Yet Another Cycling Forum
General Category => The Knowledge => Health & Fitness => Topic started by: Gattopardo on 27 December, 2018, 12:00:33 pm
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Hello,
Looking at you diabetics and wondering what drugs you are on. Mainly so I can go to my doctor and ask for MOAR DRUGS as current meds are not working. Suspect possible interactions with other meds but hey ho.
So me:
Slow release metformin 2g januvia 100g.
Thinking of upping the slow release to 3g. See what happens.
Since 24th Dec haven't been below 12mmol, before no testing and diet is low carb...
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3 x 500 mg metformin, manufacturer's name like Christer or I.G. Farben, probably comes from Israel or India. HbA1c is 6.5% which doc OKs. Usual BS is 100-120 mg/dl.
When I'm going to be cycling the doc tells me to cut out the pills before, during and immediately after. He also tells me (and Mrs. Proudy agrees) not to worry too much about figures over Christmas/New Year.
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I'm on Gliclazide 40mg, but my sugar level is around 8-10 doctor thinks that's OK
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For those who measure their glucose in mmol/l rather than mg/l, T42's glucose is in the 5.56 - 6.67 range...
Divide/multiply by 18 to convert.
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...manufacturer's name like Christer or I.G. Farben...
Most amusing
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Manufacturer of Zyklon B, the cyanide gas used in the extermination chambers AIUI...
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Indeed, and complicit in much more. In 1978 KZ Buchenwald, in the GDR, had an exhibition showing documentation for female inmates sent to IG Farben facilities for experimental purposes. Gruesome. Salvatore OTP has probably seen that too.
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Type 1, using an insulin pump with Novorapid.
Also have a back up insulin pen and needles with injectable Novorapid and Levemir
I've given myself a holiday from strict control since Christmas Eve. I've had beer, chocolates, twiglets, potatoes and bread, all of which need strict watching. I'll start again tomorrow. No beer in the house.
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Type 1, using an insulin pump with Novorapid.
Also have a back up insulin pen and needles with injectable Novorapid and Levemir
That ^^^ sounds like a fiddly PITA. Every time I tell the doc that metformin's a pain in the arse he grins and offers me an insulin pen. No ta.
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Type 1, using an insulin pump with Novorapid.
Also have a back up insulin pen and needles with injectable Novorapid and Levemir
That ^^^ sounds like a fiddly PITA. Every time I tell the doc that metformin's a pain in the arse he grins and offers me an insulin pen. No ta.
Especially for your driving licence ;)
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3 x 500 mg metformin, manufacturer's name like Christer or I.G. Farben, probably comes from Israel or India. HbA1c is 6.5% which doc OKs. Usual BS is 100-120 mg/dl.
When I'm going to be cycling the doc tells me to cut out the pills before, during and immediately after. He also tells me (and Mrs. Proudy agrees) not to worry too much about figures over Christmas/New Year.
Is that the slow release or normal?
Have heard the comments about christmas/new year quite often...
I'm on Gliclazide 40mg, but my sugar level is around 8-10 doctor thinks that's OK
Just gliclazide?
Do you mean HbA1c?
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For those who measure their glucose in mmol/l rather than mg/l, T42's glucose is in the 5.56 - 6.67 range...
Divide/multiply by 18 to convert.
Find it amusing that the UK system was supposed to have changed to mmol/l from mg/l a few years ago. Pity bg machines and labs are sticking with the mg/l readings.
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Its kind of hard to be T1 and not have insulin :P
With a borked pancreas its "give me insulin, or give me death!"
The pump is the size of an old pager, powered by an AAA, and holds the insulin cartridge. Connected by a fine tube to a subcutaneous cannula for continuous delivery. The other option would be two different types of insulin, five injections per day, five needles to dispose of.
The pump is by far the least faffy of the two.
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Dr bernstein disagrees with your type 1 and Insulin. 8)
Pumps are brilliant, from what pump users have said to me.
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For those who measure their glucose in mmol/l rather than mg/l, T42's glucose is in the 5.56 - 6.67 range...
Divide/multiply by 18 to convert.
Find it amusing that the UK system was supposed to have changed to mmol/l from mg/l a few years ago. Pity bg machines and labs are sticking with the mg/l readings.
UK labs measure in mmol/l.
US labs use mg/l
Suspect blood glucose machines were developed for the American market.
