# Been very ill



## kukka (Apr 17, 2011)

hi all.i got lost and didnt find my way back here until now after i joined
thats partly due to being very ill indeed.

i just didnt know what was happening to me anymore.i had been taking metformin for several months and gp insisted they coulnt do anything with my diarrhea problems.and didnt think it was down to the metformin so i persisted takign it but what i didnt realise was how weak i was getting and diarrhea so severe i coulnt make it to the loo.i was in bed all the time exhausted as also suffer from M.E.CFS

i decided to try and stop the metformin and within 2 days no diarrhea.so i realised it was definately that but i stayed of it a while then started again to see if it was def it and yes it is.went to doctor last week to explain and got told of.got the usual but you need to take it as its the best cant you just put up with the side effects.theres nothing else we can give you thats as good and so on..i was so shocked and frustrated and felt bullied.

i managed to get a perscription from them for 40mg gliclazide even though i asked for one that doesnt help put on weight.i am over weght and i struggled to lose a few stone i dont want to put it back on.

Does gliclazide always make you put weight on ?

i picked it up from chemist yesterday and havent started it yet as im worried re more gastro side effects and about gaining weight.i want to chop this tablet in half and start lower dose to increase slowly to try and keep away any more upset tummy..for a few weeks without the metformin i was tummy ache Free and had more energy and was able to be up and about and i feel on the metformin i have no life and it isnt helping me control the diabetes as im already housebound doing no exercise but it cant be good for me to be so immobile due to severe diarhea.yet the gp insisted i still try and take the metformin too as well as try the gliclazide..im fuming !!!

i have tried it and continued to take 1 a day while i waited for the chmeist to have the gliclazide in although i admit ive been slow to pick it up since last week.even on 1 metformin my tummy is always hard and so sore and i feel sick.i really want to stop it but he doctor has made me scared i will die if i do and im also worried i wont cope with the gliclazide too.is it less likely to cause tum upsets or does it wear of after a week or so?

ive just been so very very ill with it i dont know what to do anymore.ive no one to talk to about it either.each doc ive seen has given me no advice re the diabetes from the start.one thinks i should go without any med.the others insists im risking my life.both very differnt opinions

my sugars are down to various 7.7 to 8.7 fasting and 2 hr after tea they roughly 9 to 11.thats a big improvement for me.and i think its down to me controlling my diet.i feel so scared now though that even those reading are bad as my % has improved from 9.9 to 8.3 within the 7months but the gp i visited is not happy with me tryign the low crb dieting and says i need take metformin and gliclazide and she says she thinks i will need somethign else too

sorry such a long thread.so sorry to be laying all this down.im just in despare


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## vince13 (Apr 17, 2011)

Hi Kukka,  I was sorry to read your post and shocked that you seem to have such an uncaring Dr.

I am on Metformin and have been for 2 years now but I am on the slow release  kind which is called Glucophage which is dearer for Drs to prescribe but doesn't have the upset tummy side effects and there is yet another one which is in liquid form - someone else on here will probably know its generic name. Once the upset tummy can be stopped the only other thing with all kinds of Metformin it seems is f**ting like mad !!

Gliclazide and Metformin are I think usually given together - again someone on here will be able to explain which does which to the insulin your body is presumably still producing.

Don't give up - if necessary I would change my Dr - you can't go on feeling so ill.  Sending hugs - I think you need them.

Best wishes


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## margie (Apr 17, 2011)

Sorry that you are feeling so rotten. As Faith said there is a modified release of metformin which hits the system at a slower rate and which people generally tolerate better. Though some people still have problems with that.

A couple of things to try (if you are not already). Take the metformin in the middle of after a meal. Try less fatty meals - in some people fat seems to intensify the effects of metformin.

Have you started on a slow dose - its common advice from hospitals to start with a low dose and then build it up once you can tolerate the smaller dose which is a few weeks for most people.

Saying that some people can't tolerate metformin and your Dr is quite frankly wrong to say its the only alternative.

Take a friend with you who can confirm how ill you have been (sometimes Drs take other peoples perceptions more seriously). Have a look at the newer drugs, byetta, victoza and ask your Dr if he/she has any experience of them. As the Dr sees metformin as the only alternative ask to see a specialist for a second opinion.  

I agree with Faith if there are a few surgeries in your area - you may be better off changing GP.


