# Recently diagnosed in Spain, confused!



## Jeandp (Feb 22, 2017)

I have lived in Spain for 5 years with my very supportive husband, but will soon be returning to the UK. We have a grandchild on the way!

I was diagnosed as type 2 last week. I have tried hard to avoid diabetes as it is in my family but it's got me now!

I am now on Velmetia, which the box says it contains 50 mg sitagliptina and 1000 mg metformina cloridrato. I take one in the morning, then I have to also take one at night after another week. I felt fine before my diagnosis but since taking these tablets I have had stomache ache, headache and fatigue. The side effects are easing a bit now though.

I am trying to work out what the figures mean. My glucose level on my initial blood test was 220, yesterday afternoon with the nurse it was 171. She gave me a home checking kit which this morning is giving a result of 182. I thought it would be lower in the morning before eating??? Though I suppose it is a vast improvement on 220.

This looks like a great forum. Thanks for having me.


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## Bubbsie (Feb 22, 2017)

Hi Jeandp...sorry to hear about your diagnosis...even though you may have anticipated it with a family history of diabetes ...it still comes as a shock...I did try to look at your BG levels on the conversion chart...difficult not knowing which measurements were used...I assumed you were using a meter...and the 182 was a spot check given in mmols?...as opposed to your HbA1c (gives an average of BG's over the last three months)...I can say that as someone who has used Metformin for the last eight months its not unusual to have stomach ache...digestive problems and feel tired...had the same effect on me...however over a period of a month or so as my body got used to it...the symptoms did ease...if it does continue to cause difficulties...then you can ask to change to the extended release Metformin...which I hear is gentler on the system...I have no experience of sitagliptina...so won't offer advice on that...diabetes may have 'got me now!'...but...with the right plan...and a bit of hard work it can be managed well...likely you know this with the family history...good to hear you have support...and a new addition to the family to look forward to...yes...this is a great forum...doubt very much if I would have managed to control my diabetes without the support I received here...ask any question you need to...no judgement or disapproval here...would be interested to hear of your progress...good luck.


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## Carolg (Feb 22, 2017)

Hello and welcome to forum


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## grovesy (Feb 22, 2017)

Welcome.
Is that combination drug as I take Siptiaglipin and Metfromin but as seperate drugs which is more common in the UK.


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## Jeandp (Feb 22, 2017)

Thanks for the welcome. 

I have not been offered a HbA1c test. I don't know if they do them in Spain. My first result was from a general blood test. The 2nd 2 with my home tester "GlucoMen areo 2K" It would be nice to know what my results actually mean.


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## Northerner (Feb 22, 2017)

Jeandp said:


> I have lived in Spain for 5 years with my very supportive husband, but will soon be returning to the UK. We have a grandchild on the way!
> 
> I was diagnosed as type 2 last week. I have tried hard to avoid diabetes as it is in my family but it's got me now!
> 
> ...


Hi Jeandp, welcome to the forum  Very sorry to hear about your diagnosis, how did it come about? Metformin is known to take a little while to 'settle in', so hopefully you will be able to tolerate them a little better very soon  The sitagliptin is a fairly common Type 2 medication also, and it sounds like your medication is a combination of the two in one pill.

Basically, your numbers are on the high side, but not hugely so, and hopefully now you are diagnosed and on medication, plus with what you can learn from us, you will be able to get things under good control  Spain uses different units of measurement to us - we use mmol/l, Spain uses mg/dl - but you can convert tbetween the two by dividing the Spanish number by 18, or multiplying the UK version by 18 

A 220 mg/dl is therefore 12.2 mmol/l. A non-diabetic person would expect to see no more than 126 mg/dl (7.0 mmol/l) as a 'fasting level' i.e. first test when you wake up and before eating anything. The ideal is to be between 72-126 mg/dl on waking and before meals, and no more than 150 mg/dl two hours after eating. Bear in mind though that this is the ideal and it will take a little time and experience before you are able to achieve this, so don't be alarmed or frustrated if it seems to be taking a while, think of this as more of a marathon than a sprint! 

I would recommend reading the excellent Jennifer's Advice and Maggie Davey's letter which should really help put you in the picture  Also, Type 2 Diabetes: The First Year by Gretchen Becker is a very positive and helpful guide through these early months  You have a meter and test strips, which will provide you with your best tool for learning how different foods (or rather, the carbohydrates in your meals, which are what raise your blood sugar levels as they digest) affect your blood glucose levels. Have a look at Test,Review, Adjust by Alan S to understand how to test efficiently and effectively - people can have very different tolerances for the same food choices, so it's important to learn what your own particular tolerances are so you can tailor your diet to maintain good blood glucose control, but at the same time retain maximum flexibility in your food choices - no point in ditching things that don't cause you a problem!  Some things you may discover are really not good for you, and you will need to reduce or replace these things in your diet. For a good idea of the kinds of things that generally work well for people with diabetes I'd recommend looking into the GL (Glycaemic Load) Diet. This is an approach to selecting and combining foods so that they have a slow, steady impact on blood glucose levels - The GL Diet for Dummies is a very good introduction.

