new to diabetes 2 and the group

[arlenecarol]

Hi All,

I am going to need a lot of coaching!! This is only the second time in my life that I am seeing my 'mortality'...and I'm feeling very alone. I live in the Western part of Turkey, but I'm an American expat. No medical help close by
so I'm having to do a lot of monitoring of my own blood sugar levels but I see that many of you do the same. I'm in phone contact with my former doctor, now living too far for me to get to reasonably often. She told me to start on Diamicron MR (gliclazide 30mg). This is only my third day and I had expected to see immediate results. I guess it doesn't happen that way. Have had some problems with my monitoring device, the company (roche) is sending me a new one (nice of them!!). This should help make things more real...the readings I've been getting are bizarre (I hope). At any rate, I do need a lot of help so please feel free to point me in the right direction. Thanks.
ArleneCarol
:confused:

[duck]

Welcome Arlene,

Where are you in Turkey and why are you in Turkey?

I am a Type 1, but I have read here a few times that meds for Type 2 take a little while to take effect, so don't get down on yourself right away. Keep an eye on your sugars, etc., and use that monitor when it gets to you...

What tipped you off that you were diabetic?

[Harold]

Hi AC and Welcome to the Forums!

Have no experience with Gliclazide myself, since dx been taking Avandia. No more than we know about you advice will be somewhat limited. Still untill your med starts working and even after cutting back on your calorie intake will help reduce your blood glucose. Reducing your intake by cutting out meals will not work because your liver will provide glucose whenever your bg levels drop too quickly or too much, there is no set level or rate. So most type 2's need to eat at least three meals a day and sometimes a snack inbetween. Even if your slightly over weight a loss of 10 or 15 pounds can make a big difference in bg levels. Did your doctor give you any goals for your meter readings and how often or when did they say to test. Also are you using md/dl or mmol/L values.

In the meantime for more information you might try David Mendosa's (http://www.mendosa.com/) web site. To get started go to Basics in the upper left corner between Meters and Complications.

[mg_2204]

Hello and welcome ArleneCarol!

I was first put on Diamicron. It didn't agree with me. Had hypos all the time. It is also a known side effect of that medication. Here is a useful link for meds by the way : Drugs.com - Complete info about meds (http://drugs.com) . Read more about your meds.

I'm on Metformin now. It's going well. It took a good 6 weeks to really kick in though.

How long will you be in Turkey? How come you can't have a good follow up over there?

----> Ins't there a member of the forum that lives in Turkey??! I'm sure I've seen that somewhere. I don't remember the name though. I'm sure it's a man, and he's T1. Anyone can help or can remember?

Take good care now!

[mg_2204]

Found it!!!

Here is the profile : SnakeEye (http://psax001.data393.net/~diabetesforums.com/member.php?userid=207)

You could perhaps get in touch with that member, since you live in the same country? :)

[Peter Lee]

She told me to start on Diamicron MR (gliclazide 30mg). This is only my third day and I had expected to see immediate results. I guess it doesn't happen that way
As you can see in my signature, I am on Gliclazide amongst other things.

I started the Gliclazide after I had been on Metformin for about 8 weeks and the pioglitazone for 1 week.

I was told to carry out the following procedure to get onto the Gliclazide (80mg tablets).

Take 1 tablet with the Metformin and with food in the morning. If that doesn't bring me down to a fasting BG of 6.0mmole/dl (108mg/dl) by the end of one week, then introduce a second tablet. If that doesn't do the trick by the end of the second week, add another tablet with the evening Meftormin. If after a week that doesn't work, add a second tablet to the evening one. Four tablets is the max. dose allowable.

When I introduced the 4th tablet, after one week the bg came down to the levels we needed i.e. 6.0 (108) and have stayed down.

Don't forget we are all different and what works for one person doesn't necessarily work for another, so you do need to keep in touch with medical advice.

I agree absolutely with what Harold says about diet.

Hope that helps.

[arlenecarol]

[snipped]Welcome Arlene,

Where are you in Turkey and why are you in Turkey?
What tipped you off that you were diabetic?[/QUOTE]

Hi, phew where do i begin? i'm in western turkey below Troy.
i came here in 1990 to teach for a year or two!!! i loved it
so much that i stayed. then after teaching for 6 years, i
had an asthma attack that landed me in the hospital for
a week. my doctor said 'get outa town if you love your life'
the pollution in winter in the part of town where i lived was
dangerous to my health. so i moved to the coast, to a
very very clean climate and have had NO problems with my
breathing since. HOWEVER, now i find i have diabetes and
i'm 8 hours from the city and from excellent medical care! this is NUTZ
so most of what i have to do is in my own hands which is okay with me
as long as i know what to do.

i just took a bs reading and it was 395!! after dinner...so i shouldn't panic
but i am! what to do now?

ar.

