Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 " Susie M. " wrote: > > Dave O. wrote: > > << " s wife was on insulin during her clinic treatment when the > glucophage was discontinued. >> > > I hope I'm not putting words in his mouth, but was wondering about > diabetics who don't wind up in a hospital setting. Are all of us who use > Glucophage supposed to keep insulin and needles around, and learn how to > inject ourselves, in the event we become ill and heed the warning to > discontinue Glucophage? Or do just discontinue it and let our readings soar > temporarily? I think that in the case of severe infection we should communicate with our physician, and make decisions after consultation. IIRC, you don't take Glucophage ala prescribed regimen. I.E., BID or TID, but based on the way you eat. I understand the way the drug works is to establish a level of drug in your body, and then to maintain that level, not up and down. I realize also that it was prior to you getting insurance. -- Dave - 1:43:41 PM T2 - 8/98 Glucophage, Precose - Davors Daily Aphorism: Dumb luck beats sound planning every time. Trust me. -- Visit my HomePage: http://dorcutt.homepage.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 In a message dated 00-12-04 20:24:16 EST, you write: << for hypo I get freezing cold carol >> interesting! V. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 In a message dated 12/04/2000 10:14:03 PM Eastern Standard Time, whimsy2@... writes: << << for hypo I get freezing cold carol >> interesting! V. >> Before my surgery for crohns disease I used to get freezing cold just before my fever spiked at the beginning of the flare-ups. BG's. were high even then, but I was told(stupid me!!!) didn't matter it was only from the prednisone so no treatment was needed. LOL carol Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 Carol, hi. I wasn't dx with diabetes until Sept. 2000, but had an ulnar shortening done Dec.98.{that is were they cut out an inch of bone from the smaller forearm bone}It should of taken only 3 months for the bone to heal but took almost a year. Also I had a number of infections the last 18 months. At times I had bone infections so bad the infection would bore to the surface of the skin. Since getting my sugar down it has really cleared up alot. My arm and hand are no longer green. D.J. Re: Re: Another diabetes complication > In a message dated 12/04/2000 2:39:23 PM Eastern Standard Time, > lists@... writes: > > << What I didn't realize before > was that an increased susceptibility to acquiring infections due to > impaired lymphocyte function was a diabetes complication. >> > > This is true, my ulcer sores were being treated a GI problem, now that its > being treated as a DM problem, its healing. I'm told it takes a few months to > heal completely from other people with diabetes and crohns that have > ostomies, but that really doesn't matter, I had sores on my lower legs too, > now I keep bg really low all the time, that disappeared. > carol > > > Public website for Diabetes International: > http://www.msteri.com/diabetes-info/diabetes_int > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 Carol, hi. I wasn't dx with diabetes until Sept. 2000, but had an ulnar shortening done Dec.98.{that is were they cut out an inch of bone from the smaller forearm bone}It should of taken only 3 months for the bone to heal but took almost a year. Also I had a number of infections the last 18 months. At times I had bone infections so bad the infection would bore to the surface of the skin. Since getting my sugar down it has really cleared up alot. My arm and hand are no longer green. D.J. Re: Re: Another diabetes complication > In a message dated 12/04/2000 2:39:23 PM Eastern Standard Time, > lists@... writes: > > << What I didn't realize before > was that an increased susceptibility to acquiring infections due to > impaired lymphocyte function was a diabetes complication. >> > > This is true, my ulcer sores were being treated a GI problem, now that its > being treated as a DM problem, its healing. I'm told it takes a few months to > heal completely from other people with diabetes and crohns that have > ostomies, but that really doesn't matter, I had sores on my lower legs too, > now I keep bg really low all the time, that disappeared. > carol > > > Public website for Diabetes International: > http://www.msteri.com/diabetes-info/diabetes_int > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 Thornton wrote: I wonder if Susie missed the fact that your wife was hospitalized due to reaction to a penicillin-type product, instead of poor diabetic control because she's on the road? > > It is not really fair to apply the attribute " accurate " to subjective > terms like " lopsided " and " balanced " . I withdraw the word " balanced " , > which I included really only to get you going, which I admit is also > not fair, sorry. > > > I would think that increasing her Glucophage > > to the max. - 2,550 mg a day - during times of > > medication- or stress- or infection-induced > > hyperglycemic episodes would be helpful. > > No thank you, Susie! Under those conditions, it is mandatory to > suspend treatment with Glucophage altogether - read the package > insert! That is just my problem - do I have to be prepared to > switch to full insulin control during those times or is there some > other useful strategy? > > > We have been told