Newbie T2 and Gluclazide

[AnnM99]

Hi everyone,
Not sure where to start but here goes.
Feeling a complete nervous wreck. Diagnosed 3rd June. Told levels were 85. Cholesterol 6.8.
Im 48, BMI 25.
After a brief phone chat with nurse, (most of which I was crying!) I have been given Gliclazide to take. Nothing else. 1 x 80mg with breakfast and 1 x 80mg with dinner. Been told to test bs both times before eating/taking pills as can cause hypos. Other advice: watch your carbs. So.... Pills still in box.... Too scared to take..... Main thought going round and round in my head..... Is this the right treatment?????? I thought Metformin was first treatment. Spoke to GP last night who did nothing to reassure me. In fact, seemed irritated by me asking questions and said "up to you if you take it or not" and that's how the conversation ended. I'm a mess this morning. Any help or advice appreciated. Thanks.

 

[Goonergal]

Hi @AnnM99 and welcome

Sorry that you’ve been left a bit in limbo, but the good news is that you’ve come to the right place for advice and support.

If you have concerns about the medication you’ve been prescribed, then you’re absolutely right to ask your GP for further information and clarify your options.

The decision you make about which (if any) medication to take will directly impact the sort of advice we give here, so please bear that in mind.

Other advice: watch your carbs.

In my opinion, for a type 2, that’s the best advice you’ve been given. If you’re on no diabetes medication or just metformin, then reducing your carbs as much as you’re comfortable with/as far as you need (guided by your meter) then that will be the fastest, most effective way to bring your blood sugars down. Many of us here have got down to non-diabetic numbers doing just that, often from a similar (or higher) starting point than yours, so it can be done!

There is a fabulous website that explains more about this - https://www.dietdoctor.com/ - no need to take the paid options (unless you want to).

up to you if you take it or not

Bearing in mind the points above, it seems you’ve been given an option to make your own decision on this. If you do start taking the Gliclazide, you will need to be aware of hypos and I’d recommend having support from the GP if you want to cut carbs significantly while taking it.

It sounds like you’ve been given a blood glucose monitor and that will be your best friend, whatever you decide. The idea is to test immediately before eating and then again 2 hours after the first bite. You’re looking for a rise of no more than 2 mmols. Any more and the meal needs adjusting to reduce carbs.

I hope this helps a bit, but please have a good read around the forum and keep asking questions.

 

[AnnM99]

Hi. Thanks for replying. I've not started the Gliclazide and am reluctant to until I've changed my diet and lost 7 pounds. Then, I'd like to see what it's like. I was told to test presumably as they thought I'd take tablets but using the monitor anyway!!!

 

[AnnM99]

Yes, certainly been left in limbo!!! Very upset this morning. Hardly slept. Don't know if I'm doing wrong by not taking them.

 

[Goonergal]

Yes, certainly been left in limbo!!! Very upset this morning. Hardly slept. Don't know if I'm doing wrong by not taking them.

The thing to remember is that you are in charge of what goes into your mouth/body. The GP and nurse can provide suggestions and guidance, but ultimately it’s your decision. If you’re inclined to give diet a whirl, then it’s definitely worth a shot and you can always add meds in later if that doesn’t work for you.

 

[VashtiB]

Hello and welcome,

I echo the advice given by @Goonergal . This site really is the best place for advice and support

So you have a meter. When I started I tested a lot- at least 10 times a day- I was worried anxious not to mention obsessive. Having said that you will likely test a lot more in the early weeks than later on. This is the time to find out how different levels and types of carbs affect you.

Also stress and anxiety affect levels. This was definitely something I wished I had know earlier. I was very upset. it took at least 2 weeks before I wasn't in tears at least once a day. The awesome people on here helped me so so much.

So if you are not taking any medication then you have to worry about hypos a lot less. That doesn't mean you may not suffer false hypos but your meter is your guide. If you get into the 4s early let us know. I do now get into the 4s but it took me a while.

So your meter will help you work out how many carbs your body can tolerate. If you need food ideas- the diet doctor website is helpful or post here and people will give suggestions.

