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This is Dr. David
yes, if you are exercising more, you should have less dose of your medication
you and your doctor should be working together on this.
your metformin can be cut down
your gliclazide can be cut down.
but you and your doctor have to do this together.
when is your next appointment with your doctor.
does your doctor know you are exercising more recently?
your pioglitazone can also be cut as well
but I would not cut all of them at the same time.
I would cut the gliclazide in 1/2 dose first and get repeat a1c testing in 2-3 months
and then see.
and continue to monitor your glucose levels.
yes, i am in full consultation with my doctor, but as i said, this is within the NHS scheme and there is never enough time to assess the situation in detail. That is what i am asking here so that i can discuss with her next time i see her in 2 months time unfortunately!
your doctor might suggest you cut the metformin dose in 1/2 or possibly the gliclazide dose in 1/2
I would cut your gliclazide dose
so i see, the safe sequence is (a) cut the gliclazide by 50% (b) retest in a couple of months.
that would be one way to go
there is no one safest way to go.
but cutting it down slowly is safest and resting.
and continuing to monitor your glucose level to show your doctors your levels are well controlled and sometimes low.
So i guess what you are saying is that i more or less have to accept the almost constant hypo which lasts well into the next day after exercise.
this would be good evidence that your dose can be cut.
and your a1c is really good.
you have to try to eat more at this point
until you can talk to your doctor about cutting your dose.
and as soon as you cut your dose, then your levels will be better.
sometimes my glucose levels when i measure at home fall to 3.5 mmol/l especially after exercise and stays low for quite some time, even after eating.
I would try to call your doctor on the phone and let him know of your low glucose levels as well
or get a sooner appointment than 2 months.
you can also see one of his partners if possible.
the sooner you can see or talk to one of the doctors, the sooner you can cut your dose and get your levels better.
does this help?
Having been diabetic since 1998, is it possible through change of lifestyle (such as i have done) to completely be free of the disease?
if you loose weight and improve your health and eat a good vegitarian diet, you can reverse or highly improve type 2 diabetes.
so it is possible to improve.
and it looks like you are improving your health and being to reverse your diabetes
continue to burn calories by exercising and you will need less and less medication
and is the only way of knowing this to gradually reduce medication while monitoring a1c? in other words there is method that is more definitive and somewhat less 'empirical'?
and there can be a time when you might not need any blood pressure or diabetes medication.
if your fasting glucose becomes normal and your a1c is normal without any diabetes medication, can reverse your diabetes and make it go away.
so it can go away.
keep up your exercise and eating healthy.
do you have any other questions?
No, that is all for now. Thank you very much. can i mail you if i have any other followup questions?
yes, you can always reach me in the future
is my webpage if you need to reach me again.
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