Author Topic: Diabetics- what type and drugs are you on?  (Read 1085 times)

FifeingEejit

  • Not Small just Far Away at the back
Re: Diabetics- what type and drugs are you on?
« Reply #25 on: December 28, 2018, 12:36:49 am »
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...

hellymedic

  • Just do it!
Re: Diabetics- what type and drugs are you on?
« Reply #26 on: December 28, 2018, 12:45:29 am »
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.

FifeingEejit

  • Not Small just Far Away at the back
Re: Diabetics- what type and drugs are you on?
« Reply #27 on: December 28, 2018, 12:56:59 am »
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...

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FifeingEejit

  • Not Small just Far Away at the back
Re: Diabetics- what type and drugs are you on?
« Reply #28 on: December 28, 2018, 01:09:01 am »
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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ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Diabetics- what type and drugs are you on?
« Reply #29 on: December 28, 2018, 06:09:10 am »
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.
“Procrastination is the thief of time, collar him.” –Charles Dickens

T42

  • Gaulois réfractaire
Re: Diabetics- what type and drugs are you on?
« Reply #30 on: December 28, 2018, 08:16:07 am »
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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ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Diabetics- what type and drugs are you on?
« Reply #31 on: December 28, 2018, 08:23:03 am »
And to make it even more confusing, in the UK, HbA1c is given as mmol/mol these days.
“Procrastination is the thief of time, collar him.” –Charles Dickens

T42

  • Gaulois réfractaire
Re: Diabetics- what type and drugs are you on?
« Reply #32 on: December 28, 2018, 09:31:44 am »
"These days", Google inquit, being post 1st Oct 2011.  After Brexit they'll probably change it to drachms/quart.
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Re: Diabetics- what type and drugs are you on?
« Reply #33 on: December 28, 2018, 09:46:22 am »
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.

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Diabetics- what type and drugs are you on?
« Reply #34 on: December 28, 2018, 02:30:00 pm »
"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"
“Procrastination is the thief of time, collar him.” –Charles Dickens

Kim

  • 2nd in the world
Re: Diabetics- what type and drugs are you on?
« Reply #35 on: December 28, 2018, 02:44:26 pm »
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.
To ride the Windcheetah, first, you must embrace the cantilever...

Re: Diabetics- what type and drugs are you on?
« Reply #36 on: December 28, 2018, 02:49:14 pm »
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

T42

  • Gaulois réfractaire
Re: Diabetics- what type and drugs are you on?
« Reply #37 on: December 28, 2018, 03:07:20 pm »
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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hellymedic

  • Just do it!
Re: Diabetics- what type and drugs are you on?
« Reply #38 on: December 28, 2018, 03:19:14 pm »
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.)

T42

  • Gaulois réfractaire
Re: Diabetics- what type and drugs are you on?
« Reply #39 on: December 28, 2018, 05:20:52 pm »
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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ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Diabetics- what type and drugs are you on?
« Reply #40 on: December 28, 2018, 05:59:30 pm »
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.
“Procrastination is the thief of time, collar him.” –Charles Dickens

hellymedic

  • Just do it!
Re: Diabetics- what type and drugs are you on?
« Reply #41 on: December 28, 2018, 06:09:48 pm »
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

T42

  • Gaulois réfractaire
Re: Diabetics- what type and drugs are you on?
« Reply #42 on: December 29, 2018, 01:02:45 pm »
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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hellymedic

  • Just do it!
Re: Diabetics- what type and drugs are you on?
« Reply #43 on: December 29, 2018, 01:31:08 pm »
It's a tiny study of Asians on a rice'n'noodles diet...

AIUI rice'n'noodles' glycaemic index is like confectionary.

Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Diabetics- what type and drugs are you on?
« Reply #44 on: December 30, 2018, 01:46:54 pm »
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.

Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Diabetics- what type and drugs are you on?
« Reply #45 on: December 30, 2018, 01:51:02 pm »
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.

Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Diabetics- what type and drugs are you on?
« Reply #46 on: December 30, 2018, 03:27:21 pm »
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.

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Diabetics- what type and drugs are you on?
« Reply #47 on: December 30, 2018, 04:08:50 pm »
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.
“Procrastination is the thief of time, collar him.” –Charles Dickens