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Old 09-01-2008, 06:24 PM   #1
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Question

I hear a lot of people saying they had gained weight because of diabetes medication regardless of oral medications, or insulin. For most of the people I know and including myself diabetics seem to battle with weight issues and are often over weight, or obese. I too have type 2 diabetes and also am considered obese. 4'8" and around 165 lbs. I had gained 40-50lbs from the in a years time being put onto actos. I am also insulin resistance. My question is, how are those who already deal with weight issues able to either at least stay the same weight or perferably lose weight and be healthier if our meds are making us gain weight.

I know for a fact that in my case it was the actos, because being taken off of it, I had lost that weight. Dr. is thinking of insulin because blood levels keep fluctuing. (personally I think the reason why blood levels are off is because I am on 23 different meds.) So I am trying to avoid insuling at this point.

Last edited by brattybratteddi; 09-01-2008 at 06:26 PM.

 
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Old 09-01-2008, 09:39 PM   #2
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Re: Question

Why are you on 23 different types of medicine? I assume you have other health conditions besides diabetes since that is excessive as usually diabetes can be controlled with only one or two different types of medicine...If you diabetes is not controlled with just diet and exercise you need to be on something as diabetes is not something you can ignore. I have come to realize everyone reacts differently to different meds, so what works for one, may not work for you... So just because one makes you gain weight does not mean the next will or that what made your neighbor gain weight may not have the same effect on you...Why is your doctor wanting to go to insulin with only trying one medicine, is what I want to know...there are many more oral meds out there beside actos...

 
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Old 09-01-2008, 10:40 PM   #3
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Re: Question

The unfortunate bad news is that ALL diabetes medications seek the same result, and that is the better metabolization of food intake. Therefore, a person with insulin resistance tends to gain weight when taking ANY diabetic medicine, including insulin.

Insulin is a medicine which is tailor-made for the application, too. It can be controlled to a very fine degree, where oral meds tend to be more grossly applied in the dosages available from the pharmaceutical companies.

Actos is a medicine which can also cause fluid retention, which mimics weight gain.

 
Old 09-01-2008, 10:43 PM   #4
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Re: Question

Yes, I have multiple conditions:
asthma, coronary disease (heart attack at age 37 Nov 06), high blood pressure, cholesterol, allergies, acid reflux, sleep disorder (due to pain) Chronic pain, depression, Dry skin on R, foot (due to a spider bite 10 yrs ago brown lecruse (sp), heat rash under breast (also quite endowed at least for my height 4'8"). There is a listing of all meds in the drug interaction forums as I am also concerned about the vast cocktail.

I started diabeties meds 2 yrs ago after the heart attack. Actos, and glucotrol. Actually my cardiologist had recommended the change of getting of actos, and changing my cholesterol med because the 2 were conflicting, and also within a years time I had gained 40-50 lbs. I then changed to Januvia and kept with the glucotrol. Each time I do my blood work my levels are always off. If the cholesterol is fine, then sugar is off and vice versa. Last couple of times I have shown an increase of liver enzymes, but the cholesterol is stable; but the sugar A1C had changed again. Fasting sugar is 94 and during the day runs in low 100's. usually not higher than 110. But the doctor didn't like the A1C numbers, so dr. change glocutrol from 5mg to 20mg per day (10mg 2x's daily) dinner and b4 bed, and added again actos 15mg because when I was asked about doing insulin 1 x daily I had declined. A1C came out 6.5 one time, 3 months later 7 and now 7.5 while other numbers haven't changed much ( I really don't understand stand what is going on, just know what numbers she told me) Either way, I still believe its the cocktail of meds I am on.

heart: cartia xt 120mg, aspirin 81mg, lisinopril 2.5mg, plavix 75mg, furosemide 20mg
allergies: alavert d
Constipation (due to meds): doc q lace 100mg, and senokotxtra
asthma: albuterol inhaler, spiriva, and singulair 10mg
diabeties: januvia 100mg, glucotrol 20mg, actos 15mg
acid reflux: aciphex 20mg
high cholesterol: crestor 10mg
sleep med (don't have name in front of me at the moment) Sorry, but if you like I can look it up for ya.
back and hip pain: ms contin 15 mg, es vicodin, flexmid 7.5mg
female problem (hormones and heavy bleeding): motrin 800mg
foot (and cream to help with the dry skin, and relieve itching
rash (nystatin powder)

