Blood Sugars Questions - Confused

[Sweettooth81]

So I've been on Gliclazide for three weeks. Doctor made me up the dose to 80mg twice a day, this week because my sugars are still high.
My morning bloods are 17-19 (give or take a decimal). I don't have carbs or sugars for breakfast anymore.
My lunch is salads with occasional cheese for some fats.
My pre dinner bloods are 16-18.
If I don't eat lunch (teacher life it happens often) I will be a 10.
Then after dinner - the only time I'm having carbs and I'm keeping it to around 30gs and they shoot up to 18-20 even with the meds.
Why does it feel like my meds aren't working?!?!?!?

 

[markpj31]

Given what you said you are eating, I would say that they don't appear to be doing much if anything at all, or the dose isn't quite right yet. I think I'm going through the same thing re medicine as I take 2x glicazide for breakfast and 5 units of insulin for dinner. My post breakfast/pre-lunch are high (10+) but come dinner time after a shot of insulin I'm good. My opinion is that the glicazide isn't working anymore.

Ultimately it depends on how much/if any insulin you are producing. I would also test for ketones.

 

[Antje77]

How were you diagnosed as a T2? Any tests done to rule out other types?

 

[Sweettooth81]

How were you diagnosed as a T2? Any tests done to rule out other types?

Just a simple blood test. No test have been taken for other types.

 

[Sweettooth81]

Given what you said you are eating, I would say that they don't appear to be doing much if anything at all, or the dose isn't quite right yet. I think I'm going through the same thing re medicine as I take 2x glicazide for breakfast and 5 units of insulin for dinner. My post breakfast/pre-lunch are high (10+) but come dinner time after a shot of insulin I'm good. My opinion is that the glicazide isn't working anymore.

Ultimately it depends on how much/if any insulin you are producing. I would also test for ketones.

That's what I'm thinking. Is the doc trying to gentle ease me in and I'm actually on a low dosage or are they not working?

 

[EllieM]

That's what I'm thinking. Is the doc trying to gentle ease me in and I'm actually on a low dosage or are they not working?

Well, you're still on a low dosage (Dr google says max dose is 320mg per day).

Doctor made me up the dose to 80mg twice a week, this week because my sugars are still high.

Do you mean twice a week or twice a day? I've never heard of people being on a weekly dosage (doesn't mean it doesn't happen, just that I haven't heard of it.)

Having said that, it also might not be working, we just don't know. Given that you are so newly diagnosed, it may just be that they haven't done the T1 tests yet (cpeptide and GAD) and I guess they may be waiting to see how the gliclazide wotks first. (Most diabetics are T2, so that is the first assumption they make). Does the doctor know how low carb you are eating?

 

[Sweettooth81]

Well, you're still on a low dosage (Dr google says max dose is 320mg per day).



Do you mean twice a week or twice a day? I've never heard of people being on a weekly dosage (doesn't mean it doesn't happen, just that I haven't heard of it.)

Having said that, it also might not be working, we just don't know. Given that you are so newly diagnosed, it may just be that they haven't done the T1 tests yet (cpeptide and GAD) and I guess they may be waiting to see how the gliclazide wotks first. (Most diabetics are T2, so that is the first assumption they make). Does the doctor know how low carb you are eating?

Yep I meant daily! Haha

 

[finzi1966]

Although the maximum dose is indeed 320mg a day, 160mg per day is still a pretty whopping dose to be having essentially no effect on your blood sugar at all in the context of a low carb diet. Like others, I’d be wondering about the possibility of Type 1/LADA.

(Just anecdotally, I’m a bog-standard overweight Type 2: I can’t even take 40mg gliclazide without my blood sugars going through the floor - 160mg would have me unconscious. Obviously everyone is different but something just doesn’t sound quite right about this. Gliclazide encourages your pancreas to produce more insulin- the total lack of response to it would send up a red flag to me that your pancreas is not playing ball.)

 

[NicoleC1971]

So I've been on Gliclazide for three weeks. Doctor made me up the dose to 80mg twice a day, this week because my sugars are still high.
My morning bloods are 17-19 (give or take a decimal). I don't have carbs or sugars for breakfast anymore.
My lunch is salads with occasional cheese for some fats.
My pre dinner bloods are 16-18.
If I don't eat lunch (teacher life it happens often) I will be a 10.
Then after dinner - the only time I'm having carbs and I'm keeping it to around 30gs and they shoot up to 18-20 even with the meds.
Why does it feel like my meds aren't working?!?!?!?