Read around and post. I can promise that one day you will be able to look back and feel a lot lot better than you do now. Some of the nicest people I know I have 'met' here and finding this site is the best thing that came from my diagnosis .

Welcome.

 

[jaywak]

If you can stay off the meds with just a few lifestyle changes thats got to be the best advice , But don't worry to much if you can't it's certainly not the end of the world .

 

[EllieM]

If you get into the 4s early let us know. I do now get into the 4s but it took me a while.

@AnnM99
The 4s are not hypo. (though you may feel like it if you aren't used to those levels). Hypos are an issue for people who take insulin (or drugs such as gliclazide which stimulate insulin production). If you are not on meds then I wouldn't worry. Non diabetics can go down into the threes and just feel hangry (yes, spelling is deliberate).

Having said that, if you get into the 4s without meds, then congratulations.

 

[Andydragon]

@AnnM99
The 4s are not hypo. (though you may feel like it if you aren't used to those levels). Hypos are an issue for people who take insulin (or drugs such as gliclazide which stimulate insulin production). If you are not on meds then I wouldn't worry. Non diabetics can go down into the threes and just feel hangry (yes, spelling is deliberate).

Having said that, if you get into the 4s without meds, then congratulations.

From a type 2 not on drugs now, I can attest to going sub 4 and being fine. Generally after a longer day without eating or after intense cardio will be what pushes me to those levels (3.5 or lowest 2.5 (but i think my meter was well into inaccuracy at the bottom of that)). I actually don’t feel the effects like I used to when I was really hangry at the 5s or 6s, so yeah, body adjusts

Hangry is such a good way of describing it. Stand between me and eating with those sensations at your peril!

 

[Daibell]

Hi. This is difficult. Yes, Metformin is the standard first med if you are T2. It has a limited effect, is very safe and very few side effects apart from some bowel issues for a while. It mainly works by reducing the glucose output from the liver. Gliclazide is used where it is believed the pancreatic beta cells are under-producing insulin. A C-peptide text would be needed to show how much insulin you are producing. If you have a meter and have frequent BS highs into the teens that would be an indicator. I was on Gliclazide max dose for a few years as a LADA. I would certainly try low-carb to see if you can reduce your weight/BMI a bit and you may not need any meds. I'm not sure how you persuade your GP to prescribe Metformin rather than Gliclazide other than saying you don't want to risk hypos and that most of your diabetic friends take Metformin?

 

[AnnM99]

Hi. This is difficult. Yes, Metformin is the standard first med if you are T2. It has a limited effect, is very safe and very few side effects apart from some bowel issues for a while. It mainly works by reducing the glucose output from the liver. Gliclazide is used where it is believed the pancreatic beta cells are under-producing insulin. A C-peptide text would be needed to show how much insulin you are producing. If you have a meter and have frequent BS highs into the teens that would be an indicator. I was on Gliclazide max dose for a few years as a LADA. I would certainly try low-carb to see if you can reduce your weight/BMI a bit and you may not need any meds. I'm not sure how you persuade your GP to prescribe Metformin rather than Gliclazide other than saying you don't want to risk hypos and that most of your diabetic friends take Metformin?

Thank you so much for this. I didn't know about a c peptide test. Gp upset me do much last night. Told me I'm 'over thinking' it and he agrees with the DN that I should be on Gliclazide x 2 because I was 85. He said no amount of dieting will change the result and was clearly irritated to the point he said 'thank you, that's all I have to say. Goodbye'. Didn't tell me anything about a c peptide test. I suppose I'm concerned because Metformin is the first line treatment and a friends friend (also diabetic nurse) was shocked I'd been put on Gliclazide as a first option. I'm currently not taking any meds. The box of tabs is on the window sill. I was 7 this morning, has breakfast, 2 hours later 9.9 but I had steel cut porridge with pear. I hardly slept last night, have been crying lots and feel like the gp has washed his hands of me. Now thinking I should change gp. No idea what to do. Don't want to damage my health by taking them but don't want yo damage my health by not raking them or another treatment.

