Opinions on Gliclazide in combination with LC diet

[pleinster]

Hi. I've been doing really well on a very low carb diet, having come off my Gliclazide (own choice) as it wasn't being particularly effective (despite being doubled from 80 to 160 mg)....and levels had really dropped, but yesterday my BS spiked unusually (going from 5.9 premeal to 9.8 a couple of hours later and rising to 10.4,taking about five hours to drop into the normal range again). My meal had next to no carbs in it. I checked with a separate meter, so it's definitely the level. Question is...I still have some Gliclazide, and think I will try some later today as maybe it will have a better effect now that my diet is under control. I also have a wee spike from a steroid I take and that was coming down nicely too but it's up today for first time in ages. Not a good day at all. Pretty fed up atm. Any advice would be greatly appreciated. Anyone on this kind of diet who had stopped taking Gliclazide and went back on it? Any joy at all?

 

[Lamont D]

You are just having one of those days, for no reason whatsoever, your bloods are just higher than normal.
You are doing well, so what's the panic, your body is adjusting again and it's just a hiccup!
Take it easy, relax and see what your blood levels are like in the morning!
Stopping and starting meds is not recommended in such a short time.
If you are happy so far without the glicizide and your average blood glucose levels are generally descending, what's the problem. It's a marathon not a sprint!

 

[Oldvatr]

Hi. I've been doing really well on a very low carb diet, having come off my Gliclazide (own choice) as it wasn't being particularly effective (despite being doubled from 80 to 160 mg)....and levels had really dropped, but yesterday my BS spiked unusually (going from 5.9 premeal to 9.8 a couple of hours later and rising to 10.4,taking about five hours to drop into the normal range again). My meal had next to no carbs in it. I checked with a separate meter, so it's definitely the level. Question is...I still have some Gliclazide, and think I will try some later today as maybe it will have a better effect now that my diet is under control. I also have a wee spike from a steroid I take and that was coming down nicely too but it's up today for first time in ages. Not a good day at all. Pretty fed up atm. Any advice would be greatly appreciated. Anyone on this kind of diet who had stopped taking Gliclazide and went back on it? Any joy at all?

Well done on coming off meds. I too am on Gliclazide, and my bgl was bouncing around like a pinpong ball on heat. I managed to calm it down a bit by altering the timings of my meds, I am still on the same meds and dosage, but they are distributed differently wrt mealtimes. Recently i started Bitter melon, and was very surprised to see all 4 of my daily readings converge together and drop together to a stable daily average of 6.4 mmol/L. It rose back up and diverged when i stopped the Bitter Melon. It works for me so I will be back on it again soon. One thought, bgl readings are affected by the GI Load of meal, and if your meal was low GI then maybe the spike moved to the right or flattened out a bit so it became noticeable at the time you tested. One other thing that could be behind the spike is a so called LiverDump, which the body does sometimes if it thinks your bgl has been too low for too long - it is a defence mechanism against starvation, and is prevalent for those on a ketonic diet. The glucose in Liverdump comes from stored glucose in your cells. (King Midas in Reverse - see Krebs Cycle for explanation)

 

[Lamont D]

Well done on coming off meds. I too am on Gliclazide, and my bgl was bouncing around like a pinpong ball on heat. I managed to calm it down a bit by altering the timings of my meds, I am still on the same meds and dosage, but they are distributed differently wrt mealtimes. Recently i started Bitter melon, and was very surprised to see all 4 of my daily readings converge together and drop together to a stable daily average of 6.4 mmol/L. It rose back up and diverged when i stopped the Bitter Melon. It works for me so I will be back on it again soon. One thought, bgl readings are affected by the GI Load of meal, and if your meal was low GI then maybe the spike moved to the right or flattened out a bit so it became noticeable at the time you tested. One other thing that could be behind the spike is a so called LiverDump, which the body does sometimes if it thinks your bgl has been too low for too long - it is a defence mechanism against starvation, and is prevalent for those on a ketonic diet. The glucose in Liverdump comes from stored glucose in your cells. (King Midas in Reverse - see Krebs Cycle for explanation)

Hi, good post and good explanation!
Well done on your readings!
Why are you only testing four times a day?
I'm ketogenic and have been for a couple of years, I have to be!
I cannot go by low GI, they are still carbs and if I was recommending a low carb diet, I would not subscribe to a diet, where someone has a grain tolerance or a starch tolerance like myself. It is difficult enough for newbies to wade through misinformation like this.
What I would recommend in this situation is to reduce all carbs and not promote so called healthy carbs!

Also liver dumps or dawn phenomenon can happen to anyone and not just ketogenic posters like myself. I have never knowingly had a liver dump whilst in ketosis.