in the U.S. that the > > " minimum effective dosage " of Glucophage is 1500 mg. > > That is quite obviously a mistake. Since they recommend starting > dosage at 500 mg/day and working up from there, they must expect that > 500 mg/day could, under some circumstances, be an " effective dose " - > and it is. No , it's not a mistake; they recommend that because to start at 1500mg right off the bat tends to create severe gastric problems. They (my doc included), started me on 500mg the first week, 1000mg the second, working up to the 2250mg that I'm at now. I avoided the problems. I will concede that 500mg does work for some super-sensitive individuals. > > > Do you suppose that would be because our diet > > is higher in carbohydrates than yours? > > I don't use the word " diet " very much, except perhaps in the > term " fad diet " , referring to the recommendations of Atkins, > Bernstein, et al., especially when I am in a fighting mood. > > Careful, she's been known to put truckers up against the wall... -- Dave - 3:18:43 PM T2 - 8/98 Glucophage, Precose - Davors Daily Aphorism: I don't think, therefore I am not. -- Visit my HomePage: http://dorcutt.homepage.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 I get the hot flashes with a hypo, like Vicki. It starts to happen around 70. The first time it happened I thought " Dang hormone therapy! It's not working! " Re: Another diabetes complication In a message dated 12/04/2000 8:19:10 PM Eastern Standard Time, whimsy2@... writes: << does everybody feel this? when my bg is starting to rise, I feel really hot, like hot flashes. >> No, that's what happens to me when I get hyPOglycemic - like when I hit about 40 I get hot and sweaty. (Haven't done that for a long time tho, thank goodness!) >> for hypo I get freezing cold carol eGroups Sponsor Public website for Diabetes International: http://www.msteri.com/diabetes-info/diabetes_int Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 I get the hot flashes with a hypo, like Vicki. It starts to happen around 70. The first time it happened I thought " Dang hormone therapy! It's not working! " Re: Another diabetes complication In a message dated 12/04/2000 8:19:10 PM Eastern Standard Time, whimsy2@... writes: << does everybody feel this? when my bg is starting to rise, I feel really hot, like hot flashes. >> No, that's what happens to me when I get hyPOglycemic - like when I hit about 40 I get hot and sweaty. (Haven't done that for a long time tho, thank goodness!) >> for hypo I get freezing cold carol eGroups Sponsor Public website for Diabetes International: http://www.msteri.com/diabetes-info/diabetes_int Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 << That is quite obviously a mistake. Since they recommend starting dosage at 500 mg/day and working up from there, they must expect that 500 mg/day could, under some circumstances, be an " effective dose " - and it is. >> This is of interest to me too, . Dave O. says we need to take at least 1500 mg daily, regardless of the content of our meals. Don't you think that initial dosage is not really intended to be fully effective, but is recommended to minimize gastrointestinal upset? Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 Thornton wrote: << Where on earth did you get that one from, Susie? Who is the genius that is pretending to be able to decide what is natural and what is unnatural? The whole of evolution depends on mutations - that's the way it works. If 85% of us are born in that condition, whose genes are serving as a reference in order to be able to call it a " variant " ? >> It's a study I posted to the group just recently. And I agree with you. That's why I put " gene variant " in quotation marks. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2000 Report Share Posted December 4, 2000 Dave O. wrote: << I wonder if Susie missed the fact that your wife was hospitalized due to reaction to a penicillin-type product, instead of poor diabetic control because she's on the road? >> I was referring to 's wife's visual problems as an indication of complications. << Careful, she's been known to put truckers up against the wall... >> I saw the doctor today. It was very cool. When he asked me how I controlled my diabetes, I stammered and stalled, and finally said, " Uhh - low-carbing? " And he shot right back, " That's very good! " Later, as he was checking my physical strength, he said, " I hope you never get mad at me! " Susie ) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 Thornton wrote: << What I didn't realize before was that an increased susceptibility to acquiring infections due to impaired lymphocyte function was a diabetes complication. >> I didn't know that, . I had thought it was primarily due to impaired circulation. Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 Carol wrote: << does everybody feel this? when my bg is starting to rise, I feel really hot, like hot flashes. >> I have heard it said that insulin and adrenalin are first cousins; one will accompany the other. That is the reason, they say, that elevated insulin levels overnight can cause a pounding heart, restless leg syndrome, nightmares, night sweats, etc. My diabetic mother and sisters frequently complain of feeling hot, and their pulse is often 95-100 at rest. One sister (not yet diagnosed) reports, " When I drink Coke at night, I ride my bicycle in the bed. " Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 That is the reason, they say, > that elevated insulin > levels overnight can cause a pounding heart, > restless leg syndrome, > nightmares, night sweats, etc --- That describes me when I am in a low state, all except nightmares. The heart pounding is the worst. Lily __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 In a message dated 00-12-05 15:38:42 EST, you write: << The alternative way is to emphasise the " quality of life " aspect and adopt the attitude that a diabetic with good control is, in fact, just as healthy as most of the other folks walking about with all kinds of diagnosed and undiagnosed chronic illnesses, either already there or on the way. >> Works for me, . But it does take constant vigilence. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 In a message dated 00-12-05 15:50:40 EST, you write: << Neither of us ever had gastric symptoms from Glucophage. >> Neither did I, and I was up to 2500 mg. per day. I quit taking it when I started on insulin. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 > I have also started taking my temperature > every time that I take my blood sugar readings > and I record it right along with the BG's I am just beginning to think about the tips that Carol just gave - the ones about using only liquid soap in a dispenser and only having paper towels in the place. This will mean having to archive our " collection " of hotel towels but hygiene comes first. I am just worried that we will end up every morning scrubbing-up like surgeons and walking about in face masks and disposable gowns and caps! The clinic atmosphere with blood pressure and blood glucose measuring equipment, thermometers, tablets, ointments, etc. lying around will surely get us into a " being sick " state of mind that I would really like to avoid if I can. It is hard to know where to draw the line - there has to be one somewhere. If I had the money I would probably finish up like with his very own private medical staff - if I had the luxury penthouse apartment to go with it! The alternative way is to emphasise the " quality of life " aspect and adopt the attitude that a diabetic with good control is, in fact, just as healthy as most of the other folks walking about with all kinds of diagnosed and undiagnosed chronic illnesses, either already there or on the way. That might not be a good idea, however. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 > No, , I think they suggest 500 a day > to start because of the possibility of gastric > symptoms which can occur with Glucophage. By > starting low and working up this can possibly > be avoided. At least that's what my doc told me > when I started it. I must admit that I hadn't thought about that possibility, Vicki. I remember that I was on 500 mg unsuccessfully for many months before it was upped to 2 x 500 mg/day. My physician told me at that time that if that didn't work, he would put me on insulin as 1500 mg Glucophage per day was too risky (and I have no kidney problem). I understand that the problem is not that you get a reaction from taking a higher dose but that after a time the higher dose will eventually cause Glucophage to fail altogether and you have to move to some other oral medication anyway. The philosophy over here seems to be to keep the dose as low as possible, supplementing with a low dose of a sulfonylurea if necessary, in the hope of postponing total failure for as long as possible. My wife is well adjusted on an 850 mg Glucophage split in half, one half taken in the morning together with 0.5 mg Amaryl and the other half in the evening. We have tried a wide range of other combinations and doses but the one she is on now gives the best results for her. Neither of us ever had gastric symptoms from Glucophage. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 > This is of interest to me too, . > Dave O. says we need to take at least > 1500 mg daily, regardless of the content > of our meals. Don't you think that > initial dosage is not really intended to > be fully effective, but is recommended to > minimize gastrointestinal upset? Well, now - I don't think that the medication dose prescribed over here takes account of the content of meals. The approach seems to be to start off with 500 mg and stay on it for a few months and watch the HbA1c. If that does not fall, the dose is upped to 1000 mg for a few months and again the HbA1c is watched. If it falls then we stay on that dose; if it doesn't fall we are put onto insulin. Don't forget that the treatment goal for metformin as defined in the safety study was to reduce the HbA1c linearly to below 7% within 2 years at the most without ever once showing a positive trend. Any increase in HbA1c during the 2 years was to be reason for cessation of the metformin treatment. I am wondering if the Glucophage sold over here is the same as the kind sold in the US. Our Glucophage has a barrier to prevent the mouth and gullet coming into contact with the metformin and to let it out slooooowly when the barrier dissolves in the gastric juices. Could that be saving us from the " gastrointestinal upset " ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 Thornton wrote: << If I had the money I would probably finish up like with his very own private medical staff - if I had the luxury penthouse apartment to go with it! >> And don't forget the Kleenex boxes to wear as slippers! ) Susie Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 , I get boil-like sores and have for several years. The 6 months before diagnosis, I also noticed I started getting these big pimple-like boils on the back of my neck. My brother, diagnosed 5 years ahead of me, also has these. My doc gave me an anti-biotic wash to use on them. *sigh* Judith Another diabetes complication >I am also left wondering - has anybody on this list: >- observed the appearance of boils or other skin infections? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2000 Report Share Posted December 5, 2000 , I don't take my temperature ALL OF THE TIME. I have only been taking it during this siege with the flu. The doc always wants to know if I'm running a temperature when I call in to let him know that I'm still alive and kicking and give him my weekly BG readings. I'm really not a " health nut " , but just a diabetic trying to beat this darned old flu bug. I'm much better now but still coughing and sneezing and staying in isolation. I sure don't want anyone else to catch it from me. Tootie Re: Another diabetes complication > I have also started taking my temperature > every time that I take my blood sugar readings > and I record it right along with the BG's I am just beginning to think about the tips that Carol just gave - the ones about using only liquid soap in a dispenser and only having paper towels in the place. This will mean having to archive our " collection " of hotel towels but hygiene comes first. I am just worried that we will end up every morning scrubbing-up like surgeons and walking about in face masks and disposable gowns and caps! The clinic atmosphere with blood pressure and blood glucose measuring equipment, thermometers, tablets, ointments, etc. lying around will surely get us into a " being sick " state of mind that I would really like to avoid if I can. It is hard to know where to draw the line - there has to be one somewhere. If I had the money I would probably finish up like with his very own private medical staff - if I had the luxury penthouse apartment to go with it! The alternative way is to emphasise the " quality of life " aspect and adopt the attitude that a diabetic with good control is, in fact, just as healthy as most of the other folks walking about with all kinds of diagnosed and undiagnosed chronic illnesses, either already there or on the way. That might not be a good idea, however. eGroups Sponsor Public website for Diabetes International: http://www.msteri.com/diabetes-info/diabetes_int Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2000 Report Share Posted December 9, 2000 : I realize I'm posting late (I'm about a week behind reading most of my emails). Anyway, here's my 2 cents worth. I notice when I don't have good control I am prone to developing boils. Not when I get readings of 160 or so but when I have a few days or a week of high readings---that's when I start to notice the boils developing. Also I get yeast infections when I don't have good control. Thornton wrote: > All: > > During my wife's recent hospital treatment, I asked the chief of > the diabetes clinic to recommend a good strategy for dealing with > the incidental infections that can compel a Type 2 diabetic to > discontinue taking Glucophage until the infection has cleared. > > He answered that I was making a big mistake if I really thought that > the infections were only incidental. > > In fact, he said, an increased infection susceptibility was another > diabetes complication, just like the others. Apparently, cells that, > as a result of insulin resistance, do not get enough glucose, shrink > due to extracellular hyperosmolarity. When this happens to the > lymphocytes (just another type of white corpuscle), their function is > restricted, in particular the formation of the superoxides which are > so important for the immune system. > > He claimed that most diabetes patients show signs of this increased > infection susceptibility. Apparently, the primary consequences > are infections of the skin (boils) and the kidneys (pyelonephritis). > The infections, in turn, increase the body's requirement for > insulin which leads to an increased production of insulin- > antagonistic hormones. > > So I assume that anything which tends to reduce insulin resistance > (e.g. exercise) will also serve as a prophylactic measure against > this particular diabetes complication. > > I am also left wondering - has anybody on this list: > - observed the appearance of boils or other skin infections? > - ever been diagnosed with pyelonephritis? (what are the symptoms?, > what is the treatment?) > - found out how to measure insulin resistance? > - heard how immune system deficiency (particularly lymphocyte > dysfunction) is detected ahead of time? > > I have a feeling that this is another potential diabetes complication > that should be monitored and I am fairly sure that for me and my wife > it is not yet being done. Our present method is to measure body > temperature whenever the blood glucose response to food intake > departs from the usual pattern - but then the infection has already > taken a hold. > > > > > > eGroups Sponsor [Click Here!] > > Public website for Diabetes International: > http://www.msteri.com/diabetes-info/diabetes_int > > > Quote Link to comment Share on other sites More sharing options...
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