blood sugar results?

Hello all, I have a query I'm hoping someone will be able to help me with.

Dave saw the Dr (not our usual dr) 2 weeks ago about his diabetes and after a blood test the Dr game him Gliclazide to take alongside his other tablets. So now he is on 1000mg Metformin twice a day, 160mg Gliclazide twice a day, 10mg Ramipril and 40mg Simvastatin daily. The Dr said his blood sugar levels are too high at 72 hence the change in meds and wants his blood levels around 58 and will retest in 3 months time.
We got a blood glucose meter for free to test at home as one of the symptoms of the Gliclazide is a risk of hypo, so he wanted to be able to test to make sure it doesn't go to low etc. Now he woke up this afternoon ready for a night shift and complained he was feeling very dizzy and weak so we tested his sugar levels, with his result tonight being 5.5mmol/L.

I know they have changed the way they do the test results but its left us rather confused. I can only find 2 ways for results mmol/L or mg/dl but from my understanding if he was to get test results of 58mg/dl that would work out about 3.2mmol/L Now this is whats confusing us... before they said his level was 'stable' at around 8 and that they wanted to get it below 7 which was the normal blood sugar levels. Is the dr expecting too much? or is my understanding of this way off?

Hi Shona,

I think you are using a converter which is for the US and not the new (but delayed) measurement in the UK!

An HbA1c of 48 mmol/mol (6.5%) is recommended as the cut point for diagnosing diabetes. A value of less than 48 mmol/mol (6.5%) does not exclude diabetes diagnosed using glucose tests. .............. Just found that and am trying to find the scale for new measurements somewhere!

Will find in a minute or day

http://www.diabetes.org.uk/Guide-to-diabetes/Monitoring/Blood_glucose/Glycated_haemoglobin_HbA1c_and_fructosamine/

Try that !


As usual Diabetes UK website is as confusing as ever!

so 9.3 = 78

and 7.5 = 58

Why did he put him on Gliclazide and not Sitagliptin? Low risk of hypos...good HbA1c drop and stops you wanting to eat so much.

I'm on it...newish drug but very good. Just loads of GP's like staying 'safe' and not giving you new stuff that is far better than the old stuff with less side effects.

Hope that helps

Nick

he has been having some problems with maintaining an erection and our dr initially said that it was likely caused by the diabetes and the cialis would help, but if it wasnt working to go back and it did work for a while, this is why he made the appointment. the new dr said it was just caused by the diabetes and that once the diabetes was under control things would fix themselves.
We have another appointment to see our dr next tuesday as we're not overly happy with some of the medicines he is currently on. I think i might have to go along with him because he doesnt ask the questions he needs to know the answers too. While we were looking through the leaflet at the side effects etc we noticed it said not to use gliclazide whilst using ramipril but it doesnt say why.. and while looking at the side effects of ramipril we discovered that one of the side effects is sexual disfunction as well as localised numbness which he has had several times in his leg. Since he is on ramipril for prevenatative measures we're looking to getting him off it to see if it helps improve things.

I will have a look at the link you've provided Nick and hopefully my brain will understand it. I take it the 5.5mmol/L is the old UK way of measuring blood levels, as i couldnt find an alternative for here i just assumed we had switched to the same method as used by USA.

ok i've just looked and although the meter says gives results in mmol/L it would look like it actually gives the percentage figure. i will bookmark the webpage though and refer back to it as and when needed

Ramipril is an ACE inhibitor ( blood pressure tablet). There are no specific reasons why the two should not be taken together but it 'may' enhance hypos. There are other BP tablets available (apart from which Ramipril and Lisinopril tend to give you a tickly throat and permanent silly little cough and sometimes runny nose(or in my case it poured!)

Yes HbA1c measurements were mmol and now they are changing to percentage and sorry I still can't work out an easy way to correlate the two together. I will try and get a copy of a chart that a diabetic nurse in teh room next to me has and post it on here, unless I can find an online version.

Yes erectile dysfunction is a side line of diabetes and they are now doing research (new) into female sexual dysfunction re diabetes too (about time).

Probably a good time to talk to your usual quack and ask about the possibility of Sitagliptin instead of a hypo giver!

Good luck and let me know how you get on

IFCC-HbA1c DCCT- HbA1c Mono S- HbA1c[10]
(mmol/mol) (%) (%)
10 3.1 2.0
20 4.0 2.9
30 4.9 3.9
40 5.8 4.8
45 6.3 5.3
50 6.7 5.8
55 7.2 6.3
60 7.6 6.8
65 8.1 7.2
70 8.6 7.7
80 9.5 8.7
90 10.4 9.6
100 11.3 10.6


Left column is new figure
Middle column is old HbA1c figure

Ignore right column !

Nick thank you. I've copied the list and popped a copy in with his glucose meter. Another quick question... With his fasting test showing as 5.5 will that explain the wooziness? It is considerably lower than it has been in a very long time, was it just his body adjusting to the drop?

Yes might be, although 5.5 shouldn't really be near 'hypo' stage but if his levels have been much higher recently then it is possible that his body was reacting to that much lower reading.

Just realised i havent been back to update.. typical me, got about 30 things on the go at once and cant remember any of them.

We saw the regular doctor who wasn't overly happy about the fact that Gliclazide had been prescribed at the higher rate, but said if its dropped his blood sugar levels to 5.5 in such a short time to carry on taking it and retest in 3months. he did say if there is no overall improvement in the 3 months they would definitely consider Sitagliptin, and the only real reason it hasnt been prescribed before is because our doctor hasnt seen any weight loss benefits in patients until just now. He has also been asked to continue with the ramipril and simvastatin mix at the moment, both doctors are adamant that once the blood sugar levels sort themselves out the erectile dysfunction will also sort itself out, but in the mean time Levitra has been prescribed.

Hi Shona,

Sitagliptin is a slight saiety drug and it helped me lose weight...get him on it instead of Gliclazide if you can !!

Ramipril is OK so long as you don't get the irritating cough and rhinitis. If he he does ask for Candesartan....little side effects.

Ask your GP if he /she has seen this??

http://zocorlawsuit-info.com/2011/09/fda-names-erectile-dysfunction-zocor-side-effect/

http://fampra.oxfordjournals.org/content/19/1/95.short

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2710.1996.tb00006.x/abstract

http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2006.00793.x/abstract?userIsAuthenticated=false&deniedAccessCustomisedMessage=

Dooooh !!!

I HATE STATINS !!!!!!

Hope the little tabs help you both

xx