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Medical Forum / Diseases and Disorders / Diabetes / May 2008

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hyperglycaemic

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steve bod - 16 May 2008 10:11 GMT
Hi all,
I have been on Orlistat fat busting drug for 5 weeks now and since
being on it I have been almost  permanently hyperglycaemic, I'm due at
the endocrinologist next week and have been adjusting my nova rapid
and glargine accordingly but remain very high with my lowest count
during the day at 12.00 mmols and the highest around 20 mmols.
I know its high and I don't feel sick when I go that high either.
I have been in contact with lifescan who sent new batteries for my
meter and I have tested the meter and all is OK.
How high does my blood glucose have to get before I should consider
going to hospital?
I was told 25 mmols but I am unsure.
I am also certain that Orlistat is supposed to give inaccurate low BG
readings but that appears to be rubbish as mine are so high.

Please advise.

Many thanks to the group in advance.

Stephen B.
Alan S - 16 May 2008 11:16 GMT
>Hi all,
>I have been on Orlistat fat busting drug for 5 weeks now and since
[quoted text clipped - 12 lines]
>
>Please advise.

I don't know the threshold numbers for emergency - but if
your numbers were OK before the Orlistat I'd dump it now and
see the doc ASAP.

Those BG levels are way too high for comfort. What timing
are they, relative to your meals?

You mentioned the drug - but not your diet. What are you
eating? What, if anything, have you changed in your menu?

Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Latest:What to Eat Until You Get Your Meter.

Angkor Wat
http://loraltravel.blogspot.com
steve bod - 16 May 2008 12:00 GMT
> On Fri, 16 May 2008 02:11:14 -0700 (PDT), steve bod
>
[quoted text clipped - 35 lines]
>
> - Show quoted text -

Thanks for the reply,
I spoke to my diabetic Nurse at Hammersmith Hospital earlier, she has
increased my nova rapid to 18 units and my glargine to 32.
She's asking advise from the docs at the hammersmith hospital
concerning my orlistat drug, my GP put me on this drug to lose weight
and I think its working. but don't really want to risk my health and
remain hyper because of this.
I did try explaining to my GP that I don't infact eat much fat despite
my weight, but he said I was in denial, but I can assure you I do not
eat much fat, indeed I have been on diets pretty much all my life and
for a fat guy i'm actually firmer than many of my slimmer friends.
I forgot to mention Im 45 years old.
my diet is low fat, zero sugar.
I think because the doc thinks im eating lots of fat when infact I'm
not it's giving me some odd readings.
I actually went up to 24.4 earler but its falling now.
the nurse said that the higher dose of glargine will take 3 days to
become effective.

Thanks again for the advice, but will continue the orlistat until doc
tells me to come off, but your right it's only since being on this
drug that the readings have been high.

Steve.
Nick Cramer - 16 May 2008 12:26 GMT
> > On Fri, 16 May 2008 02:11:14 -0700 (PDT), steve bod
[ . . . ]
> > You mentioned the drug - but not your diet. What are you
> > eating? What, if anything, have you changed in your menu?

> Thanks for the reply,
> I spoke to my diabetic Nurse at Hammersmith Hospital earlier, she has
[quoted text clipped - 18 lines]
> tells me to come off, but your right it's only since being on this
> drug that the readings have been high.

You didn't mention your carbohydrates. Bread stuffs, rice, pastas and such.
Those are major contributors to your blood glucose and fat. How much of
those? Milk? Fruits? What kind? The best way to lose weight is by reducing
your carbs and exercising more.

Can you get the results of your blood tests?

Take care.

Signature

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I've known US vets who served as far back as the Spanish American War. They
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Nicky - 16 May 2008 12:49 GMT
>I did try explaining to my GP that I don't infact eat much fat despite
>my weight, but he said I was in denial, but I can assure you I do not
>eat much fat, indeed I have been on diets pretty much all my life and
>for a fat guy i'm actually firmer than many of my slimmer friends.
>I forgot to mention Im 45 years old.
>my diet is low fat, zero sugar.