Thing is I am on so much, and I don't feel I am getting the proper benefit of anyof them truthfully. Pain is out of control, can't sleep, asthma still flares up, still have acid reflux and heartburn, blood levels are never accurate or stable, constant headache, fatigue and frankly am frustrated with the pain in my back that is only getting worse. (am looking at a discectomy (3bad discs) in near future based on test I did last week.

Hope this helps clear up the remaining questions. I am just very frustrated, and truthfully everytime I wan't to weed off some, or most of these meds; the doctor is pushing more pills on me (yet admits if I was older this combo could have bad effects) Granted I am 39, but sheesh the vast amount of meds I am on is rediculous and truthfully I don't feel I need ALL of them.

2 years ago, I was only on albuterol, HCTZ, claritian, prilosec, and something for cholesterol. (though I did usually have on hand, motrin 800 (period) vicodin, and flexiril when back pain would bother me. At this point the motrin wasn't just for the period, it was also for the chronic pain. And frequently because of my job, or lack of transportation at the time I often over did it for my back.

My health has change dramatically in the past 2 years, where I used to love to walk, I am unable to stand or walk for more than 2 minutes without pain, numbness and weakness becomes unbearable. And franky just don't feel I am getting the proper benefits on the lot of meds.

I have considered changing primary doctors because of this, but am a little concerned about timing at the m oment as FINALLY, a doctor may have an idea of what is wrong with my back and looking at surgery soon. For the past 2 years they blamed the pain on fibromyalgia even though the MRI's had shown a herniated disc, and bulging disc. Primary was getting frustrating cause nothing worked in lessen the pain. Even what I am on right now (barely takes the edge off).

The type 2 diabeties came about since the heart attack in Nov 06.

I am just not ready or willing to use insulin at the moment unless I know for sure that is the right thing. I don't see how anyone could expect blood levels to regulated with this cocktail of meds. I still feel that there is drug interactions and no one, not even my pharmacist has been able to answer this question. I just don't understand why in the last 2 yrs my life has changed so dramatically. TO me, something just doesn't make sense and maybe perhaps the doctors are missing something, or concentrating on the various symptoms but not looking at the whole picture.

Last edited by brattybratteddi; 09-01-2008 at 10:47 PM.

 
Old 09-01-2008, 10:52 PM   #5
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Re: Question

Quote:
Originally Posted by tfkeel View Post
The unfortunate bad news is that ALL diabetes medications seek the same result, and that is the better metabolization of food intake. Therefore, a person with insulin resistance tends to gain weight when taking ANY diabetic medicine, including insulin.

Insulin is a medicine which is tailor-made for the application, too. It can be controlled to a very fine degree, where oral meds tend to be more grossly applied in the dosages available from the pharmaceutical companies.

Actos is a medicine which can also cause fluid retention, which mimics weight gain.
I noticed this myself, and I am not a doctor. But since on a water pill my weight had came down and the weight I initially gain in a years time, I lost again. But being put back onto Actos again, am afraid of it coming back. I have always battled with weight, and I really don't like to take a med, that contributes or hinders that problem.

I just feel that there is a better answer, better control and wipe off some of my meds and I would feel a lot better. I feel I am just way to much, and that is complicating things, not to mention I haven't gotten a clear answer in regards if these meds have drug interactions, or other problems.

 
Old 09-02-2008, 09:08 AM   #6
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dream77 HB User
Re: Question

maybe you should get some more opinions on whether you actually need so much medication and you aren't stuck with an over - aggressive doc

Last edited by dream77; 09-02-2008 at 09:09 AM.

 
Old 09-03-2008, 07:32 AM   #7
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Re: Question

With your HbA1c continuing to climb into the high 7's, it is wise and prudent for you to have a change in your diabetes management. You are resisting the idea of insulin and I can understand some of what might be your motivation and apprehension in doing so.