Everyone is different, no two are the same and even though your advice is good, it can be misinterpreted.

I hope you continue to post as you do give good advice!

 

[Oldvatr]

Hi, good post and good explanation!
Well done on your readings!
Why are you only testing four times a day?
I'm ketogenic and have been for a couple of years, I have to be!
I cannot go by low GI, they are still carbs and if I was recommending a low carb diet, I would not subscribe to a diet, where someone has a grain tolerance or a starch tolerance like myself. It is difficult enough for newbies to wade through misinformation like this.
What I would recommend in this situation is to reduce all carbs and not promote so called healthy carbs!

Also liver dumps or dawn phenomenon can happen to anyone and not just ketogenic posters like myself. I have never knowingly had a liver dump whilst in ketosis.

Everyone is different, no two are the same and even though your advice is good, it can be misinterpreted.

I hope you continue to post as you do give good advice!

Hi nosher. I am T2D and so I had to fight hard for my test strip support by my GP. Testing 4 times a day is a luxury for me, so I do fasting am, premeal, 2hr PP, and 4hr PP. This gives me a daily running average that is close to my HBA1c (within 0.5 mmol/L). The reason why I bought up ketogenic diets is that I had a work colleague who went on Atkins in big way, and ended up in emergency in a coma. He did recover, but it has made me sensitive to diets that push the envelope to lose weight too quickly. This LC technique does bring us closer to the point where our body automatically takes evading action if the low bgl continues for too long. I too get liverdumps because I fast for half the day, and if I don't have proper breakfast (with carbs) then I get high evening bgl. I use GI slightly myself to reduce my spikes, but I am not a slave to it. I am just using food swaps to remove the very high carb culprits. I am currently using LCHF diet guidelines for same reason, but at present i get too close to hypo territory for comfort, so am backing off LC a bit at present. I am also at my target weight so do not have a weight loss agenda to follow.

 

[Lamont D]

Hi @Oldvatr.
Sorry for the questions, but why do you test at fours hours?
I know the fight for strips, I had to get my consultant to intervene on my behalf!
My mate did Atkins and it was in desperation and it didn't work, not enough fresh vegetables for me!
Just wondering why you think you are going close to hypo territory?
I have to live like that forever, so that thought has never crossed my mind. Is it because of the glicizide? I don't get that you need to bump your numbers up with other than low carb. Using high GI carbs will bounce your bloods around and you won't be in control! Control is very important in getting your bloods average hba1c levels down.
If you are getting normal fasting readings, maybe a word with your doctor and diet, should get you free of it!
Glicizide should be only used as a blood glucose lowering drug temporarily. It shouldn't be for a long period. If it works you come off it, if it doesn't other meds or insulin depending on insulin resistance.
Diet is always a personal choice because of tastes and affordability. If you continually eat low carb with the necessary full fat and ignore the medium to high GI foods, then your control will be better and the need for glicizide will not be necessary.

Hope I'm not confusing you. I am trying to explain this through my experience.

 

[Oldvatr]

Hi @Oldvatr.
Sorry for the questions, but why do you test at fours hours?
I know the fight for strips, I had to get my consultant to intervene on my behalf!
My mate did Atkins and it was in desperation and it didn't work, not enough fresh vegetables for me!
Just wondering why you think you are going close to hypo territory?
I have to live like that forever, so that thought has never crossed my mind. Is it because of the glicizide? I don't get that you need to bump your numbers up with other than low carb. Using high GI carbs will bounce your bloods around and you won't be in control! Control is very important in getting your bloods average hba1c levels down.
If you are getting normal fasting readings, maybe a word with your doctor and diet, should get you free of it!
Glicizide should be only used as a blood glucose lowering drug temporarily. It shouldn't be for a long period. If it works you come off it, if it doesn't other meds or insulin depending on insulin resistance.
Diet is always a personal choice because of tastes and affordability. If you continually eat low carb with the necessary full fat and ignore the medium to high GI foods, then your control will be better and the need for glicizide will not be necessary.

Hope I'm not confusing you. I am trying to explain this through my experience.