 

[JoKalsbeek]

Hi everyone,
Not sure where to start but here goes.
Feeling a complete nervous wreck. Diagnosed 3rd June. Told levels were 85. Cholesterol 6.8.
Im 48, BMI 25.
After a brief phone chat with nurse, (most of which I was crying!) I have been given Gliclazide to take. Nothing else. 1 x 80mg with breakfast and 1 x 80mg with dinner. Been told to test bs both times before eating/taking pills as can cause hypos. Other advice: watch your carbs. So.... Pills still in box.... Too scared to take..... Main thought going round and round in my head..... Is this the right treatment?????? I thought Metformin was first treatment. Spoke to GP last night who did nothing to reassure me. In fact, seemed irritated by me asking questions and said "up to you if you take it or not" and that's how the conversation ended. I'm a mess this morning. Any help or advice appreciated. Thanks.

*sigh* I'm so sorry you're going through this! And while "watch the carbs" is good advice, mixing that advice with a drug like gliclazide isn't exactly a wise move... Hypo's are indeed a possibility, so you're absolutely right to hold off on the glic for now. As for metformin, it is the usual first port of call. Ironically enough, if you read the leaflet, it says to try diet first for 3 months. And if that fails, to start the met.

I'd say, start off with the dietary changes. Cut the carbs, up the fats, keep protein moderate. And yes, yes, a thousand times yes, use that meter! Test before a meal and 2 hours after the first bite, you're aiming for a rise of no more than 2.0 mmol/l. You're asking the right questions, do NOT let the response from the GP and nurse get to you, okay? Getting a T2 diagnosis isn't something you deal with every day, so yeah, there's the whole crying and confusion and fear thing, and if they don't understand that that's all part of this, then they're.... Well, a word I can't use on here without being moderated. Just know your reaction is normal, your questions are excellent, and you know what else...? You're going to be okay. The bulk of us were in your scared, upset shoes once upon a time. Now we're on here giving advice on how to kick high blood sugars to the curb. Before long you'll be able to do the same.

There's hope here. Be good to yourself eh. And maybe not mention that you're not taking the glic just yet, because they'll stop giving you test strips if they know. (The bulk of us here self-fund).

Hugs,
Jo

 

[JoKalsbeek]

Thank you so much for this. I didn't know about a c peptide test. Gp upset me do much last night. Told me I'm 'over thinking' it and he agrees with the DN that I should be on Gliclazide x 2 because I was 85. He said no amount of dieting will change the result and was clearly irritated to the point he said 'thank you, that's all I have to say. Goodbye'. Didn't tell me anything about a c peptide test. I suppose I'm concerned because Metformin is the first line treatment and a friends friend (also diabetic nurse) was shocked I'd been put on Gliclazide as a first option. I'm currently not taking any meds. The box of tabs is on the window sill. I was 7 this morning, has breakfast, 2 hours later 9.9 but I had steel cut porridge with pear. I hardly slept last night, have been crying lots and feel like the gp has washed his hands of me. Now thinking I should change gp. No idea what to do. Don't want to damage my health by taking them but don't want yo damage my health by not raking them or another treatment.

How long after the oats and pear did you test? That breakfast would send my blood sugars into the stratosphere. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ and dietdoctor.com might help find more suitable breakfasts. And for your information, my HbA1c was significantly higher than yours, I had non-alcoholic fatty liver disease, was morbidly obese and whatnot.... And all that got sorted solely on diet. It CAN be done. Also, don't worry about your cholesterol. I really hope you haven't been automatically put on statins, because those can raise blood sugars, and in some people, cause T2. Just so you know. Get your blood sugars under control and the rest'll improve too, okay?

And yes, maybe get a new GP. This one's..... Another something I can't say on here.