Please let us know if you have any questions and we will be very happy to help!


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## Jeandp (Feb 22, 2017)

Thank you so much Northerner for making sense of my results, it is all starting to make more sense now. I will look into your recommendations. Yes Grovesy it is a combination drug. I am looking forward to the side effects quietening down. The doctor sent me for a blood test because my blood pressure was high, I felt perfectly ok!


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## Northerner (Feb 22, 2017)

Jeandp said:


> Thank you so much Northerner for making sense of my results, it is all starting to make more sense now. I will look into your recommendations. Yes Grovesy it is a combination drug. I am looking forward to the side effects quietening down. The doctor sent me for a blood test because my blood pressure was high, I felt perfectly ok!


Unfortunately, our bodies and brains are able to adapt to elevated blood glucose levels to a certain degree, so we don't always realise there might be a problem and it is often discovered by 'accident' when being tested for something else  Still, you know now, so you can take action  How have your other family members managed with their diabetes (you said it was in your family)?


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## Bubbsie (Feb 22, 2017)

Jeandp said:


> Thank you so much Northerner for making sense of my results, it is all starting to make more sense now. I will look into your recommendations. Yes Grovesy it is a combination drug. I am looking forward to the side effects quietening down. The doctor sent me for a blood test because my blood pressure was high, I felt perfectly ok!


Exactly the same for me Jean... I would recommend the book Northerner mentioned...I read it...about to go through it again...answers a lot of questions... easy to read...and straight from the Horses Mouth...she is diabetic herself...takes you through her first year as a diabetic month by month...helps you make sense of it all.


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## Jeandp (Feb 22, 2017)

Northerner said:


> How have your other family members managed with their diabetes (you said it was in your family)?


My maternal grandmother had T1, I remember lots of dramas when I was growing up when she had comas. My mother is T2, and has been for as long as I can remember. My cousin has T1 which was diagnosed when she was pregnant at 16. So I didn't stand much chance did I?


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## grovesy (Feb 22, 2017)

Some experts think that some people can have Type 2 for up to 10 years before diagnosis.


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## Northerner (Feb 22, 2017)

Jeandp said:


> My maternal grandmother had T1, I remember lots of dramas when I was growing up when she had comas. My mother is T2, and has been for as long as I can remember. My cousin has T1 which was diagnosed when she was pregnant at 16. So I didn't stand much chance did I?


Interesting. Was Type 1 considered at your diagnosis? There is a 'slow-onset' version of Type 1 which can get confused with Type 2 in the early stages. Also known as Type 1.5 or LADA (Latent Autoimmune Diabetes in Adulthood). This is basically what I have (and many other members are the same) - in my case it took around 18 months to develop to a point where I needed insulin. 

I'm not saying this is the case with you, but given that there is a history of Type 1, it's something to bear in mind should things not improve with the medication you have been given. Both major types have a strong genetic component, but Type 1 is an autoimmune condition, where your levels rise due to a shortage of insulin, whereas Type 2 is generally insulin-resistance - you're producing enough, but your body can't use it efficiently.


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## Jeandp (Feb 22, 2017)

Northerner said:


> Interesting. Was Type 1 considered at your diagnosis?



Being in Spain some things are lost in translation, but she did answer my question of "no needles?" with "no, not yet" which I find quite scarey.


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## Jeandp (Feb 22, 2017)

Considering my reading this morning before food was 182 or 10.1 UK, and my reading now before my lunch is 108 or 6 UK, should I be worried? That is a big fluctuation!


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## grovesy (Feb 22, 2017)

In the UK before meals 4-7 and 2 hours after meals less than 8.5 are the recommended targets. 
The morning one is on the high side but that is often the last to drop. The before lunch is spot on.


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## Northerner (Feb 22, 2017)

Jeandp said:


> Considering my reading this morning before food was 182 or 10.1 UK, and my reading now before my lunch is 108 or 6 UK, should I be worried? That is a big fluctuation!


No. The readings have gone in the right direction and a 6.0 before lunch is actually very good  It's possible that the 10.1 is due to something called 'Dawn Phenomenon' - this is when your liver releases extra glucose from its stores into your blood in order to give you an 'energy boost' to start the day. It's quite common, although admittedly frustrating - as people with diabetes we'd very much rather it didn't! A person without diabetes would promptly produce sufficient insulin to keep the blood sugar levels within a much narrower range.


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## Bubbsie (Feb 22, 2017)

Jeandp said:


> My maternal grandmother had T1, I remember lots of dramas when I was growing up when she had comas. My mother is T2, and has been for as long as I can remember. My cousin has T1 which was diagnosed when she was pregnant at 16. So I didn't stand much chance did I?


Jean...there was nothing you could do about that...now you've set about managing your diabetes...concentrate your energies on that...you've already brought your BG down...so you're working on it...I was devastated when I was diagnosed...didn't understand what diabetes was...why I had it...then read...tested...found the forum...now much of what I do to manage my diabetes is second nature...it does take hard work...but it is worth it...you  may find it takes some while to get 'settled' in to a routine...most of us do...takes time to overcome the shock & disappointment...do things at a steady pace...no need to rush...best to have a routine that is sustainable long term...you'll get there.