Hi. My DCN advised my test regime in conjunction with my GP (who pays for the strips) and ir is similar to regimes i have seen on other forums. It gives the closest moving average to my HBA1c. I think the reason why is because although the other regime of Pre, 1 hrPP, 2 hrPP shows the peak spike at 1hr after a meal, if that spike is fast acting then it has little effect on the Hba1c. Current thinking appears to be that the 2 and 4 hr tests give better indication of the harmful peaks that tend to last longer than the medication half life. I work on deltas to guage how foods affect me, so a falling reading at 2 hrs is good news, a rising delta at 4 hrs is bad news, and tends to show in the morning reading as well since the Gliclazide effect has washed out by 4 hrs, so I am raised all night. That is my understanding of my test phikosophy. I have only recently started LCHF diet, so have only just started learning how to control it. The Gliclazide does cause me to get too low, and I am learning how to delay or omit a dose to compensate. I never hypo'd until I started LCHF, but am getting sub 4.2 mmol.L readings regularly. I do not sleep comfortably with a level that low at bedtime, and could end up sleeping too well. I will not risk it, So, I am adjusting my meds and also my carbs to suit. I cannot see my DCN, or the dietician, or my GP until April - May next year, so I am left to experiment. With a daily average of between 6.4 and 7.1, I am happy with what I have achieved so far. Six months ago my average was 15.9, my HBa1c was 99, and I was getting PP readings in the 30's.

 

[Lamont D]

Yes you have done great, but now, you need to stabilize and control your blood glucose levels by mainly diet.
I've heard about the 'must be above 8mmols' before but not for T2s!
I can understand the theory, but as I've said I don't have the problem.
I don't have a problem sleeping at that (normal) level, but I did when my bloods were bouncing around all the time.
Sleep disruption is severe as a fluctuating reactive hypoglycaemic, especially what I call hypo hell!
If your not aware of my condition, we spike very quickly and use our glucose up so we have an excess of insulin, so after a few hours we hypo! If we don't hyper, we don't hypo!
Only very low carb does this, we have to have complete control over our blood glucose levels and eat little and often, small meals! I was testing at least nine times a day.
When the most important thing is control, then after the experimental stage and testing and recording and then seeing the patterns.
You realise what's good for you and what's not!
Staying in ketosis for me is a no brainer!
It is what works and keeping me fit and healthy.

I understand your logic and I think you are doing great but keep up with the low carb. It works! It really does!

By the time you see your dn you should be in normal range, lost weight, feel healthier and off most of your meds.

But everyone is different and any way that works is great!

 

[Oldvatr]

Yes you have done great, but now, you need to stabilize and control your blood glucose levels by mainly diet.
I've heard about the 'must be above 8mmols' before but not for T2s!
I can understand the theory, but as I've said I don't have the problem.
I don't have a problem sleeping at that (normal) level, but I did when my bloods were bouncing around all the time.
Sleep disruption is severe as a fluctuating reactive hypoglycaemic, especially what I call hypo hell!
If your not aware of my condition, we spike very quickly and use our glucose up so we have an excess of insulin, so after a few hours we hypo! If we don't hyper, we don't hypo!
Only very low carb does this, we have to have complete control over our blood glucose levels and eat little and often, small meals! I was testing at least nine times a day.
When the most important thing is control, then after the experimental stage and testing and recording and then seeing the patterns.
You realise what's good for you and what's not!
Staying in ketosis for me is a no brainer!
It is what works and keeping me fit and healthy.

I understand your logic and I think you are doing great but keep up with the low carb. It works! It really does!

By the time you see your dn you should be in normal range, lost weight, feel healthier and off most of your meds.

But everyone is different and any way that works is great!

Thanks. I was unaware of what reactive hypoglycaemia was, but reading your description I can see where you are coming from. i am lucky in that as a T2 I perhaps have more leeway in what I do. My status as a Newbie shows I am on a learning journey myself, but I do have 8 years in post training. I agree that LC solves some of my problems, but It produces weight loss that I do not need at this time. I am looking at HF to compensate, but should I believe the current advice that saturated fats are ok, or am I building up long term problems? I have already had two strokes and a heart attack, so need to be aware that current advice could be wrong. I am trying to do a soft landing with my bgl and aim to reduce my medication, but not by cold turkey,but by softly softly catchee monkey. I think we have moved away from the OP, so I will end by making it clear that for me Glicazide and LC does not integrate very well, and that I prefer to drop the tabs in favour of diet. i am happy to use Gliclazide for the moment, but only while I adjust my apparel. Night all......

 

[Lamont D]

I only use saturated fats as there is now scientific evidence linking polyunsaturated fats and visceral fats!

Keep learning, keep posting!

Have a good sleep!