Don't know what domestic machines aimed at our Continental cousins use. I think their labs use mmol/l though.
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3 x 500 mg metformin, manufacturer's name like Christer or I.G. Farben, probably comes from Israel or India. HbA1c is 6.5% which doc OKs. Usual BS is 100-120 mg/dl.
When I'm going to be cycling the doc tells me to cut out the pills before, during and immediately after. He also tells me (and Mrs. Proudy agrees) not to worry too much about figures over Christmas/New Year.
Is that the slow release or normal?
Have heard the comments about christmas/new year quite often...
I'm on Gliclazide 40mg, but my sugar level is around 8-10 doctor thinks that's OK
Just gliclazide?
Do you mean HbA1c?
Slow release, my tester reads in mmol/L
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Dr bernstein disagrees with your type 1 and Insulin. 8)
Pumps are brilliant, from what pump users have said to me.
Then Dr Bernstein is a twat.
I'm on the lowest dose of insulin I know of, and have the best control I know of. That is achieved by a low carb diet, target less than fifty grammes a day, high levels of activity and use of the pump. Trying to keep in a mild nutritional ketosis. Even with all that, I know that if my pump stops, or I have a bad cannula, or a bad insulin cartridge, my levels will go out of control.
Yes, T2's can achieve remission with all of the above, in which Dr B is correct, but not T1.
As for the pump, they are extremely effective in certain circumstances
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For those who measure their glucose in mmol/l rather than mg/l, T42's glucose is in the 5.56 - 6.67 range...
Divide/multiply by 18 to convert.
Find it amusing that the UK system was supposed to have changed to mmol/l from mg/l a few years ago. Pity bg machines and labs are sticking with the mg/l readings.
UK labs measure in mmol/l.
US labs use mg/l
Suspect blood glucose machines were developed for the American market.
Don't know what domestic machines aimed at our Continental cousins use. I think their labs use mmol/l though.
Machines used to let you choose. All my machines are mmol/L. Machine sellers give the readers away for free.
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I think some people reclassify T2s as T1 once they go onto insulin.
I am not a diabetologist but some folk have some residual insulin secretion; some don't. If there is NONE exogenous insulin is needed.
My uncle became insulin-dependant after ingesting HUGE quantities of orange juice at around the age of 60. He is now on a very low-carb diet and off insulin. I'd term him as T2 though others may disagree.
David's dad became diabetic at 38, like his mother before him. He is now on insulin and multiple other medications. He has been told he is T1 now but...
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Dr bernstein disagrees with your type 1 and Insulin. 8)
Pumps are brilliant, from what pump users have said to me.
Then Dr Bernstein is a twat.
I'm on the lowest dose of insulin I know of, and have the best control I know of. That is achieved by a low carb diet, target less than fifty grammes a day, high levels of activity and use of the pump. Trying to keep in a mild nutritional ketosis. Even with all that, I know that if my pump stops, or I have a bad cannula, or a bad insulin cartridge, my levels will go out of control.
Yes, T2's can achieve remission with all of the above, in which Dr B is correct, but not T1.
As for the pump, they are extremely effective in certain circumstances
At a guess you haven't come across Dr Bernstein. His regime (goes further than a diet) goes for 30g max!!! I believe that the there is a link with the type of diabetic that you are. By that I mean the sub types that under the type 1 and 2 umbrella.
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I think some people reclassify T2s as T1 once they go onto insulin.
I am not a diabetologist but some folk have some residual insulin secretion; some don't. If there is NONE exogenous insulin is needed.
My uncle became insulin-dependant after ingesting HUGE quantities of orange juice at around the age of 60. He is now on a very low-carb diet and off insulin. I'd term him as T2 though others may disagree.
David's dad became diabetic at 38, like his mother before him. He is now on insulin an multiple other medications. He has been told he is T1 now but...
We are wandering on to another topic. One I find very interesting.
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I think some people reclassify T2s as T1 once they go onto insulin.
I am not a diabetologist but some folk have some residual insulin secretion; some don't. If there is NONE exogenous insulin is needed.
My uncle became insulin-dependant after ingesting HUGE quantities of orange juice at around the age of 60. He is now on a very low-carb diet and off insulin. I'd term him as T2 though others may disagree.
David's dad became diabetic at 38, like his mother before him. He is now on insulin an multiple other medications. He has been told he is T1 now but...