 

[Resurgam]

Thank you so much for this. I didn't know about a c peptide test. Gp upset me do much last night. Told me I'm 'over thinking' it and he agrees with the DN that I should be on Gliclazide x 2 because I was 85. He said no amount of dieting will change the result and was clearly irritated to the point he said 'thank you, that's all I have to say. Goodbye'. Didn't tell me anything about a c peptide test. I suppose I'm concerned because Metformin is the first line treatment and a friends friend (also diabetic nurse) was shocked I'd been put on Gliclazide as a first option. I'm currently not taking any meds. The box of tabs is on the window sill. I was 7 this morning, has breakfast, 2 hours later 9.9 but I had steel cut porridge with pear. I hardly slept last night, have been crying lots and feel like the gp has washed his hands of me. Now thinking I should change gp. No idea what to do. Don't want to damage my health by taking them but don't want yo damage my health by not raking them or another treatment.

I have not had any contact with my GP since diagnosis in 2016 - but don't need any really.
My personal experience after giving up the tablets prescribed, as the side effects were dreadful, is that eating a low carb diet resolved a lot of problems completely.
My Hba1c was 91 at diagnosis. 80 days later it was 47, no longer classed as diabetic, and at 6 months I was at the top end of normal and felt a lot better.
The essential information for a type 2 diabetic is 'its the carbohydrate doing the damage'.
Eating sugar and starch for breakfast is not a good idea, it will spike your blood glucose and start the day badly.
My breakfast was lamb and mushrooms.
Dinner will probably be chicken with mashed swede and mixed veges.
Coffee with cream to drink otherwise water, and I'll have normal blood glucose levels and be fine.
As long as you are an ordinary type 2 with nothing extra interesting thrown in, the first thing to try if being sensible, is to reduce the source of the problem, which is carbohydrate in the diet. Your GP seems to have no idea at all if he thinks that no amount of dieting will change your Hba1c - and then to get shirty at your suggestion that it might. He has obviously got no expertise when it comes to treating us.

 

[KK123]

Thank you so much for this. I didn't know about a c peptide test. Gp upset me do much last night. Told me I'm 'over thinking' it and he agrees with the DN that I should be on Gliclazide x 2 because I was 85. He said no amount of dieting will change the result and was clearly irritated to the point he said 'thank you, that's all I have to say. Goodbye'. Didn't tell me anything about a c peptide test. I suppose I'm concerned because Metformin is the first line treatment and a friends friend (also diabetic nurse) was shocked I'd been put on Gliclazide as a first option. I'm currently not taking any meds. The box of tabs is on the window sill. I was 7 this morning, has breakfast, 2 hours later 9.9 but I had steel cut porridge with pear. I hardly slept last night, have been crying lots and feel like the gp has washed his hands of me. Now thinking I should change gp. No idea what to do. Don't want to damage my health by taking them but don't want yo damage my health by not raking them or another treatment.

Hi there, your friend's nurse friend (!) may well be right generally speaking but it's not right for her to be 'shocked' at what has been prescribed for another person, when she does not know your exact circumstances. I suspect that because your hb1ac was high, the GP wants to get it down more quickly than what he feels a change in diet may do. He hasn't seen this site.......As long as there is no chance of you actually being type 1/lada, then it really is up to you whether to take that medication. In your position, I would see what happens over the next few weeks, record everything and obtain the data as you are already doing. Make a decision as to how many carbs you wish to eat, if you decide on low/lower carb then the porridge and pears will probably have to go (you could hardly get a higher carb combination!!) but again it's all about a person's carb threshold. I think your Gp is making assumptions about people with diabetes and going with the nonsensical mantra that 'it's progressive, you won't be able to keep up with a lower carb diet' and therefore skeptical. Have a go, prove him wrong instead of getting upset, I would LOVE to see his face in 3 months time when you go back having halved your hb1ac without the Gliclazide!!!! As always though, keep an eye on your levels and how you are feeling because assumptions have already been made about type. x

 

[VashtiB]

I agree that 4s are not hypo but I was worried about the poster potentially starting the gliclazide - @JoKalsbeek said it more eloquently and more clearly

I am sorry that you feel dismissed by your medical professionals. That is very disheartening.