However, it was my experience that going on insulin was the best thing that ever happened to me. I had better control of my sugars and lost weight, too.
I took Actos for several years myself and had terrible fluid retention that I took off with HCTZ and Lasix.

Insulin is a NATURAL medicine. It is produced by the body... it is not treated by the body as an "invader" and has very low side effects.

I echo the words of dream77, too. Your medicines are "stacked up".... you are taking some for the reason of overcoming side effects of others and need a doctor who will "take the bull by the horns" for you and cut this lineup in half.

Quote:
I haven't gotten a clear answer in regards if these meds have drug interactions, or other problems.
There AREN'T ANY clear answers. However, doctors are very well- trained to not say "I don't know" in answer to any question. But, the TRUTH is, they don't. That's why they call it "practice"...

When you take a matrix of 23 medicines, the possible combinations which have to be explored is 23 X 23, or 529 cases of possible interaction of only the primary species. Add to this all the metabolic products of these medicines, and investigating whether or not your particular set of medicines has interactions BECOMES A CAREER....

Last edited by tfkeel; 09-03-2008 at 07:48 AM.

 
Old 09-03-2008, 10:41 AM   #8
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Re: Question

Thank you for your comments. I had gone to my pain management doctor today, so I will have to stay with my primary for a while longer as I need prior auth's for my upcoming procedures for my back. 1st step is epidural injections,(based on the discography from last week), and if that doesn't work Percutaneous discectomy Probe, then lastly possible surgery if either of these faily me. The L3-4, L4-5 and the L5-S1 are bad and are the reasons why I can't stand nor walk outside of a very minimual window of say no longer than 2 minutes and in most cases not even that.

While my sugar does remain a problem and this vast amount of medications I am on, and the constant pain it is just very frustrating to say the very least. I just have a real problem in seeing the legitamit reasons for all these meds, blood levels being off all the time (should also say potassium is often low too) and the quality of my life changing so drastically from Nov of 06 when I had the heart attack. I feel like my life has stopped, being disabled, not getting relief and just merely exhisting.

Possibly insulin would be a better answer for my blood levels, just seriously not too sure with all the other meds I am on. I realize that it is hard to get a definate answer to the interactions especially on 23 of them. I just would like to get off of someof them. Going from 5 or 6 for years (and at that time, thought it was a lot) and 2 years later going to 23 is just too much to handle, or to think about.

It bothers me also because for years I have had cholesterol, and sugar level checked and nothing ever showed up (from what I been told until 2 years ago)
Cholesterol triglycerides were off the chart at 495ish, HD level was off, and LDH didn't even registar because of the tri's.

Then factor in when they checked my sugar whle in the hospital for the heart attack my sugar level was way high and well into the 200's, at 1 point 300's and they gave me insulin at the hospital. Told me to check it out post stent, and have been on diabetic meds since. I just have problem contiplating why all these things change so dramatically in a short time and haven't been squared yet (at least together since).
The first time my doctor checked my A1c it was 10, it has since came done, but keep juggling between 6- 7.5 in the last 2 years. It is just very frustrating, and frustrating being on all these meds, andnot feeling like I am getting the proper relief or benefit from anyof them.

I am concerned about the diabeties and all the other conditions mainly cause they all run in our family so I sussceptable in getting them, and I know the complications of not having your sugar stay under control and would prefer not to go blind, or lose limbs and what not. I also know the importance of exercise (though at the moment till back is taken care of exercise is literally impossible as I am in extreme pain dialy (usually in the 8-10+++++) area daily. (And actually I do have a high tolerance to pain). I worked with chipped and broken bones, I have worked the day after surgery in getting pins out into my hand, and taken out. I have always had weak ankles, knees, hips and always had pain in those areas as well. I have always had a chronic bad back, I am just not used to meds not working, or barely taking off the edge. The pain I deal with daily is from damage to the scaitic nerve, constantly inflammation (you can feel the heat coming from those parts). I really do try not to take the pain meds so as not to get addicted to them, and especially since they aren't really working don't see much of a benefit in taking them. This pain is just unbearable and hard to discribe. But can say exercise is just not in the picture at the moment as a result.

