D-DAY - Living with Type 2: 2018 Update, New Meds, New Results

An ongoing look a life as a type II diabetic...

Last year at this time, I was in the 8 range for my A1C readings and pushing 160-190 on my glucose readings. My weight wasn't going anywhere, either, so in June, I sat down with my doctor and discusses my options.

I had been taking a combination of Metformin and pioglitazone to control my glucose, plus supplementing those with broccoli sprout extract. 

I hate the pioglitazone because it doesn't do a lot for my readings...a very temporary drop of 10 points or so...and has the troubling side effect of weight gain. It also increases your risk for bladder cancer.

My personal research showed that SGLT2 Inhibitors also lower your numbers and have a common side effect of weight loss.  This class is where you find the likes of Trulicity, Farxiga, and Jardiance.

The bad side effects of this type of drug, where it triggers your kidneys to flush out excess blood sugar through urination, is dehydration which can lead to a urinary tract infection. 

Still, it sounded like something that would work for me...I'd just have to make sure to stay hydrated.

Before my June appointment, I check with my insurer to see how much these meds...which currently have no generic equivalent...would cost. Jardiance, for example, without insurance would be well above $500 for a 1 month supply. With my insurance, Trulicity would be $100 a month and Jardiance $35.

My doctor preferred the once-a-week injection of Trulicity but I preferred paying the lower amount for the pill form of Jardiance. He said he'd consider it after he reviewed the results of this visit's tests.

Low and behold, the lab got the instructions wrong and didn't do a A1C test...the main test to check on a diabetic's progress. The doctor told me to come back in for another blood test. After being stuck 5 times for the last test, I wasn't thrilled with that prospect. 

Metformin, twice a day, and one Jardiance in the morning

I told him I'd wait until the next 3 month checkup and would appreciate it if he'd make the call to the pharmacy for the Jardiance.  He was agreeable to this so I started the new Jardiance regimen (at 10mg a day, the lowest dose).

I haven't gotten any UTIs yet but I do get very thirsty and dehydrated at times. I now have a liter sized sports bottle that I bought in Calgary last year. This gets filled once in the morning, drank from during the day, then filled again at dinner so I drink two liters of water a day.

As you can imagine, I need to know where the nearest restroom is at all times but, otherwise, it's a small price to pay.

In addition, I had my first hypoglycemic incident when I took my midday metformin at a local diner after ordering. The food didn't come out for 45 minutes and I got real woozy until the manager gave me a glass of orange juice.  I'll never take metformin again with having some food handy.

Fast forward to October, it's time for my next checkup.  A1C has dropped to 7.4. Still too high but headed in the right direction. My weight has finally started to drop again, another 5 pounds came off bringing my total weight loss from diagnosis (three years ago) to 30 pounds. My blood sugar numbers have dropped back to the 120-140 range, with occasional forays down below 100 and up to 180.

For now, it's not a perfect score but it's headed in the right direction. The doctor agrees, too, so we'll keep this regimen in place and keep monitoring every few months. Since this is a progressive disease, there will come a time when we'll need to adjust again but I'll enjoy this level for awhile.

(DISCLAIMER: This series about Type II is not meant to apply to everyone. This is what works for me, you need to consult with your own medical professionals to find out what will work for you.  My goal here is to simply give you hope that once you're diagnosed, life as you know it does not have to end...you can still enjoy life and the treats it offers.)

Darryl Musick
Copyright 2018 - All Rights Reserved

D-Day - Type II: Better Living Through Chemistry

Yeah, it's been awhile since I've done one of these posts and even longer since I updated the other blog that they appeared on (just don't have time to maintain multiple blogs right now, hopefully that will change in the near future but that's a topic for another time). So let's catch up...

Until last fall (in 2016), I'd been able to maintain a sub 150 blood glucose reading and a 7.0 A1C score fairly easy with diet and exercise alone. Then, I was hit with a double-whammy.

First, I neglected to get a Flu shot and came down with a bout of it late November.  That put my system out of whack and my liver tried to overcompensate and lost it's calibration for awhile.  My numbers shot up to over 200 and over 9 for the A1C.

Just when I was managing to get those numbers to inch down again, I came down with a nasty cold in January which had the same effect.

I couldn't get those numbers down fast enough for my regular check up in March so the doctor put me on metformin, pioglitazone, and a statin. Suddenly, I was the one with all the prescriptions at the pharmacy (I already picked up a monthy supply of test strips, needles, and lisinopril for my blood pressure) and another date with the doctor in two months to see how the new medicine routine effected me.

One thing that concerned my was the pioglitazone. First, most diabetics start off with just metformin, why the extra pill? Second, my doctor said the number one side effect was weight gain.  I'd fought pretty hard to lose 25 pounds and didn't look forward to adding a medication that promised to wipe that out.

So, I faithfully followed instructions and by June my daily readings dropped down to the 150-160 range and A1C to 8.4 plus I had gained 4 pounds.  My doctor advised that I start insulin injections and lose weight.  I told him I wanted to hold off as long as my numbers were trending downward and we made a date for September to check progress.

After that visit and the weight gain, I was a little beside myself, especially with the weight gain that I'm sure was a result of the pioglitazone. To test that theory, I stopped the pioglitazone for a week. At the end of the week, I was down four pounds.

That seemed like some progress.  That same week, I started seeing news about the promising effects of broccoli sprout extract on blood glucose readings in studies. It was easy and cheap to order some via Amazon so I thought "what the heck" and ordered a bottle to see what happened.

Taking the broccoli extract did wonders. Along with the metformin but without the pioglitazone, taking it brought my daily readings down to the 100-140 range. At the September checkup, my A1C was back to 7.1 and I'd lost another pound, bringing my post pioglitazone weight loss to five pounds.

While the formal studies are ongoing, my experience with it seems to support the general thesis that it does work very well in helping to reduce glucose levels. It has also allowed me to stop taking the pioglitazone for now, which only seems to make me gain weight.

Another thing I've noticed is that the metformin in particular, and with the broccoli adding to the effect, is that I cannot eat as much food as I used to. At first, I have the same appetite but if I eat a full portion like I used to, I will get physically ill.  After several episodes, I'm learning...and my body is learning...that smaller portions keep me feeling better.

I'm hoping this effect will also help me peel off a few more pounds. It also means I'm taking quite a bit more leftovers home from restaurants so it helps me save money as one meal turns into two.

While type II diabetes is a progressive disease, so far it seems like I'm able to keep it down with the current medication, diet, and exercise routine (I walk at least 10,000 steps a day and work out two days a week).

This year, I made sure I got my flu shot early and am working hard so that the next check up in January will show some more concrete results.  We'll check back after that to see.

(DISCLAIMER: This series about Type II diabetes is not meant to apply to everyone. This is what works for me, you need to consult with your own medical professionals to find out what will work for you.  My goal here is to simply give you hope that once you're diagnosed, life as you know it does not have to end...you can still enjoy life and the treats it offers.)

Darryl
Copyright 2017 - Darryl Musick
All Rights Reserved