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## Ellie Jones (Apr 17, 2011)

I would either be asking for referral to a consultant or changing doctors..

I'm horrified to think that a GP doesn't know their are alternitives to metformin or doens't know that it can cause upset stomach's

You can also get metformin in liquid form as well...


It's pretty common paractice to prescribe Metformin and Gliclazide together after metformin on it's own isn't having the disired effect..  But Gliclazide can be prescribed on it's own as well

Metformin works by reducing the amount of Glucogen (glucose) coming from the liver, and helps the cell uptake and utilize insulin a lot better, but over all metformin can only reduce blood glucose by around 3%..

Gliclazide works completely differently, as it stimilates the pancrease to produce more insulin (one reason why one might find weight gain) when on Gliclazide you really do need a BG meter as you can face the same dangers as a T1 when it comes to hypo's..

I would say even though it's pretty hard just at the moment to put weight issues on the back shelf you need to really, so that you can get your medication sorted as until this is better sorted, you are going to find it extremely difficult to impossible to start to address weight issues leading to a very stressfull time making it all seem a lot worse..

I would do some downloading and printing, get the info for Metfromin and it's side effects hight light the diarrahea, and also download the verious treatments for T2, go back to GP ask to see a consultant and when the doctor whinges, then show him what you've downloaded and say so I have no faith in you and your knowledge of diabetes..


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## Pumper_Sue (Apr 17, 2011)

kukka said:


> hi all.i got lost and didnt find my way back here until now after i joined
> thats partly due to being very ill indeed.
> 
> i just didnt know what was happening to me anymore.i had been taking metformin for several months and gp insisted they coulnt do anything with my diarrhea problems.and didnt think it was down to the metformin so i persisted takign it but what i didnt realise was how weak i was getting and diarrhea so severe i coulnt make it to the loo.i was in bed all the time exhausted as also suffer from M.E.CFS
> ...



Hi Kukka,
So sorry you have been so unwell.
Sounds as if your GP wants shooting at dawn yesterday 
Can you change GP? If so do so sooner rather than later.
Everyone knows being carb aware and moderating your carb intake will help with your diabetes no end.
Have you been offered the slow release Metaformin? Many find this works rather the normal stuff.
Also is there any chance of seeing a specialist regarding your diabetes and treatment options? Personally I think your GP is well out of her depth and needs to be educated.
Please ask for a referral to see a consultant.
I would also write a letter to the practice manager pointing out your dissatisfaction with your GP and lack of diabetes education provided by the surgery.

Many congratulation's on your weight loss so far that's a fab achievement as is the drop in your A1c.


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## KateR (Apr 17, 2011)

Ellie Jones said:


> I would either be asking for referral to a consultant or changing doctors..
> 
> I'm horrified to think that a GP doesn't know their are alternitives to metformin or doens't know that it can cause upset stomach's
> 
> ...



I would print off the replies to this post and take them with you as well and if he's still angry, change your GP.


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## Alba37 (Apr 17, 2011)

Sorry you have had such a horrible time  If weight is a consideration you would be much better trying Byetta or Victoza than taking gliclazide.  In Glasgow a GP can't prescribe either of them though, you need a referral to a consultant! 

I couldn't tolerate metformin.  I take metformin SR now, it still makes me feel rubbish but no where near as bad as the normal one.  I am hoping to eventually get Victoza.


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## Vicsetter (Apr 17, 2011)

Sorry about your problems.  What does your GP mean, he can't do anything for your diarrhoea, there are standard treatments.  It can be a serious problem leading to dehydration.  No GP should tell you off that is so Victorian.  I was taken off Metformin and after trying the Slow Release version taken of that as well and put on Victoza.  It is one of the drugs that are being targeted as part of the current round of NHS cost cutting efforts, but I see no reason why you shouldn't be offered insulin.

If you are sure it is the Metformin then if I was you I would stop taking it and follow other advise to complain to the practice manager and/or change doctors.

P.S. seems like living in the sticks pays dividends, my GP practice is also the pharmacy so any repeat prescription take 2 days (for the GP to sign the form and the pharmacist  to order from Numark and them to deliver) and the GP can presecribe Byetta and Victoza.  And only 56 miles from Glasgow.