[liz32]

Hi Arlene! I am a type 2. Your last reading is fairly high, but like the others have said, a change in diet will start bringing down your sugars as the meds kick in. Here in Canada, my dietician instructed me to stict to no more than 200 grams of carbohydrate in a day. I find that eating a fair amount of protien with every meal slows down the rise in b/s. Another thing to do in the meantime when your sugars are high is to go for a walk. Don't do anything overly hard at first to make sure that it doesn't push your sugars higher (sometimes that can happen when they are above 288). Test your sugar before the walk and after. Then keep an eye on it for the nest day or so...some people don't see any effect for a day. This should get you started. I hope you can find some medical help closer to you but if not keep coming here. Everyone wants to help..we're just not doc's, all we can give is our own experiences. Take care and we hope to hear from you again. :thumbsup:

[arlenecarol]

(snipped)
Another thing to do in the meantime when your sugars are high is to go for a walk. Don't do anything overly hard at first to make sure that it doesn't push your sugars higher (sometimes that can happen when they are above 288). Test your sugar before the walk and after. Then keep an eye on it for the nest day or so...some people don't see any effect for a day. This should get you started. I hope you can find some medical help closer to you but if not keep coming here. Everyone wants to help..we're just not doc's, all we can give is our own experiences. Take care and we hope to hear from you again. :thumbsup:[/QUOTE]
THanks Liz, et al...i'm really bummed out. First of all, I know i've done this to myself..but that's okay..i'm not kicking myself for it...i have this theory that if i got myself into this situation, i can dare sure get myself out! that's how i beat cancer in '85. anyway...my OTHER big problem is that i can't walk!
i have to use a rollator or canes to walk...years ago, when i was young and active, I had a number of falls from my horse...eventually i had back surgery and the doctor said that one day down the road i might have problems again.
sure enough..one day arrived slowly about 5 years ago. i got progressively worse and now i'm really handicapped. i can drive and i can use the rollator but not for long distances. shopping in a supermarket is exhausting. i guess i should try it anyway because i don't seem to have any other choice. even walking with a rollator (incase you don't know what that is, it's a walker with wheels and a seat if i need to sit) is better than nothing at all! right? okay, tomorrow, i'm going to tell my daughter to 'force' me to get out and get to the road and start walking...every day. i'm willing to try anything and everything to beat this illness! and no more carbos...at all .. let's try it for a few days and see what happens...i'm motivated. i only hope i see some progress!! and i have just developed another problem...i think i have a fungus infection (you know where) and also in my mouth! i'm a total mess!! what is going on with me?? :eek:
the one good thing about being here in turkey...i can get just about any medication i need provided i know what it's called!! except for narcotics, which i'm not into anyway...i can get almost anything. i worked for a few years in a hospital pharmacy in Atlantic City and during my post-graduate years part-time in a pharmacy so i know 'something' about meds. i'm going to
try to get some stuff to clear this all up. at least i am able to get some terrific homemade yogurt here!
okay, i know i'm boring the heck out of you guys...point me in a direction so that i can see a list of foods i CAN eat...it seems the list of foods i can't eat won't fit in my RAM!!! :(

thanks you all. i do appreciate the moral support and your advice. you guys are the experts, i'm just a newbe..

arlene

[liz32]

You have my sympathy and my admiration! If you can overcome cancer...you can overcome this..well at least get in control. My mother-in-law is a nurse and she told me that once she had a patient who was in a similar position as you..what she did was flap her arms up and down until she was tired. It helped her bring down her sugars. If going to the market gets your heart pumping then I'm sure that it qualifies.

Are you on any medications? I take metformin (oral meds) and inject lantus. The lantus gave me faster results and has helped to keep my sugars under control. Maybe you can call a doc and talk it over. Oh, it's also peakless. I've been on it for 3 months now and have never had a hypo..that doesn't mean it's not possible, it is. Anyways, I hope this is of some help.

