Changed diabetic meds and now feeling PMRy

[IdasMum]

Hello ladies and gents.

I am tired and achy. My fatigue levels are up and I am back to needing to pace myself more.

Why I hear you ask.

I am wondering (and am too tired to have a good rummage in the forum) was Metformin anti inflammatory? Or was it getting the diabetes treated that reduced inflammation. I have forgotten.

10 days ago I change my Metformin to Novonorm (Rapaglinide) due to an ongoing side effect which culminated in a horrible incident in our local public loo.

I am currently on 8mg x6 and 7.5 x 1 of Pred per week. I have a blood test on Friday so don't want to make any changes until after this, tempted as I am to up my steroids.

Thanks in advance for your knowledge.

[PMRpro Ambassador]

Very possibly:

ncbi.nlm.nih.gov/pubmed/257...

The new stuff also seems to be antiinflammatory - but you'd need much higher doses.

[IdasMum in reply to PMRpro]

Thank you. I knew you'd know )

Once I have my results (both CRP and Hb41c this time) I'll go back to Dr to rethink.

[Hidden in reply to IdasMum]

Metformin seems to. Help. Me and diabetes UK nodded to wards it a while back. Always use the ones that work. I take max dose of Metformin, weekly duglatide and insulin twice a day. 🤞🌻

[BonnyQuine in reply to IdasMum]

Hello Ida's Mum

I also had to stop Metformin because it caused terrible gastritis. It's very good for controlling diabetes, but no use if it causes those side effects.

I take Repaglinide (two 2mg tabs before meals), plus alogliptin once a day and dapagliflozin once a day. I've been taking these for a year or two now, and don't have any problems with them at all. They control the diabetes v well, are easy to use, and I never have hypos.

As to aches and fatigue - mine seem mostly related to reducing pred, and quite often are just unpredictable. I was diagnosed w GCA in Nov 2016, and am now gradually getting down to 3.5mg pred. The diabetes kicked in a few days after starting pred.

GCA causes terrible fatigue which, in my case, was made much worse by large doses of pred. It seems to me that the side-effects of pred are probably cumulative. Any serious illness also causes fatigue - including diabetes. Aches seem to have multiple causes.

'The deathly fatigue' has been part of my life ever since GCA diagnosis, and I suspect it also has multiple causes. Comes and goes, but mostly comes. However - fingers crossed and touch wood - I think it's beginning to lessen now, for quite a lot of the time.

Hope this helps.

[BonnyQuine in reply to IdasMum]

PS: Am I right that you're on 7.5mg pred? Perhaps I should mention that I had particular difficulties reducing pred, around that level. It just went on for ages, with terrible aches and fatigue every time I tried to reduce further. If I remember correctly, that was the most difficult time of all. Could it be connected with the adrenals having to get back into functioning mode? Anyway, eventually some sort of miracle occurred, and I was able to get down lower at last.

Do hang on in there. It'll work out in the end.

[IdasMum in reply to BonnyQuine]

Tx for your replies.

I am only on 7.5 x 1 per week currently, otherwise 8mg

I took an extra 5mg yesterday evening, so am hoping today to feel less achy.

Will see what blood results say and then head back to Dr for further talks.

[BonnyQuine in reply to IdasMum]

Good luck.

[IdasMum]

So my results are in and contrary to what I'd imagined.

CRP 9! down from 14.6 last month.

I can only imagine that there is something else happening making me achy although that is less now.

My sedimentation rate is also down. Hb41c also down a small amount from 3 months ago.

All other results within normal limits.

This is pleasing for me as it means I can continue on my new diabetic meds as they seem to be working.

[Hidden in reply to IdasMum]

When you get really bad pain can you check you blood glucose? If my blood sugar is down I get increased pain and tiredness. The pain is usually my neck and shoulders. Our new med might be more likely to cause hypoglycemia in the 3 to 4 range or near hypo between 4 and 5.

[IdasMum in reply to Hidden]

That's interesting. I don't test my blood glucose.

I might see what Dr says when I next see him.

[Hidden in reply to IdasMum]

You need to on a drug that has hypoglycemia as a warning.

[BonnyQuine in reply to IdasMum]

I do test my blood glucose most days.

First thing in the morning - fasting blood sugar - mainly to check on the effects of the pred, which I take last thing at night. So blood sugar is always up a bit in the morning.

If it's not too bad, I can skip breakfast and that dose of repaglinide. (trying a bit of intermittent fasting.) But if it's 10 or more then I take repaglinide and eat something - maybe organic plain yoghurt w blueberries, or a boiled egg + a fresh fig.

I also take the alogliptin in the morning.

Then I occasionally test the blood glucose at other times - maybe to check the effect of some foodstuff (2 hours afterwards), or if I feel a bit 'off', and want to see if blood sugar level has anything to do w it.

It's v reassuring to be able to do that, and then be able to adjust food intake or medication accordingly.

In the early days it was v useful indeed.

[Hidden in reply to BonnyQuine]

I have test kits upstairs, downstairs and in the car. I always have had since I was first put on metformin initially in 2001. I tested 3 to 4 days a week until pmr. Since pred I have been on insulin so if I drive I have to have tested blood within 2 hours before and then every 2 hours when driving. I tested twice a day, on top of driving tests, for 2plus years. That can make your fingers ends hurt! The last time I saw diabetes clinic nurse she suggested that I test 3 to 5 times a week plus driving. As I have got to lower doses of pred, lower doses of insulin and a low carb plan have lowered hba1c from 114 to 45. I have started to have lower test scores regularly now and was hoping it may signal the end of insulin.... But up to 8mg from 6mg for a flare. So I will wait and see next 3 months out. You are right. Knowing daily or near enough daily readings help adjust diet and doses.

[IdasMum in reply to Hidden]

Of course, for Diabetes 1 then testing your blood glucose is par for the course.

[Hidden in reply to IdasMum]

Type 2 plus steroid induced......

[PMRpro Ambassador in reply to IdasMum]

Whether it is Type 1 or 2 is less important than the severity.

[PMRpro Ambassador in reply to IdasMum]

rxlist.com/prandin-side-eff...

Those sort of symptoms are all listed as being common!

[IdasMum in reply to PMRpro]

Thank you.

I prefer these side effects to the diarrhoea!

I am only slightly achy, I wouldn't describe it as pain.

[PMRpro Ambassador in reply to IdasMum]

I can imagine!!!