glipizide vs gliclazide?

[desidiabulum]

Can anyone help? I'm one of these slim '"Type 2 but doesn't really fit so maybe MODY or something else we're not quite sure we'll get back to you oh God knows the tests are inconclusive" people. Was prescribed glipizide (2.5mg before lunch and 5mg before evening meal) 2 years ago which worked fine, but then recurrent hypos in december made me beg for different meds. I was put on gliclazide (basically because the pills are bigger therefore easier to cut in half and have one before breakfast, thereby avoiding afternoon hypo -- taking 20mg before breakfast and 40mg before dinner.) No hypos (hooray) and fasting readings basically OK, but my hba1c has shot up from 6.1 to 7.2, and the spikes after meals are just wild (2 hours after meals always at least 9, sometimes up to 12.5). My testing seems to suggest that gliclazide can bring my levels down very effectively in longer term (a mere 20mg before breakfast and at 6pm I'm 5.4), but it is very slow acting, and that is presumably affecting my hba1c. The spikes are obviously a real concern.
Has anyone else experienced this with gliclazide? Glip and glic always tend to be simply grouped together, but do they act in different ways? And what's the point of being slow acting?
By the way, it would be good some time to run a thread on 'how many types of diabetes?' . One big diabetes professor told me that in the future we will be seen as having lived in a very primitive age when people assumed you were either T1 or T2 -- he forecast we will soon be talking about HUNDREDS of types of diabetes. Cf: 'Diabetes is not a single disease but a syndrome with at least fifty possible causes' (R. Tattersall, Diabetes. The biography).

 

[Daibell]

Hi. If you search the web you will find various papers comparing Glip with Glic. The differences aren't major but overall Glic seems to be marginally preferred. DUK provided a sheet in the Balance mag a couple of years back which showed that Glic had a 10 hour active life so it isn't short acting; perhaps that's why it is suggested you take it 1/2 hour before a meal. There is no such thing as just 'T1 or T2' diabetes. Even adding T1.5 etc still understates that it is almost a complete spectrum of types if you look at all the known potential causes and the problem genes found so far. One day the NHS, DUK and other countries will come out of the dark ages and stop referring to T1 or T2 as such. I guess it makes life a lot simpler for the HCPs but it means a lot of people get started on the wrong treatment, don't get the right tests etc

 

[desidiabulum]

Thanks Daibell. I'll try an hour before or even longer - see what happens.
It will take a long time for clinics to ditch the T1/T2 mentality. I went to a Diabetes Awareness Day where we all heard said professor tell us that there were huge numbers of diabetes types and that it was primitive to think in terms of just T1 and T2, and then immediately afterwards we were told to divide up into separate groups, T1 or T2. There were a gratifying number of us who didn't fit -- not just LADA, 1.5 etc. I think I'm officially 'God knows'.