[ADE]

Hi Arlene,
When I was diagnosed last year, I cut all potato, pasta, bread, rice from my diet. My meals are mostly vegetables, fruits and nuts. I would add some vinegar into your salad. If you like to drink coffee, you can add some cinamon. One of the biggest contributor to my controlling the glucose level is exercise/build muscle. If you have problem using your legs, than you can start lifting some heavy objects with your arm. Muscle is one of the best glucose storage. Take care yourself.

[arlenecarol]

thanks ADE..and everyone.

i have finally located a US trained Internist here...i live in Western (and very rural) Turkey, good doctors are very rare and hard to locate. i'll see him for the first time next week. i hope to understand what's going on with my body in addition to learning to control these bizarre bs levels!!

yesterday i ONLY ate veggies and cheese (beans and yogurt, no protein and just a tiny bit of homemade pita bread...equivalent to one slice at most) and my bs levels just kept going up all day! i even took three diamicron mr in the morning!!! by nighttime my levels were OVER 350!!

it was so discouraging. anyway, my present doctor was consulted and she said to add a new medication...glucofaj (i don't know the english spelling yet i have to go to the pharmacy later and pick it up). she told me to take one diamicron in the morning, the glucofaj at noon and another diamicron with the evening meal.

today's saturday so maybe i'll see some changes before monday's visit to the internist.

after that regime yesterday, my fasting bs this morning was still higher than previous days...272. i'm mystified.

does this mean my pancreas is working or not working? how can i learn the mechanics of diabetes type 2? i'm the kind of difficult patient that needs answers...i'm not at all passive. that's how i managed the whole cancer thing.
doctors either love me or hate me...i challenge them...that's fine with me.

if anyone knows where i can find easy to understand info about the highs and lows of bs level readings, please point me there.

thanks you all.

oh...i've been meaning to ask you this...
what exactly is a HYPO?? is that the feeling you get when your bs does
roller coaster imitations? when i get like that, i eat an apple...it goes away almost immediately. is that it?

a.

[ADE]

Hi Arlene,
Congratulation in finding a doctor there. However, when I was diagnosed last year, I would avoid eating beans due to the amount of carb in there. Yoghurt, too, contain lactose which some people with diabetes can not tolerate. I kept my diet mostly from vegetables, fruits (all the berries) in the first 3 months after the diagnose. Please eat with your meter so that you know what kind of food you can eat and what not. I believe the medication you were prescribe was Glucophage (Metformin). Many people reported that they experience bowel problem (gassy) in the first few weeks after taking this med. When you do, you may ask the same medication but the one with extended release kind (XR). I heard many good reports about this medication in retraining your body to be more sensitive to insulin and preventing heart attack. This medicine also doesnot cause weight gain. I would suggest for you to read the book by Dr. Richard K. Bernstein 'Diabetic Solution'. You can read some of the book through internet, please google that subject. Hypo is a condition when your glucose level goes too low (different people have different level, but mostly when it is bellow 40). Therefore, it is important for you to test when you feel that way. When you have very high glucose reading, your pancreas would keep pumping insulin until you experience a crash. Eating apple to avoid hypo is OK, but drinking orange juice would be better because it is a faster glucose for the body to absorb. Your condition now might be due to you coming down with a flu or some other thing. You might want to ask your doctor to check everything such as; thyroid, etc. Please drink alot of water to help your body dilute the glucose. I think there is another good book to read by Gretchen Becker 'My first year'. Take care Arlene.

[arlenecarol]

Thank you ADE.. i appreciate your message. I've been reading all day about type 2 and i think i'm on to something here. what about gastroparesis???
for many years, i've been having tummy troubles...at first the doctors said 'gall stones'...they wanted me to have surgery IMMEDIATELY!! i resisted.. that was about 10 years ago or more. i found another doctor who said 'change your diet'..i did and it went away...again last year i was having tummy problems and the local doctor here did an ultrasound and again he said 'stones'..gave me some meds and the problem went away...i have read that the two problems are connected... gastroparesis and diabetes...given the symptoms i have had and the blood sugar levels, i'm willing to bet that this is the thing we need to be looking at...

apparently, there's a LOT of conflicting info out there. my friend with diabetes (many years) swears by beans!! okay..starting tomorrow, i'm going to change my diet again...no fat, no high fiber...gee, what's left?? what about eggs? what about cheese (same as homemade yogurt??)...

wait...yogurt, if it's 'cured' for 12 hours or more, has most of the lactose removed...i remember this from my irritable bowel syndrom days...but just to check, i'll eliminate that for a couple of days too.

meat? can i eat meat? no...that takes forever to break down too...good grief. what's left??

am i confused? you bet your bootie i am...

liquid meals...yuck...but they are supposed to digest faster...

and some of the meds i see for gastroparesis have side effects that aren't pleasant...i really don't deal well with side effects..

i'm trying hard not to panic...i hope that nothing has been permanently damaged up to this point. and i sure hope that this new internist will have the right answers...

got me fingers, toes, and eyes crossed.
a.