I hate to be gaining weight like I am especially since I know I am already obese, if not morbilly obese and ballon because of these meds. So frustrated at this as well. Especially since I don't eat a whole lot, not out of the daily servings, don't binge on sugary sweets and what not, drink a lot of water, eat lots of fruits and veggies. In fact in general eatting a whole lot better now since post heart attack than I ever had and yet my life seems to be in a huge downward spiral and getting health getting worse regardless of what I do. Frustrating is a serious understatement to say the least.

Last edited by brattybratteddi; 09-03-2008 at 10:54 AM.

 
Old 09-03-2008, 01:20 PM   #9
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Re: Question

I think, once your back problems are corrected with surgery, or possibly without, you will have less pain and be more able to exercise. This will improve your general health by bounds....

right now, every factor is working against you....

In the interim, could you try some aquatic therapy? This takes the weight off your back and lets you do some water aerobics or something. You will find that this stimulates endorphins, the body's natural pain reliever. Except this is a pain reliever that actually works, not just make you not care about the pain like narcotics do. A swimming pool is ok, but probably won't feel as good as the nice, warm water of a therapy pool.

Hypokalemia is a constant problem with diuretics like furosemide. Your electrolyte balance in general gets affected by this drug, too. You can find yourself feeling quite depleted of energy and depressed.

There is a formula called Pedialyte which can help you replace electrolyte balance. If you are going to continue furosemide you probably need to be on a potassium supplement, too.

See.... there's just no end to drugs. You take one, you get another problem, which requires another.....

And, now, you are so balled up that doctors are going to throw up their hands and not change anything if they can somehow regard you as "stable".... never mind that the quality of your life is zip....they will justify this in their own minds that you are "tolerating" the meds ok. But, in truth, they are making you miserable and taking away your life.

You, I'm afraid, are going to have to take the initiative here.

Reduce your carbohydrate intake. Eat your vegetables and lean meats such as chicken and turkey. This will bring your sugar down. As your fat content in your diet goes down, the tendency is going to be that you will be more constipated. Make sure you drink plenty of plain water. A fiber supplement such as Metamucil or Citrucel might help, too.

You are right that your current constipation is due to meds.

If you find yourself with "asthma" attacks frequently, I would not be surprised to learn that it is somewhat due to lisinopril. This class of drugs is notoriously bad and causes about 20% of people to have a vicious cough and worse.

If you lose weight, you will need less med to control your blood pressure. Lisinopril can be replaced with an Angiotensin-receptor blocker such as Avapro or Diovan - if you actually need it....You are on a low dose of lisinopril, you may only be getting the side effects of it and not affecting your BP much at all.

A low-carbohydrate diet has a natural diuretic effect, too.

Last edited by tfkeel; 09-03-2008 at 01:27 PM.

 
Old 09-03-2008, 06:54 PM   #10
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Re: Question

Thank you again with your information. On the plus side of things my BP has been consistantly low, and from what the Drs. tell me that is their intentions of keeping it low on purpose so I don't have another heart attack. My BP stays consistantly around 100/68 with little fluctuations either up, or down. But never stays at the normal 120/80 always less than that.

Again, its just frustrating, and yes hoping if I can get relief with my back I can lose weight, and exericse again. Being off Actos for 8 months I lost the original weight I gained because of it. However, since being put back on it again in the last month I have gained almost 10 lbs. URGH!!!!!

My goal as well as trying to keep sugar regulated, or try to, is to find relief from my back and hips and hope for no permanet effects or damage and be able to regain my lif back. I have lost so much in the last 2 years its frustrating and depressing. Not to mention dealing with constant pain, and doctors throwing more, and more pills my way. Its not an exageration when I say I have a travel cosmetic bag 8x13 approx. completely filled with meds. (not including test strip and lancets). They are separate as there is no room for them with the rest of meds. Just seriously really frustrated.

In my opinion, I don't feel I need more meds and don't want any more either. I just would like to get rid a lot of the ones I currently have.

 
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