Curiouser and Curiouser

We have differing amounts of insulin resistance during the day (often higher in the mornings, and lower in the afternoons and evenings.

If that is what happens to you, then the medication may be MUCH more effective in later in the day than it is in the morning.

Erin said:

I posted a recent change elsewhere about an increase from 80mg Glyclazide to 80mg plus 40mg. This was done after 8 yrs. of diabetes as possibly the pancreas was getting weak. In any case I was getting very sleepy and tired and basically more diabetic. This increase helped. Here is the paradox I mentioned-- when taking 2x40mg in the morning or early before noon, the blood sugar was almost always high, perhaps because of breakfast, or Dawn syndrome or S**** or something. As an experiment yesterday I took the second 40mg tablet in early afternoon-- result-- hypoglycemia (3..7). Very strange.

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I am getting this as well. I have found that one of my other meds that I take for my heart is interfering with my morning Glic dose, and that delaying that tab till noon gave me much better results. I have now asked my GP to shift the offending med to last thing at night so it interferes with itself.

EDIT to Add: I have now formally reduced my Gliclazide dose from 4 tabs a day to 2, and in fact I am skipping one of those on most days. Still get the occasional low bgl but no hypo;s.

Erin said:

Thank you for your reply Oldvatr. Interaction of drugs is always a possibiilty. I do not take heart drugs, but the first drug in the morning is Synthroid, then 40mg gliclazide, then, Metmorfin, then clonazepam, then lithium, and just before early brunch 40mg gliclazide, waiting 15 min.-- always a high number. At supper always a good number (5-7). I don;t understand the high numbers in the morning. But I better stick to them as the afternoon experiment-- taking the second 40mg gliclazide gave me a hypo. My doctor was very alarmed at the frequent hypos I had when I was first diagnosed year one and switched to gliclazide (80mg) instead of gluburide. This diabetic pharmacology is pretty complex.

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I find with my antiquated plumbing that I take around 30 mins for my sugaes to peak after eating, so I time my meds to be 30 mins before I eat so that they are in place waiting for the glucose to arrive. Meds wil also take that sort of time to dissolve and metabolise too. I found retiming my metformin like this can make a significant difference to my readings. The Met needs to be up front of the meal to block sugar digestion in time, The Gliclazide works after the food has started digesting, so is not so critical. I don't see any obvious interaction problems reported for your other meds, but Lithuim needs salt and high fluid intake which you should have been advised on to avoid dehydration.

I myself am finding 2 Glics a day too much now, and I tend to only take the second one on an as requieed basis.