We can't give medical advice obviously. I understand your worry about whether or not to take the medication and worrying each way. And the kicker is that stress and illness already increase our blood sugar levels (and pain as I can confirm at the moment )

If you decide to at least delay taking the medication you could try lowering your carbs and testing and see what that does to your levels- that would allow you to talk to another doctor and ask for some further advice. You may want specific advice on whether the doctor agrees that it would be okay to delay the medication for a period- say 3 months and get another HbA1c. The regular testing gives instant feedback and kept me motivated at first.

Let us know how you plan to go and how your readings are- people here are amazing and very willing to offer support advice and encouragement.

Virtual hug as well just because.

 

[Cmdm]

I was diagnosed t2 about 6 weeks ago hba1c level was 119 which is apparently high. Told to take 40mg gliclazide morning and night. I only took the morning one for a start and checked levels before and after meals to see how my bg is. Today my doctor has agreed I’m ok to stop the gliclazide after sticking to low carb diet and exercising, bg average over 14 days is down to 5.0, hopefully my bg will maintain after coming off the meds. Keep checking your levels and change your lifestyle and you will be fine.

 

[AnnM99]

Hi @AnnM99 and welcome

Sorry that you’ve been left a bit in limbo, but the good news is that you’ve come to the right place for advice and support.

If you have concerns about the medication you’ve been prescribed, then you’re absolutely right to ask your GP for further information and clarify your options.

The decision you make about which (if any) medication to take will directly impact the sort of advice we give here, so please bear that in mind.


In my opinion, for a type 2, that’s the best advice you’ve been given. If you’re on no diabetes medication or just metformin, then reducing your carbs as much as you’re comfortable with/as far as you need (guided by your meter) then that will be the fastest, most effective way to bring your blood sugars down. Many of us here have got down to non-diabetic numbers doing just that, often from a similar (or higher) starting point than yours, so it can be done!

There is a fabulous website that explains more about this - https://www.dietdoctor.com/ - no need to take the paid options (unless you want to).



Bearing in mind the points above, it seems you’ve been given an option to make your own decision on this. If you do start taking the Gliclazide, you will need to be aware of hypos and I’d recommend having support from the GP if you want to cut carbs significantly while taking it.

It sounds like you’ve been given a blood glucose monitor and that will be your best friend, whatever you decide. The idea is to test immediately before eating and then again 2 hours after the first bite. You’re looking for a rise of no more than 2 mmols. Any more and the meal needs adjusting to reduce carbs.

I hope this helps a bit, but please have a good read around the forum and keep asking questions.

Thank you for the reply-sorry for my late reply. Still not taking the pills. Had a reading of 4.9 last night before dinner then tonight it was 7.5 before dinner.

 

[AnnM99]

Hello and welcome,

I echo the advice given by @Goonergal . This site really is the best place for advice and support

So you have a meter. When I started I tested a lot- at least 10 times a day- I was worried anxious not to mention obsessive. Having said that you will likely test a lot more in the early weeks than later on. This is the time to find out how different levels and types of carbs affect you.

Also stress and anxiety affect levels. This was definitely something I wished I had know earlier. I was very upset. it took at least 2 weeks before I wasn't in tears at least once a day. The awesome people on here helped me so so much.

So if you are not taking any medication then you have to worry about hypos a lot less. That doesn't mean you may not suffer false hypos but your meter is your guide. If you get into the 4s early let us know. I do now get into the 4s but it took me a while.

So your meter will help you work out how many carbs your body can tolerate. If you need food ideas- the diet doctor website is helpful or post here and people will give suggestions.

Read around and post. I can promise that one day you will be able to look back and feel a lot lot better than you do now. Some of the nicest people I know I have 'met' here and finding this site is the best thing that came from my diagnosis .

Welcome.

Thanks for messaging me - still a complete mess. I got a 4.9 yesterday before dinner. Tonight it was 7.5.

 

[AnnM99]

@AnnM99
The 4s are not hypo. (though you may feel like it if you aren't used to those levels). Hypos are an issue for people who take insulin (or drugs such as gliclazide which stimulate insulin production). If you are not on meds then I wouldn't worry. Non diabetics can go down into the threes and just feel hangry (yes, spelling is deliberate).

Having said that, if you get into the 4s without meds, then congratulations.

4.9 last night before dinner.