amounts of some of the items, but your meter will be the judge of that and it does not lie.  I saw you say somewhere that you are "out of your honeymoon period" but this advice to curb the carbs will still work.   I'm a fully fledged T1 in my 14th year since diagnosis and I still get better results (and use much less insulin) if I stick to the lower carb diet.

Quote
<blockquote>Same question; does it vary when you have crackers compared to a sandwich?</blockquote>
Yes it would do almost definitely however there is a type of bread I can get which is very good for diabetics and when I do have a slice of that the effect seems very reduced. But we don't always have it.
  Which bread are you talking about?  I don't eat the same bread as my hubby.  We buy loaves and put them in the freezer and take out the just requisite number of slices as and when.  That way we waste nothing and it only takes a few minutes to defrost.
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 #38 on: 01 October 2016, 03:59:35 PM »
BTW, you can now enter a profile.  It's a good idea as it saves people having to trawl back down threads to see what meds you are on every time.  Just go to the top of the page, click on profile and then on "forum profile"  :) :)
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 #39 on: 01 October 2016, 07:44:01 PM »
BTW, you can now enter a profile.  It's a good idea as it saves people having to trawl back down threads to see what meds you are on every time.  Just go to the top of the page, click on profile and then on "forum profile"  :) :)

I thought that I had.
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]

Offline Agincourt

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Re: Back Again
« Reply #40 on: 01 October 2016, 07:46:26 PM »
OK just done a deliberate set of things to get a clear answer. Please see new thread entitled 'Bad boy making good'

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

Offline Alan

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Re: Back Again
« Reply #41 on: 02 October 2016, 09:08:58 PM »
Hi there, sorry for the delayed response.

Quote
You said you test eight times daily. When, related to your meals, are those tests? Are any at your peak after meals?
Test times are flexible dependent upon what I am doing and where I am but overall it looks like this - 30 minutes after rising then about every two hours thereafter until I go to bed. However it is flexible in that I do sometimes miss one or alternatively insert one. I really depends on my day and what I am doing.

Quote
What numbers do you generally see ONE hour after breakfast? Does it vary depending on whether it included toast or porridge or baked beans?
After rising mt first one is usually in the range 8.9 - 9.1 and it seems to be pretty regular. I do not usually have breakfast but if I do [like today] it will be either 2 x hard boiled eggs or porridge made with water and nothing else added and the volume is exactly 26 table spoons to eat.  :rolleyes: I test before and then about two hours later. There is no variety to this meal. This last week I have not had breakfast on three occasions.

Quote
What numbers do you generally see ONE hour after breakfast? Does it vary depending on whether it included toast or porridge or baked beans?
I do not test one hour after so cannot answer the question. More often than not I will go through until about 1030.

Thanks for the detailed response. I read it all but my own response will be brief.

I urge you to stop wasting strips with tests every two hours or at two hours. What changes do you make to your regimen for improvement as a consequence of those two-hourly tests? A test is a waste of blood, time and materials if it neither advises action to be taken nor confirms past action as successful.

Please consider finding when you peak after meals; it is likely to be closer to one hour than two. Read this to see what I mean (click on it): When To Test?

Consider this testing regimen for a week or two:
  • On waking
  • Peak after breakfast (if you do not know your peak, one hour after your last bite)
  • Peak after lunch
  • Peak after dinner
  • Peak after any significant snacks
I was puzzled by your answer to my mention of this link so please read it again with what I just wrote in mind: Test, Review, Adjust
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)

Offline sedge

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Re: Back Again
« Reply #42 on: 03 October 2016, 11:37:08 PM »
Wow having read the entire thread LOL

Can I just say to you that ALL your HCPs are treating one symptom specifically, rather than putting all the symptoms together with the person actually having them - and seeing the big picture.

This is quite a major sin in this day and age when they are ALL supposed to be 'patient centred'  !!  It's absolutely against all modern NHS 'mission statements' and specifically against the Diabetes ones.

So - sack em!  Go to another GP Practice and start over.
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Offline Agincourt

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Re: Back Again
« Reply #43 on: 04 October 2016, 09:29:10 AM »
Wow having read the entire thread LOL

Can I just say to you that ALL your HCPs are treating one symptom specifically, rather than putting all the symptoms together with the person actually having them - and seeing the big picture.

Thank you for explaining so well. After reading this I have considered all that has happened and the above quote is precisely what has happened.

Quote
This is quite a major sin in this day and age when they are ALL supposed to be 'patient centred'  !!  It's absolutely against all modern NHS 'mission statements' and specifically against the Diabetes ones.

So - sack em!  Go to another GP Practice and start over.

I have already seriously considered doing precisely that. However, as annoying as it may be - and quite difficult for me - I have decided that I must deal with the issues in a specific order otherwise my whole argument could potentially loose a lot of force. From the word 'go' everyone [including me] made mistakes and nobody, not even the so called professionals, can excuse their failure. I need to demonstrate that everyone in the correct order, made inexcusable errors in judgement. If I can show that clearly then I win the argument and will get a correct review of my circumstances.

What I cannot afford to do is to follow my gut and go for the throat right now................. >:(
Glicklazide, Lisinopril, Amlodipine, Lantus 14 u [currently]