yesterday's visit with a diabetic case manager...

By RainSoul Latest Reply 2014-02-10 15:26:51 -0600
Started 2014-01-31 11:11:12 -0600

I've been type 2 for 3 years now and been uninsured for most of that time.
Yesterday was my first meeting with a case manager (diabetes nurse) and I got some bad news.

My recent a1c was 11.3 which I knew it was right around there but the nurse went over my test results for the other labs they ran in December.

Particularly, my kidney function test came back elevated. I guess normal range for the test results is 90-100 and mine came back at 104 which the nurse said my kidneys are now in "hyper filtration" mode. I don't know much about hyperfiltration but I know I can't live without kidneys.

So they will be adding glipizide to my metformin and if that doesn't get my a1c down I'll have to go on insulin.

I'm also supposed to work on eating more frequently (I currently just eat once a day when I get home from work)

17 replies

RainSoul 2014-02-10 05:06:06 -0600 Report

I checked my blood sugar before bed and I was at 116 4 hours after taking my glipizide… Then an hour and a half later I woke feeling hypo and my blood sugar was down to 90 and I had some unhappy stomach issues. :(

Ate half a granola bar and hopefully I can get back to sleep.

Glucerna 2014-02-10 15:26:51 -0600 Report

It sounds like you're still adapting to the medication. How are the diabetes education classes going? ~Lynn @Glucerna

RainSoul 2014-02-05 17:03:19 -0600 Report

Hey guys- just an update :)

I start my diabetes education classes tonight.
My doc put me on 5mg of glipizide to help with my night time sugar levels since my fasting glucose is really high.
May increase to 10mg soon just testing out the 5mg for now.

Dr Gary
Dr GaryCA 2014-02-02 17:23:31 -0600 Report

Hi RainSoul,

Just wanted to say hi and offer you some support. I am really glad you are here.

It's hard to get unexpected news. Nobody likes to live with all that uncertainty, wondering what the future might hold.

But I encourage you to take really good care of yourself. And get lots of support. It helps to be in touch with people who get what you are going through and are walking the road along beside you.

So stay in touch with us, my friend. Let us know how you're doing!


RainSoul 2014-02-02 12:44:09 -0600 Report

Well I have a doc appointment on Wednesday and I've been tracking my blood sugar since I started splitting my meds so they will decide whether or not I go on glipizide.

Grandmama16 2014-02-02 00:04:25 -0600 Report

Hi there…I went to the Dr 3 days ago. Haven't gotten results of blood and urine tests but suspect a bladder irritation. I've wondered if meds or vitamins can cause that or it may be too much coffee with creamer, not enough water. I don't eat much but crave my popcorn every night with butter, salt and a little sweetener. I've had BG of 212 down to 115 tonight. I take cymbalta(did it raise BG in the 1st place?), 2 blood pressure meds.,low dose Lortab, Metformin, Nuerontin, Dexilant, plus Xanax & Ambien if needed, and now my Ins requires that I take 2 more…1 for cholesterol which I haven't tolerated well in the past, and 1 for protecting kidneys which are totally normal. Dr is giving me the least amount on each. Has anyone else experienced this from Ins.? I don't want more side effects. The Nuerontin was given for Nueropathy but thru a nerve test a couple of months ago and just got results of( a snafu) I learned that I have carpal tunnel causing the numbness and tingling pain. So,now what? Do I keep on with Nuerontin or reduce it? Just wondering and wasn't sure exactly where to put this comment.

RainSoul 2014-02-01 22:15:48 -0600 Report

Splitting up my meds has helped lower my blood sugar but I'm having all those unpleasant side effects making it impossible to do my job. Kinda hard to do my job from the bathroom.

meadowrose 2014-02-01 20:37:19 -0600 Report

Keep us posted on how the addition of glipizide helps, RainSoul. Try to eat small meals throughout the day if you can, to keep your blood sugars steady. If I can ask, you're only eating once a day, but what are you eating? I'm rather surprised at the elevated kidney function test, which is why I was wondering. Too, if it turns out that you do have to go on insulin, it doesn't mean you're doing a bad job of controlling your diabetes; it's progressive and seems to progress faster with some than others. I'm assuming you are insured now? Maybe your insurance will pay for you to go to diabetic education classes, which also may help you.