Your doctor is an idiot... A diabetic gets fat because of insulin
resistance. What happens is that you eat some carbohydrate. A
non-diabetic's body would immediately produce exactly the right amount
of insulin to sweep it into your cells, where it can be used. A
diabetic's cells are resistant to the action of insulin, with two
consequences; your cells can't get enough fuel, so they send "I'm
starving!" signals to the brain, which it translates into hunger even
if you've only just eaten. Then there's all that insulin swimming
around in your system. In a non-diabetic, an excess of insulin means
good times; insulin's role then becomes to tuck spare carbohydrates
away as fat. Now a diabetic gets a third whammy, because fat around
your stomach is hormonally active, and interferes with the signaling
that says you're full. So you now have starving cells, no mechanism to
tell when you've had enough food, and excess insulin tucking away all
that nice, low fat pasta, crown rice, etc straight into fat cells,
making the cycle worse.

For heaven's sake STOP eating low fat, and try moving towards low
carbohydrate. You actually need to eat some fats, to encourage
turnover of fat cells so you can get rid of it. Oh, and stop the
disgusting drug, too... Get your blood glucose in order, and you will
almost certainly lose weight without trying. If you still have a
weight issue with normal bg, THEN you could look at total calories,
including fat ones, to see if you need to adjust.

Try this link to start working out what foods are safe for your
diabetes. You're going to have to make small changes and be prepared
to lower your insulin dose if you go low.
http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6%  BMI 25
Steve Bod - 16 May 2008 13:46 GMT
>> I did try explaining to my GP that I don't infact eat much fat despite
>> my weight, but he said I was in denial, but I can assure you I do not
[quoted text clipped - 37 lines]
> D&E, 100ug thyroxine
> Last A1c 5.6%  BMI 25

Wow, thanks Nicky,
oddly enough my tummy rumbles immediately after eating, I put that down
to the orlistat preventing me from absorbing fat.
As you probably know there are some nasty side effects from using this drug.
The side effects, particularly the tango orange coloured poo etc lasted
a very short time which I guess is because of the fact i'm not taking in
much fat.

Thanks for the enlightening information.

you guys were very helpful last new year (2007) when I had recently come
out of an 8 day diabetic coma.(newly diagnosed)

thanks for all your input, I always take it on board and bounce off my GP.

Best wishes.

Steve.
DaveT - 16 May 2008 23:00 GMT
>>> I did try explaining to my GP that I don't infact eat much fat despite
>>> my weight, but he said I was in denial, but I can assure you I do not
[quoted text clipped - 57 lines]
>
> Steve.

Personally I would bounce the doctor permanent and look for a new one.
Diabetes treatment is a balance between carbs, insulin and exercise. Fat
comes when there is too much of the first and not enough of one or both
of the last 2. Please take note of Nicky.

Signature

DaveT T1 Dx 1955 (aged 9)
Basal Hypurin Beef Lente
Bolus Lispro

Trinkwasser - 16 May 2008 19:28 GMT
>>I did try explaining to my GP that I don't infact eat much fat despite
>>my weight, but he said I was in denial, but I can assure you I do not
[quoted text clipped - 32 lines]
>to lower your insulin dose if you go low.
>http://www.alt-support-diabetes.org/Newly%20Diagnosed.htm

What she says!

Unfortunately you must have met the same clueless doctor I used to
have, he put me on a low fat high carb diet which promptly made my
llipids and blood pressure worse, so he put me on an even lower fat
and even higher carb diet and when that made things worse still he
wrote me up as "not complying" with the diet when the real problem, as
I have subsequently discovered, was that the diet was crap, and in
fact dangerous.

For a more extended read go here

http://www.dsolve.com/

the "How To" section was actually written by a clueful doctor, so your
current idiot can't dismiss it as the rantings on an amateur.

Be careful dropping your carbs that you also decrease your insulin
accordingly or you could enter hypo territory, hopefully you've been
taught how to do this? If not the insulin users here should be able to
help along with the above site.
Patti - 18 May 2008 19:57 GMT
If you aren't sure how to adjust insulin do the BDEC carb counting
course on line

http://www.bdec-e-learning.com/
Patti
Penzance, Cornwall
On Levemir and Novorapid + meds for BP and thyroid
Join us at http://www.diabetes-support.org.uk "The friendly forum!"
Ozgirl - 17 May 2008 00:38 GMT
Steve, you do know that carbs are "sigar" don't you? If you are doing low
fat then you are probably having a lot of carbs which are usually a big non
no for diabetics. There is absolutely no reason to have low fat,. Just make
sure you eat fats that are health providing rather than sat or trans fats.
Fats satisfy as well as have no impact on bg's.