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## kukka (Apr 17, 2011)

hi everyone thanks very much for the replies

Im afraid i cant change Gp practise as there are no others near to me and im unable to travel and would probably not be accepted as need to be in area.

I did start on the glucophage but then the troubles started and they decided to give me standard metformin to start on half a tablet a day and work up slowy.but they say i need at least 4 tablets of 500mg a day but didnt even get up to that many as so ill with it.

i have again tried gluchophage and no help although i maybe should have stuck with it a bit longer incase it stopped eventually.the last few weeks i have been on 2 half doses of metformin a day and again after a few weeks i have stomach upset.less diarrhea on the low dose but hard and sore stomach and feeling yucky.

not sure if i said this but the doctor quoted NICE guidelines to me and said i neded to try the gliclazide next as its in the guidlines that that is the next one.well i looked that up and it only said that that should be if patients are not obese.which i definately am..despite the diarreha lol

its no use complainging  as the practise manager is worse than the doctors.i would definately have moved gp by now if i could have.they very short staffed here and theres not much choice.all i have to see is the lady who insists on me takign gliclazide next or the other doc who im actual registered with who didnt seem bothered about me starting medication at all.like i say mixed messages and very very confusing.

does anyone know if gliclazide can be haved so i can try a low dose of it first ? i have ben given a 40mg stnadard tablet to take once a day.i think i will try that half a dose and stop metformin or maybe stick to just a half tablet of that as i seem ok on half a tablet.not a whole one though

i have already asked about being referred to the diabetic team at the hospital and was sternly informed that i d not need to be as its standard to deal with it at gp now for where i live.cost cutting i guess 

but im ok to try gliclazide in the mornign maybe just the half dose and if its very good to lower my sugars i may not need metformin as well.why do they insist that we need to continue with metformin though? i dont understand why its seen as the best thing.i was told i couldnt have any of the new meds as they also cause diarrhea and not on the NICE list yet


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## kukka (Apr 17, 2011)

oh and i wondered anyone who switchedfrom standard metformin to the gluchophage can you tell me how long it took for your tum to settle down on it? like if the standard caused diarrhea did it stop straight away wiht the switch or does it take a few weeks until you get used to the SR ? maybe i didnt give it long enough i dont know really !!


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## Caroline (Apr 18, 2011)

Ji Kukka, I'm sorry you have been so unwell. Your doctor sounds about as good as mine.

I'm on metformin and every so often my tummy has an away day and I keep the loo company. I find it helpful to keep the carbs to a minimum as they seem to set things off. Although sugary things are allowed in moderation as a treat I find I can't take metformin and have a suagry treat or my tummy will be out for a couple of days.

I hope you get things sorted. Many people find slow release metformin easier to tolerate. 

It might help to keep a diary of some sort and take it along to your doctor. A diary of two or three weeks will help point out a pattern. Good luck.


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## Copepod (Apr 18, 2011)

Kukka - with your complex situation, you should definitely ask to be be referred to a specialist in diabetes. While "not getting on with metformin" is realtively common, there are also relatively easy to try changes eg slow releaase tablets or dissolvable powder, and taking before / after food - whatever's best for you. However, doctors can only act within NICE guidelines, so, for example, if the guidelines say a second line treatment can only be tried once a first line treatment has been give a fair go, there's not really any way round that; if a certain drug can only be prescribed by a diabetes specialist consultant, then a GP can not prescribe it. 

As you mentioned CFS / ME, I also wonder if you're seeing a specialist for that? If so, worth mentioning your problems with diabetes, medication & diarrhoea, as getting up to toilet multiple times a day isn't going to help you to save energy / pace yourself. 

Keeping a diary is a very good way to help you and your doctor(s) spot patterns.


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## AlisonM (Apr 18, 2011)

Kukka, as other have said you definitely need a second opinion, I can't believe your current doctor's attitude. You should make the call today.

I know how you feel with the Metformin, I was on it for months having been diagnosed initally as Type 2 and coudn't tolerate it at all - the symptoms slowly got worse with time, it was awful. Some folk (not me) can handle the slow release version which is called Glucophage SR or Metformin SR. That's one alternative, another more expensive possibility is an injection like Byetta or Victoza. There are lots of options out there to try and no reason at all why you should be left feeling so very ill all the time.