We are wandering on to another topic. One I find very interesting.
We are wandering in another direction and while I could start another topic or split off, I think management of of diabetes is in some way best left as a single topic.
I am sure we are are ALL potential (at least) T2 diabetics. Too much sugar and/or energy will overwhelm the body's capacity to handle these.
Some folk have trouble handling even modest quantities of carbohydrate but might be OK as this approaches zero.
Those with NO insulin secretion will need exogenous insulin whatever their diet.
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For those who measure their glucose in mmol/l rather than mg/l, T42's glucose is in the 5.56 - 6.67 range...
Divide/multiply by 18 to convert.
Find it amusing that the UK system was supposed to have changed to mmol/l from mg/l a few years ago. Pity bg machines and labs are sticking with the mg/l readings.
UK labs measure in mmol/l.
US labs use mg/l
Suspect blood glucose machines were developed for the American market.
Don't know what domestic machines aimed at our Continental cousins use. I think their labs use mmol/l though.
Mmol/l is the Si unit for pretty much every medical measurement.
The switch in Scotland took place not long before I left the diabetes project, though I was looking at a lab results issue earlier and of the 8 or so results, 2 were %ages, 1 was mg/l and the rest were mmol/l
Can't remember what was in mg/l but it wasn't the blood glucose or cholesterol.
Part of the classification problem is historically type 1 was "insulin dependent" and type 2 "dietary controlled" which was eventually considered inappropriate as its the same as classifying a cough based on whether you take tixilix or a hot toddy rather than by the underlying cause of it.
Sent from my BKL-L09 using Tapatalk
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I believe the Yanks STILL use mg/L...
Backward colonials!
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I have come across Bernstein, seen him speak. Either he is wrong on T1 or you are misunderstanding. As Helly Medic states, do not confuse insulin use vs diabetes type.
I have T1, dose of flu, rogue t-cells, borked beta cells. I may have some residual insulin production but not a lot.
Bernstein is correct on T2, whether using insulin or not. All of those factors I mention, including very low carb diets may remove the need for insulin, and may put the T2 into remission. That will however not work with T1, we can reduce but not eliminate.
As HM says, the distinctions may not always be clear, in my case however, it is crystal.
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From a quick google he seems to be advocating controlling Blood Glucose levels in T1 patients by taking in little glucose by restricting carbs to 30g a day.
But if you have no insulin in order to process even that small amount of glucose, where's it going?
Oh great, now I'm remembering the pictures of diabetic feet pre-amputation...
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Even if you eat no glucose or starch, your body can make it from protein and fat.
Hormones normally regulate the level of glucose in the blood in both directions.
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Even if you eat no glucose or starch, your body can make it from protein and fat.
Hormones normally regulate the level of glucose in the blood in both directions.
Had inadvertently forgot about that, something that endurance cyclists make use of an aw...
Sent from my BKL-L09 using Tapatalk
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Read a bit more.
Seems it's about keeping blood sugar at sensible levels through a low carb diet and using insulin as needed, says to aim for no more than 7 units (no mention of the unit) an injection.
This reminds me of the explanation of HbA1c I got.
Senga is diabetic, Senga drinks 2l of irn bru a day and isn't very good at injecting insulin, except before going to the clinic because Senga knows the DSN will go ape at her if her blood glucose is through the roof, HbA1c means the DSN can see sengas rubbish control over the last few days and goes ape. Senga goes home, tanks a bottle of bru and tries to make up for it with insulin...
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I'm typically on 4-8 units per day, not per meal.
That is through combination of low carbs, and the exercise to improve insulin sensitivity. On the bike I typically need an extra 25g/hr of carbs with my pump turned down to 20% of its normal. Most texts on diabetes management would have me eating anywhere from two to four times that.
As well as gluconeogenesis, you rely on increased insulin sensitivity, additional mechanisms like GLU4, and a trai ed fat burning metabolism at audax speed.
The handyy thing is that the increased insulin sensitivity lingers afterwards, which is a problem right now as I recover from my pelvic fracture, and I've been needing to increase my background insulin by 20% instead. Just about ready to get back to it now.
As an example of control regime my target levels are 4-6mmol/l on waking, and 4-8 otherwise. At my last check up I was 98% in target. This is referred to as tight control. I'm not there right now, will be interesting to see how the accident has affected my HbA1c at the clinic on Monday.