[HeatherP]

Hypo is a condition when your glucose level goes too low (different people have different level, but mostly when it is bellow 40). Therefore, it is important for you to test when you feel that way.


I have to disagree here, 70 (3.8) is considered the low blood sugar threshold and should be treated immediately. If you wait until you're closer to the 40's you may have a hard time treating it without someone else's help.

[ADE]

Hi Arlene,
I believe fiber and fat are recommended by the Atkin, Bernstein, Southbeach diets because they slow down the absorbtion of the carb. It is the carb that we need to watch. Youghurt, too, may or may not effect your body, which basically YMMV (your mileage may vary). Therefore, it is very important to eat with your meter to find out which food you can or can not eat. HeatherP was correct to say that for some people glucose level 40 should be treated seriously. I know that when you are taking medication to lower your glucose, you should be concern about hypo (thank you Heather). Please use your meter to learn more about your condition and how to manage it. Take care.

[am1977]

Welcome, Arlene :)

As you can see, we have quite a supportive, helpful group here and I think you will quickly become part of the family ;)

See you around,

Andrea :nerd: , Type 1- MM 511 pump

[arlenecarol]

Hi ya'll...well, not exactly ONLY 9 days but that's when i started taking the new medication. all week i've been watching numbers fall...just tested myself now, 2 hours after lunch and i've hit a NEW low!! 140...not there yet, but heck...i was getting readings of 395 not that many days before finding this internist. i'll go back to see him on the 18th of July. let's see if i can maintain this success. my blood pressure is very good...and so far today the glucose has remained below 200!! a first!

all right...some serious questions...suppose i can maintain this...or actually get 'normal' readings...provided i keep on track and don't stray (so far, i haven't really been tempted to do something crazy...like eat a whole loaf of delicious bread or have a hot fudge sundae)...can i expect things to stay 'normal' or at some stage will my body betray me? if i'm good to it, will it be good to me??

and what's the side effects or long-term down side to metformin? can i take it indefinitely? what about the Avantdia? surely there's a downside?

one day will they stop working?

is there a chance that my pancreas will recover or is it gone for good?

i'll have the HbA1c when i go to see my doctor again...but that will only show if there's been damage, right?

help me here...i'm a real newbie to this disease...

thanks everyone for your help so far...
you all take care of yourselves...you can do it...with a little help from your friends..

a.

[Harold]

and what's the side effects or long-term down side to metformin? can i take it indefinitely? what about the Avantdia? surely there's a downside?

one day will they stop working? Read an article last summer that something like 80% of type 2's have to increase or change meds after 3 years. Insulin resistance increases with time and our bodies have a tendancy to become indifferent to drugs over time. So your not likely to be on the same meds/dosage for a few years to see real long term effects. A decrease in control or a slow increase in bg levels are what your likely to see rather than a sudden drop off.
is there a chance that my pancreas will recover or is it gone for good?The amount of insulin a person can produce decreases with age and not everyone starts with the same ability to produce insulin. Also as I stated above, our bodies have a tendancy to become indifferent to drugs over time and this includes the ones we make ourselves. Which is why some people show up with type 2 at 40 and some 80. There are other factors that influence when it will show up, but I am keeping this simple. In short there may be nothing really wrong other than an ageing pancrease and a body that has seen too much insulin.
i'll have the HbA1c when i go to see my doctor again...but that will only show if there's been damage, right?NO, not at all. The HBA1c checks the red blood cells for the amount of glucose they contain. Which comes from the glucose they are exposed to when created. Once they are released into the blood they do not lose or gain any glucose. The red blood cells live for 90 to 120 days and have widely varying amounts of glucose in their makeup. As a result the HBA1c only gives a Weighted Average of your glucose levels. It breaks down to approximately 60% for the last month then 25% and 15% for the previous months.

A C-Peptide test will show how much insulin your producing. C-peptides are a by product made when the pancrease makes insulin. It is also a lot cheaper test than measuring insulin directly.

I believe it is called a GAD Antibody test that checks for antibodies produced by the immune system that destroy the cells that produce insulin. A strong positive result of this test indicates Type 1 diabetes.