>> <bod6...@gmail.com> wrote:
>>> Hi all,
[quoted text clipped - 58 lines]
>
> Steve.
Alan S - 17 May 2008 01:59 GMT
>I did try explaining to my GP that I don't infact eat much fat despite
>my weight, but he said I was in denial, but I can assure you I do not
>eat much fat, indeed I have been on diets pretty much all my life and
>for a fat guy i'm actually firmer than many of my slimmer friends.
>I forgot to mention Im 45 years old.
>my diet is low fat, zero sugar.

Hi Steve

Well, I don't need to say it, as Nicky, Jan and the others
already have. I totally concur with them.

So, to head you in a better direction, I'll repeat the link
that others gave you but with a UK address:
http://jennifer.flyingrat.net/

That was the single most important advice I received from
any source since diagnosis.

And this is how I put that into practice myself:
http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html

Just one extra word. As you are on insulin, hasten slowly
with changes. You don't want to turn those horrible highs
into equally horrible lows.

Finally, on weight, the changes you make from crazy
low-fat/high carb to being guided by your meter will help
far more than the new drug IMO. Discuss that with your NEW
doctor. I'd recommend dropping that drug ASAP.

To assist with the weight loss, this is how I did it:
http://loraldiabetes.blogspot.com/2006/10/weight-loss-cooking-and-eating-plan.html

Hopefully some of the ideas there may help.

Good luck.

Cheers Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg  

I have no medical qualifications beyond my own experience.
Choose your advisers carefully, because experience can be
an expensive teacher.
http://loraldiabetes.blogspot.com/
Everything in Moderation - Except Laughter.
DaveT - 17 May 2008 18:13 GMT
snip

> Just one extra word. As you are on insulin, hasten slowly with changes.
> You don't want to turn those horrible highs into equally horrible lows.

That's the bit that worries me, instead of just upping both his basal and
bolus why did his medic team not show him how to control his highs using
the results from his meter and his bolus insulin and carb intake?
Without that information he must reduce his carb intake to get that
weight and the Bg results down, by upping the daily dose, that could lead
to hypos. Not good management IMO.

Signature

DaveT T1 Dx 1955 (aged 9)
Basal Hypurin Beef Lente
Bolus Lispro

ANITA STONE TAMPA FLORIDA - 17 May 2008 21:17 GMT
> > On Fri, 16 May 2008 02:11:14 -0700 (PDT), steve bod
>
[quoted text clipped - 62 lines]
>
> - Show quoted text -

I AGREE WITH NICKY AND ALAN.
TEST TEST TEST
You will find what you can eat, everyone is different.
Read Alan's blog -->> maybe my kitchen videos will help you:
www.youtube.com/videofitnesscoach.
BEST WISHES!
VIDEO FITNESS COACH ANITA STONE
www.videofitnesscoach.com
www.timetogetfit.biz
www.timetogetfit.blogspot.com
ANITA STONE TAMPA FLORIDA - 17 May 2008 21:20 GMT
> Hi all,
> I have been on Orlistat fat busting drug for 5 weeks now and since
[quoted text clipped - 16 lines]
>
> Stephen B.

Stephen, why are you taking Orlistat? Is that the one that binds to
fat in your intestines and flushes it out so it is not absorbed?
Or do I have it confused with another drug with a similar name?
Stephen Bowden - 19 May 2008 15:33 GMT
>> Hi all,
>> I have been on Orlistat fat busting drug for 5 weeks now and since
[quoted text clipped - 20 lines]
> fat in your intestines and flushes it out so it is not absorbed?
> Or do I have it confused with another drug with a similar name?

Yep, it prevents the body absorbing fat in the gut and has some
uncomfortable side effects for the first few weeks.(orange greasy stools
and flatulance with follow through
I was offered Orlistat or Accomplia but opted for Orlistat as Accomplia
has an effect on the brain and reports in the USA state that some people
were having suicidal thoughts whilst on the drug.

Hey my Partner and kids are not long back from Florida, they had a great
time in your neck of the woods, including Tampa.

Steve.
Erica Nurney - 17 May 2008 22:57 GMT
> Hi all,
> I have been on Orlistat fat busting drug for 5 weeks now and since
[quoted text clipped - 12 lines]
>
> Please advise.

I'm on Orlistat as well but I have the opposite problem, as soon as I
started taking it my BG's dropped and I have been able to reduce
Lantus from 52 to 34 units, and Aspart from 20-28u to 15-22u

I have been fighting hypos since I started taking it, not to mention
the oily faeces.  I have also lost 10kg since the new year.

EN

> Many thanks to the group in advance.
>
> Stephen B.
 
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