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Don't know what domestic machines aimed at our Continental cousins use. I think their labs use mmol/l though.
Probably depends which cousin you choose. French labs state results in mg/dl with the mmol/l in smaller print for those curious foreigns. Meters let you choose, at least mine does.
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And to make it even more confusing, in the UK, HbA1c is given as mmol/mol these days.
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"These days", Google inquit, being post 1st Oct 2011. After Brexit they'll probably change it to drachms/quart.
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Type 2 here, have been for several years. I am prescribed two tablets of slow release Metformin per day.
I take one of them in the morning, dont take the second one. The normal Metformin made me feel queasy and I ran to the loo a lot.
I dont know what my current glucose control is like. MY GP practice are only interested in the HbA1c score, which seems to be current guidance. They flat refuse to prescribe the testing sticks for a glucose meter.
I know I could organise my own, but they are expensive.
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"These days", Google inquit, being post 1st Oct 2011. After Brexit they'll probably change it to drachms/quart.
yebbut, loads of people have npt moved on from "the old way"
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I believe the Yanks STILL use mg/L...
Backward colonials!
At least it's metric, and not fluid ounces per quart or whatever it would be under their firkin/furlong/farenheit system.
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Type 2 here, have been for several years. I am prescribed two tablets of slow release Metformin per day.
I take one of them in the morning, dont take the second one. The normal Metformin made me feel queasy and I ran to the loo a lot.
I dont know what my current glucose control is like. MY GP practice are only interested in the HbA1c score, which seems to be current guidance. They flat refuse to prescribe the testing sticks for a glucose meter.
I know I could organise my own, but they are expensive.
I bought this one
https://www.ebay.co.uk/itm/eBwell-Blood-Glucose-Monitor-Glucose-Meter-UK-mmol-L-100-FREE-TEST-STRIPS/253016329256?_trkparms=aid%3D555017%26algo%3DPL.CASSINI%26ao%3D1%26asc%3D55149%26meid%3D6af76a3ee49c417d8ac1d3a872ec84be%26pid%3D101006%26rk%3D1%26rkt%3D1%26%26itm%3D253016329256&_trksid=p2045573.c101006.m3226
and these sticks
https://www.ebay.co.uk/itm/3x50-eBwell-BLOOD-GLUCOSE-MONITOR-MONITORING-TEST-TESTING-KIT-REPLACEMENT-STRIPS/253897404126
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Mine's a Lifescan, which AIUI is a UK company. It's fairly typical, I suppose, although last year I was a bit doubtful of the readings and they sent me a calibration kit. On the bottle of calibration solution it said (paraphrase) "a correct reading should be between 102 and 138", which to my mind means that they have an error margin of ±18%. Confidence-inspiring.
Another snippet I picked up is that such testers are only intended for capillary blood. Venous blood won't give a reliable result, I suppose because some of the blood glucose will have already been used.
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I don't think capillary and venous blood usually differ much in their sugar concentration.
I can't remember my management of a diabetic changing between the two sampling methods, so long as the capillary sample was CLEAN. (Fingertip contamination should be considered if capillary results seem spurious, obviously.)
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When I mentioned testing venous to the Lifescan help line the woman on the other end practically shrieked at me. Made me feel about this size.
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the allowable error range on those things is bigger at the high end than at the low end, you don't want to be either missing hypos, or generating false hypos.
It is, however as an overall error range far higher than i'd accept from any of my clients.
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It seems fasting capillary and venous glucose are very similar but capillary levels are higher after meals.
This study has a rather small sample.
http://www.ipcbee.com/vol39/040-ICNFS2012-N3003.pdf (http://www.ipcbee.com/vol39/040-ICNFS2012-N3003.pdf)
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I'm tickled to see that pp blood glucose in healthy subjects averaged 163 mg/dL. I was told years ago that mine should be around 140.
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It's a tiny study of Asians on a rice'n'noodles diet...
AIUI rice'n'noodles' glycaemic index is like confectionary.
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From a quick google he seems to be advocating controlling Blood Glucose levels in T1 patients by taking in little glucose by restricting carbs to 30g a day.
But if you have no insulin in order to process even that small amount of glucose, where's it going?
Oh great, now I'm remembering the pictures of diabetic feet pre-amputation...
I'm five or more years out of the loop of bleeding edge tech but it is quite fascinating how the body works and how much we don't know or understand.