The diary idea is excellent, I've used that to my benefit as have others in here. Are you able to test? I don't imagine the doctor will prescribe strips but it may help to buy a kit and test on your own for a while, keeping notes of what foods affect you as well as all the problems you're having with the Metformin.


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## kukka (Apr 18, 2011)

HI thank you for your replies.i appreciate it

have kept a very good eye on what im eating and tried differnt things with the diet and do find that lower carbs are better for me although again i was told i should be eating more carbs being diabetic.i know there is conflicting  ideas for this

it didnt seem to matter what i ate when it came to getting diarrhea.i was doing very well diet wise lower carbs etc and still had diarrhea urgently several times a day.no let up from it on only 2 metformin tablets a day

i tried all differnt ways and the minimum upset was if i took it with a small amount of food like cereal.not a main meal as that was severe reaction but it still very bad the more i tired to increase it and they said i needed to take another 2 more a day

but they were not slow release.i started on a slow release tablet a day but after a few weeks they wanted to up them but will me having diarrhea then they changed me to half a normal tablet and allowed me to increase slowly but by timeiwas up to 2 a day over several months i had severe diiarrhea.doc thought it was hospital super bug i was that bad but tests ruled that out.i went back to see him and he said nothing they could do for it.said to increase probiotics as it probably my tum had been on too mnay antibiotics which i had so i believed him and he also said unlikly to be the metformin so i persisted with it.but then decided to stop it and found within 2 days the severe diarea stopped so it is def the metformin

i would like to maybe give the SR a longer go but not sure if im just wasting time really.and im afradi to start the gliclazide now incase i have the same troubles..all this has made me very afraid of any medication as im scared id have more serious side effects.

it is well known that people with M.E have difficulty tolerating any medication.I dont have a specialist for that either im afraid.there is none where i live.its another sore point as ive been left struggling with that for years by myself and disabled with it too and no doctors support.but then thats not unusual im afraid !!

i just dont know whether to try for the SR Glucophage again for a week or to just go for half a gliclazide but i need to decicde soon as my readings had soared again last night.i was up to 17 before bed last night and i think that shows i do need medication for now until i looose more weight


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## margie (Apr 18, 2011)

I am not a Dr but I find it startling that if you were having problems with the slow release that your Dr thought the standard release would be better.  Very odd. The only reason I could possibly imagine them doing that is if they thought you were having a reaction to the constituents in the modified release tablets that slow the release. 

If you manage to get them back make sure you swallow them whole as if you cut them or chew them you are in effects converting them back to standard release metformin.

I am assuming that you must be in a rural area and it would be a long journey to see a specialist if you were referred. Surely the journey would be worth it if you could get some answers.  If you have trouble getting yourself any distance do you have someone who could take you?


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## kukka (Apr 18, 2011)

hi margie the reason doc said change to standard was so i could cut them ones in half and start on a half dose and increase at a slower rate.that works ok aslong as i dont take more than 2 half doses a day any more and i have runs.so not sure that very helpful unless i can stick to just that low dose and then add the gliclazide too

i cant swop gp practise due to being no more near me.i need to be in the catchment area for call outs.i would travel to the hospital with transport if i could get referred but gp says it policy for type 2 to be treated by gp only so i not getting referred to them.

i am housebound due to the M.E ongoing flu like ilness severe muscle pains and bedbound a lot so travel is very difficult for me but i know a charity that helps out with hospital appointments so i would manage that if needed its only that they dont think it neccesary

i just thought of one more option i can try.the gp practise has one nurse trained on diabetes.she has been better for advice than the actual gp.i could book another appointment with her and go and explain my fears and worries and see if she will act as a go between for me and the doctor.worth a try i guess.although her hands maybe tied.but its through her i got to start on meds in the first place as i told her i felt i needed them and my own gp didnt.so i will ring up tommorow and try book a long appointment with her.nothing to loose i guess

its just been hard to get my head around and im so tired at the moment.i loked up meds and found there is somethign called Sitagliptin which they say is a 2nd line of meds and doesnt cause weight gain.dont understand why they cant have perscribed that one for me instead.will ask the nurse about it


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## kukka (Apr 18, 2011)

oops sorry margie just re read the posts.Did you mean M.E specialist ?

there are none at all on my island and im told cant be referred to uk for one either

we do have a diabetic centre at the local hospital though


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