 

[pleinster]

Th

Well done on coming off meds. I too am on Gliclazide, and my bgl was bouncing around like a pinpong ball on heat. I managed to calm it down a bit by altering the timings of my meds, I am still on the same meds and dosage, but they are distributed differently wrt mealtimes. Recently i started Bitter melon, and was very surprised to see all 4 of my daily readings converge together and drop together to a stable daily average of 6.4 mmol/L. It rose back up and diverged when i stopped the Bitter Melon. It works for me so I will be back on it again soon. One thought, bgl readings are affected by the GI Load of meal, and if your meal was low GI then maybe the spike moved to the right or flattened out a bit so it became noticeable at the time you tested. One other thing that could be behind the spike is a so called LiverDump, which the body does sometimes if it thinks your bgl has been too low for too long - it is a defence mechanism against starvation, and is prevalent for those on a ketonic diet. The glucose in Liverdump comes from stored glucose in your cells. (King Midas in Reverse - see Krebs Cycle for explanation)

Thanks for that. Bitter melon sounds well worth a try. I shall take the GI on board and experiment a bit. I have just been working on the principle that I should get my carb intake right down as it was lowering my levels well, and because I feel healthier and don't struggle much to stick to it...in fact it's a relatively enjoyable challenge...but I've not given much thought to how long it takes certain things to be absorbed. I shall now. I'm thinking a wee handful of protein nuts I had immediately post meal may have been the culprit, but appreciate very much your words on this liver dump thing. Thanks a lot.

 

[Oldvatr]

I sm happy that you now have some things to explore. I am happy to share my experiences, and Bitter Melon is one I find works for me. It may not work for you, but its probably worth a try. Its also cheap. I do emphasise that for me it did nothing for a week or so, then suddenly and dramatically dropped my bgl like a stone. My daily average dropped about 5 mmol/L within a couple of days,so keep an eye on it. In my case I started LC AFTER the Bitter melon kicked in, so was starting from a safe level (around 9 mmol/L) but if you are already low with LC diet, then I am not sure if it will drop you too kow. I use BM to replace my Glicazide at the moment.

 

[pleinster]

I sm happy that you now have some things to explore. I am happy to share my experiences, and Bitter Melon is one I find works for me. It may not work for you, but its probably worth a try. Its also cheap. I do emphasise that for me it did nothing for a week or so, then suddenly and dramatically dropped my bgl like a stone. My daily average dropped about 5 mmol/L within a couple of days,so keep an eye on it. In my case I started LC AFTER the Bitter melon kicked in, so was starting from a safe level (around 9 mmol/L) but if you are already low with LC diet, then I am not sure if it will drop you too kow. I use BM to replace my Glicazide at the moment.

Much appreciated. Thanks.

 

[uart]

It may not work for you, but its probably worth a try. Its also cheap.

Hi Oldvatr. In what form do you take bitter melon. Is it the fresh vegetable or a dried extract in tablet or capsule form? Also, could you tell us where do you get it and what is the cost. Thanks.

 

[Oldvatr]

I had not intended hijacking this thread, so will be brief. i buy my Bitter Melon in capsule form via a large internet distributor (not sure if tradenames are acceptable here) The brand is supplied by a reputable source of supplements. The cost is around 3 GBP for 60 tabs with free UK delivery. I find 2 tabs a day produces a good effect for me, but it takes a week or so to kick in.

 

[Oldvatr]

Much appreciated. Thanks.

Hi Pleinster, Just to give you an update on my Bitter Melon experience. Last month I stopped taking it, and my bgl went out of control quite quiclky, I have recently started taking it again, and at the start my bgl was bouncing around like the Bally table king, (range 8 - 15 mmol/L). Three days ago it kicked in midday. My a.m. bgl was around 10, then the next 11 consecutive readings have all been in the range 6.1- 8.1 and my daily average has dropped from 9.2 to 6.6. Like I said, for me it is a sudden change, like a switch being pulled. I bought 3 months supply for Xmas, and will try to report back later. (I will probably start a new thread for this)

 

[pleinster]

Hi Pleinster, Just to give you an update on my Bitter Melon experience. Last month I stopped taking it, and my bgl went out of control quite quiclky, I have recently started taking it again, and at the start my bgl was bouncing around like the Bally table king, (range 8 - 15 mmol/L). Three days ago it kicked in midday. My a.m. bgl was around 10, then the next 11 consecutive readings have all been in the range 6.1- 8.1 and my daily average has dropped from 9.2 to 6.6. Like I said, for me it is a sudden change, like a switch being pulled. I bought 3 months supply for Xmas, and will try to report back later. (I will probably start a new thread for this)

Thanks for the update. I shall definitely try it. I'm following you now (sounds real creepy) but a new thread would be good, I think. Cheers.

 

[Oldvatr]

Thanks for the update. I shall definitely try it. I'm following you now (sounds real creepy) but a new thread would be good, I think. Cheers.

I have opened a thread on Bitter Melon in the Diabetes Discussions section of the Forum.

 

[Oldvatr]

I have opened a thread on Bitter Melon in the Diabetes Discussions section of the Forum.

Apparently I opened it up in the wrong section, and it has been redirected. It is now in the Mind, Body and Spirit section instead