Sorry that the combination of low carb and meds aren't working for you as well as they do for many others.
I am linking you to an interesting discussion with a patient who had the same issue.

To summarise they found that this guy's insulin response was inadequate after long standing diabetes and in spite of going low carb, but watch to see the solution which is so far working well for him (not meds btw).

 

[markpj31]

That's what I'm thinking. Is the doc trying to gentle ease me in and I'm actually on a low dosage or are they not working?

They could increase you to the maximum dose I guess (which is 4x 80mg tablets a day) but given your blood sugars now, I can't see it making much difference. The way the drug works is it tries to stimulate your pancreas into making more insulin, but if the pancreas is 'burnt out' due to strain or prolonged diabetes then it's not going to happen. Of course, everybody is different.

Doctors will always start low and work up gradually, its quite difficult to get someone stable, but they have to start low because of the danger of hypos.

My doctor always said 'you don't want to go down the path of insulin' when I was on oral meds and kept on about lifestyle. Given the fact I am active, 72 kilos (11 stone) and was on a low-carb diet, it was hardly ever something I could control anymore. I was fighting a losing battle and it was out of my control.

I went on insulin in the end as I was borderline keto acidosis and I have no idea what the fuss was about from him. It's pretty easy going and you don't even feel the needle (it's tiny).

 

[Sweettooth81]

Thank all. I'll check out that video.
I will also look at LADA too.
When I told the doc my numbers he accused me of taking half the pill instead of the whole so not impressed so far.
I was diagnosed two years ago but was in denial about my condition. I didn't and don't have any of the typical symptoms not being high until I take the meds. Then my sugars hardly move but I feel rubbish like I'm about to dip into a hypo. So I did eat something sweet, now I don't and I just get on with it. Still don't like the feeling though.
I've started behaving now and doing what I should but I'm not seeing a change really. Yes I get it could be early days but 3-4 weeks in I'd expect the meds to have taken affect by now.
I am also the typical overweight person. Very high BMI so I do get I haven't helped myself but I am trying now.
So like now - woke on 20.1 had 80mg of gliclazide. Forgot to have breakfast, just tested my bloods and I'm on 14.2. I feel like I shouldn't eat lunch because they are too high.

 

[finzi1966]

If you’re a very high BMI the other possibility (although it’s a myth that LADA’s *have* to be slim) is that you’re very, very insulin resistant. When you say “very high”, how high? Sorry, I know that sounds a bit intrusive, but women in particular are so often shamed about their weight that I’ve heard people with a BMI of 28 describe it as “very high”.

For context, I had a BMI of about 42 when diagnosed, it’s now 32 after losing maybe 4 or 5 stone. That has made a tremendous difference to insulin resistance- like I said, if I have a gliclazide now (and I would only ever sneak a very occasional half-a-tablet, if I know I’m going to have a carb-heavy meal (eg the last time I had 40mg was Christmas Day) my blood sugars will be on the 3’s if I’m not careful

 

[Sweettooth81]

If you’re a very high BMI the other possibility (although it’s a myth that LADA’s *have* to be slim) is that you’re very, very insulin resistant. When you say “very high”, how high? Sorry, I know that sounds a bit intrusive, but women in particular are so often shamed about their weight that I’ve heard people with a BMI of 28 describe it as “very high”.

For context, I had a BMI of about 42 when diagnosed, it’s now 32 after losing maybe 4 or 5 stone. That has made a tremendous difference to insulin resistance- like I said, if I have a gliclazide now (and I would only ever sneak a very occasional half-a-tablet, if I know I’m going to have a carb-heavy meal (eg the last time I had 40mg was Christmas Day) my blood sugars will be on the 3’s if I’m not careful

I'm a BMI of 38 so classed as obese.

 

[Outlier]

BMI should be seen as just one aspect, not a god to be worshipped. Any of you who are artistic know the different body shapes that are normal in humans, so for medical people simply to measure people around the middle and call out a condition is remarkably naive. Some people carry their weight around the bum and thighs but have small waists and flat tummies, some have weight across the shoulders and upper arms but are small waisted, some are slim all over except for fat around the middle, and so on. The whole person should be assessed, not just one measurement. However, that's modern medicine for us - seeing people holistically is rare, and if we find such a medic we should make the most of them.

 

[finzi1966]

Agree with you 100% - BMI is a very outdated idea really, and also a very blunt instrument. Having said that, a BMI of 38 *is* probably high enough to come accompanied by a certain amount of insulin resistance, which may or may not be contributing to the OP’s continuing high blood sugars.

(I’d still want testing for LADA though).