RainSoul 2014-02-01 21:13:11 -0600 Report

I am insured now and they are paying for me to take the classes, I start on Wednesday.

I was eating fast food usually- because its fast and it takes too long to cook.
I work at a call center so I can't just eat whenever I want.

Since my meeting with the nurse I haven't eaten anything fried, and I'm bringing snacks to eat on my breaks. My blood sugar was a good # as of yesterday before dinner I was at 139 but after dinner I was at 276 :( I had an egg sandwich with whole grain bread 20 g carbs each slice :(

meadowrose 2014-02-01 22:05:04 -0600 Report

You might want to watch the bread. I don't know where you live, but you might want to check into lower-carb breads. For me, I've discovered that such breads are more expensive but well worth it for their convenience. I like the FiberOne bread. Two slices combine for a total of 100 calories and 14-15 net carbs. My official diagnosis is still pre-diabetes, though I've been holding that since 2006 and wonder how much longer that will continue. However, that said, I'm on Metformin ER twice a day and am still trying to learn to eat in a way to control bg. Am learning that fried foods tend to hike me but good, though I do still eat them from time to time as it's hard to let them go. :) They don't call it a journey for nothing. Do you have a slow cooker? I don't know what your schedule is, but something like that might come in handy for cooking more nutritious meals. But, I hear you when you said it's fast. On the rare occasions when my friend picks me up for work and I haven't had a chance to have breakfast yet, Mickey D's (McDonald's) sausage biscuits and a large diet Dr. Pepper are my breakfast fare.

RainSoul 2014-02-01 12:45:33 -0600 Report

I signed up for diabetes education classes, I'm following the nurses advice for how to take my meds and so far my blood sugar is running a lot lower. I ate 3 meals and 2 snacks yesterday which is hard to do with my work schedule and I took 500mg each time. When I got home my blood sugar was 139 :)

Type1Lou 2014-02-01 09:20:11 -0600 Report

You need to work on changing habits that have led you to this point IF you want to avoid all the nasty complications that come with uncontrolled diabetes: kidney failure, blindness, neuropathy, amputation, gastroparesis etc. Learn as much as you can about what causes high BG; evaluate and track what you eat and drink (how many carbs?) and how often you are eating. Do you know what your daily carb intake is? If not, find out and work on reducing it. Reading food labels for carb content is an important first step. Frequent BG testing is also helpful. You have the power to make the correct choices if you know what they are and are willing. Wishing you well.

meadowrose 2014-02-01 22:09:23 -0600 Report

I've never tried to tabulate what my actual daily carb intake is; just try to be careful of carbs at meals, at times with better success than others. That sounds like something I should start doing. The problem is, I am lousy at keeping food journals!

Type1Lou 2014-02-02 10:10:55 -0600 Report

For many years now, I've tried to limit my carbs to no more than 120 grams per day. My last A1c was 6.7. I'm a moderately active 64 year old woman who is barely 5'3" tall and have been able to keep my weight around 120 lbs. Low carb definitely works for me!

Glucerna 2014-01-31 16:10:48 -0600 Report

This sounds like a wake-up call for you, and that you're ready to make changes in your usual habits. There's quite a bit you can do to lower your A1c, and you'll find excellent information here and at Learn as much as you can and you'll feel empowered to manage your health. ~Lynn @Glucerna

Just Joyce
Just Joyce 2014-01-31 14:15:48 -0600 Report

With diabetes you cannot eat just once a day. You have to eat at least 3 healthy meals per day and drink lots of water.

Look for a diabetes education class most are free. They often have a nutrtionist there who can tell you about eating the right foods with the correct portion size.

Diabetes needs to be controlled and only you can do that. You can bring your a1c down with proper diet and exercise.

Prior to being diagnosed, I use to only eat twice a day. My doctor told me I could no longer do that. I managed to get my numbers down with patience and diet and eating habit changes. All of this takes time but as long as you do the right things you will feel an over all improvement and your numbers will go down. Good luck.

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