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It's a tiny study of Asians on a rice'n'noodles diet...
AIUI rice'n'noodles' glycaemic index is like confectionary.
What matters is that you are getting the same blood to compare so skin level should be perfect as a guide. Hey there a patches that can read bg levels hence making pumps possible.
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Started this thread to see what other diabetics are on. Looks like I'm on the most advanced meds with sitagliptin with my metformin.
Then I was the one who took the thread on to a tangent.
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The closed loop systems work on a cgm based on capillary blood or interstitial fluid. Neither the infrared technologies or the patches are on general release yet, to my knowledge.
The Abbot flash glucose monitor has been approved for NHS use, but the criteria are still being decided so I'm not sure if I'm eligible yet.
I'd argue I'm on the most advanced med with synthetic rapid acting insulin in a pump.
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After my hospital spell, my BG are still running to double figures. Even first thing in the morning with at least 12 hours fasting.
So is it the other medication I am on, or something else. The something else is rising insulin resistance, or insulin production issues.
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Stress
Lack of Exercise
Your other meds
More Stress
Diet
Stress
All may play a part. This time of year I know I generally have a few weeks of less exercise and more stress, which really has an effect.
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I'm not a diabetic but methinks ED has it.
ANGER - Adrenaline raises sugar as well as stressy cortisol...
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I'm on 4 x 500 mg metformin and usually sit around 16 on the meter, which ain't great but its better than the 34 it was 6 months ago.
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'ain't great' is an understatement!
We love you Sam and want to love you for a LONG time.
There's a LOT of room for improvement; we REALLY don't want to see you suffer!
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Was on 2*500mg metformin.
But my massive weightloss have dramatic results.
My Hb1Ac is down from 51 mmol/mol to 39 mmol/mol
So No more medicine for me now 😀😀
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Well done Gus!
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That is great progress Gus.
Sam 34 to 16 is a big improvement in 6 months. Keep on with the diet and weight loss and it will only go one way, see this as positive progress not a failure. Have you spoken to GP or specialist nurse, about other possible treaments?
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Doing well, lads.
Not so great, me. In January & February I usually had around 115 mg/dl (6.5 mmol/l) of a morning but with the weather going apeshit so have I because I can't ride. 130 on Sunday and ICBA testing since. Ice cream is my downfall.
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The ice cream you eat is too good! ;) ;D
Cheap soft scoop ice cream hardly budges David's dad's readings!
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I think it's quantity rather than quality!
I find good quality ice cream not too difficult to cope with because the higher fat content from the cream slows the sugar absorption, one of the reasons why T1's are told not to use chocolate as a hypo treatment
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[Veering OT]
Suspect there's more gas & water in cheap ice cream, which are devoid of both calories & sugar!
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as a student I did some work on ice cream, a membrane bioreactor to treat liquid effluent from the plant. One thing I learned was that there are all sorts of "kemikulz" in what we call ice cream to make it hold all those little air bubbles and stay light and frothy. The actually come in handy when treating the effluent as well as they help when you are trying to oxygenate it
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[More OT] Remember meeting a Colloid Science student who was surprised I knew and understood this was A Thing.
It's all starting to gel now...
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an example of stress in diabetics, my control is such that normally I have <2% of my readings outside my target zone, my waking readings are typicall 4.5-5.5.
This time of year I have a series of mandatory government emissions reports that need to be verified for my clients. This year, instead of 31st March deadline, Brexit has stolen 20 days from us and the verified reports are due on Monday. This week with stress and little exercise I've been waking at 7-8 and rarely dropping lower. 30 min on the turbo hsa managed to get me down to 7.2.
I probably said this last year as well
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Stress hormones do a great job when a quick boost is needed.
It's just a shame diabetics can't put their sugar In A Safe Place.
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The ice cream you eat is too good! ;) ;D
Cheap soft scoop ice cream hardly budges David's dad's readings!
Well, back when I did the re-ed course after my first stent the dietician told me that two balls of ice-cream for dessert would be OK. She didn't say what size of ball, however, so I went with pétanque. I do measure by volume, though, not weight.
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Am a bit jealous of you all. My BMI is in the normal range, just below overweight. But have no muscle tone.
BG levels at 11 even with eating no carbs for two days.
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So being given novorapid insulin if I am above 16....
Beginning of injecting