Raised HbA1c, Glicazide

[PJH2903]

I have been diagnosed with T2 for 3 years and my HbA1c has always been mid 40’s on Metformin.
At my last review my HbA1c has shot up to 76, no major changes in diet or lifestyle to account for this. Practice nurse has recommended adding Glicazide to my medications and has given me a glucometer to measure my levels.
Having done my bloods over the last couple of days my fasting level (on waking before food/drink) is around 11.8mmol/L with peaks in the evening around 15mmol/L
How long does it take the Glicazide to have an effect and what would you consider acceptable blood glucose levels, nurse just said to aim for 6mmol/L and 2 hourly tests when driving.

 

[Lamont D]

Testing is recommended, and use them pre and post meals. (2 hours after eating)
Have you reduced your carb intake, your portion sizes, your snacks, upped your protein and good fats?
Or been advised to stick to normal diet?
Have you done more exercise?
Give us an idea what you eat, please?

Glicizide is a drug designed to help with control of blood glucose levels and adjusting your dietary regime will help.
this can take a few weeks or months depending on you and your lifestyle. Your age and your mobility.

A brief warning about the drug and the advice to test. This is because many patients do achieve to get their blood glucose levels back down around normal, and then can push your blood glucose levels down into hypoglycaemia.
So do use your glucometer and if you get back to good levels, speak to your doctor about reducing the dose.

Best wishes.

 

[Daibell]

Hi. Gliclazide should work within hours. Are you slim or overweight? If slim I would suspect being LADA (T1). The implication for the lack of effect of the Gliclazide is that your beta cells may be declining. If slim do ask the GP for the two tests for T1 i.e. GAD and C-Peptide.

 

[EllieM]

If slim do ask the GP for the two tests for T1 i.e. GAD and C-Peptide.

Larger people can be T1/LADA too. Long term T2s with high blood sugars can also have declining insulin production, though my understanding is that insulin production can improve for T2s if their blood sugars lower, because the insulin decline is caused by high blood sugars not an autoimmune reaction.

Personally, I'd be tempted to ask for the tests anyway. Far too many people get misdiagnosed as T2 when they are LADA or even T3c (damaged insulin production due to damage to the pancreas). Then there's also MODY, and probably a few other types of diabetes that I haven't heard of. At least we can rule out gestational diabetes as @PJH2903 is male.

 

[markpj31]

How long does it take the Glicazide to have an effect and what would you consider acceptable blood glucose levels, nurse just said to aim for 6mmol/L and 2 hourly tests when driving.

It pretty much worked straight away for me, but then I was getting a lot of hypos (which is why they give you a meter). It then, after a couple of years just stopped working altogether.