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## Martin Canty (Feb 22, 2017)

Hi Jean, welcome to the group....

Actually your figures are pretty good, looks like you were caught early (or at least before BG got out of hand). The good news is that with some work you can control this & live with BG in the "normal" range. Feel free to ask any question & you are bound to gave at lease a few people give you the answer


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## Jeandp (Feb 22, 2017)

Martin Canty said:


> Hi Jean, welcome to the group....
> 
> Actually your figures are pretty good, looks like you were caught early (or at least before BG got out of hand). The good news is that with some work you can control this & live with BG in the "normal" range. Feel free to ask any question & you are bound to gave at lease a few people give you the answer


Hi Martin
Thanks for your support, I appreciate it. I see you are on Metformin 1000 x2. I am taking the 1000 dose and my doctor told me to increase to twice a day after 10 days. To be honest I am dreading it, I am only just getting used to the one tablet a day. Most other people are on the 500 tablet. I wonder why we have been prescribed the 1000 x2 dose?


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## Jeandp (Feb 22, 2017)

Bubbsie said:


> .I was devastated when I was diagnosed...didn't understand what diabetes was...why I had it...then read...tested...found the forum...now much of what I do to manage my diabetes is second nature...it does take hard work...but it is worth it...you  may find it takes some while to get 'settled' in to a routine...most of us do...takes time to overcome the shock & disappointment...do things at a steady pace...no need to rush...best to have a routine that is sustainable long term...you'll get there.


Me too Bubbsie, gutted .... especially as I had tried so hard to avoid it. Very true about the shock and disappointment. Thank you for your understanding.


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## Ditto (Feb 22, 2017)

Hello Jeandp, welcome to the forum.  I was determined D wasn't gonna get me either!  I refused water tablets back in the day because I'd read that they caused D, then I pigged myself into anyway.


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## Grogg1 (Feb 22, 2017)

Jeandp said:


> Hi Martin
> Thanks for your support, I appreciate it. I see you are on Metformin 1000 x2. I am taking the 1000 dose and my doctor told me to increase to twice a day after 10 days. To be honest I am dreading it, I am only just getting used to the one tablet a day. Most other people are on the 500 tablet. I wonder why we have been prescribed the 1000 x2 dose?



I was diagnosed with much higher levels than you but I'm only on 500 x 2 and from home testing it seems to be okay - I have my first 3 month check up this week.  But I too have noticed from this site that many with lower levels than me have been put  on higher doses. I have my first review next week and I'm hoping for a big improvement on my level 3 months ago.  At what level do you think they will want to increase my meds or should I resist any increase in meds?


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## Bubbsie (Feb 22, 2017)

Grogg1 said:


> I was diagnosed with much higher levels than you but I'm only on 500 x 2 and from home testing it seems to be okay - I have my first 3 month check up this week.  But I too have noticed from this site that many with lower levels than me have been put  on higher doses. I have my first review next week and I'm hoping for a big improvement on my level 3 months ago.  At what level do you think they will want to increase my meds or should I resist any increase in meds?


Hi Grogg...I was diagnosed with quite high levels...17.4...been on two 500mgs metformin daily since DX...at my first review managed to get my BG down to average of 8.2 (66mmols)...as soon as I walked into my doctors office he wanted to increase my medication to the maximum...I did resist the increase...since I had managed to halve my levels...I asked to remain on the lower dosage with diet & exercise...it worked...my HbA1c at my second review was 51...I am expecting it to be lower at my third one next month (fingers crossed)...why not wait and see what your HbA1c is at your review...and discuss it with your GP...then you can make that decision...its your first review...you may not hit your desired target first go...but with the numbers you're posting seems you will... no reason to increase your medication as long as your levels are improving.


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## Ralph-YK (Feb 22, 2017)

Hello from a fellow T2, two years in.


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## Martin Canty (Feb 23, 2017)

Jeandp said:


> Hi Martin
> Thanks for your support, I appreciate it. I see you are on Metformin 1000 x2. I am taking the 1000 dose and my doctor told me to increase to twice a day after 10 days. To be honest I am dreading it, I am only just getting used to the one tablet a day. Most other people are on the 500 tablet. I wonder why we have been prescribed the 1000 x2 dose?


Different countries do things differently, I now live in the States & I guess 1000mg is standard here, along with prescribing a test meter. I also noted that you quoted BG in mg/dL.... Whenever I post I do the conversion just so I don't freak out the uninitiated who would think I should be in the morgue with a (typical) FBG of about 80.


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## robert@fm (Feb 23, 2017)

grovesy said:


> Some experts think that some people can have Type 2 for up to 10 years before diagnosis.


On a mailing list I was on (run by an Indian guy), the list owner once said that people in India often go all their lives with undiagnosed Type 2.


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