Dr Bernstein

[lorri1]

Hi, I am newly diagnosed, last Dec, type 2 although now awaiting hosp app to determine whether I am Type 1 or 2, due to being very slim and always very active etc in the meantime my medication is Glicazide, started off on 40mg then double to 80mg and now on 120mg twice a day, since the last increase my BG have finally started to come down considerably, however I am just reading Dr Bernstein and in the section of meds it says that the drug that make your pancreas make more insulin is not the way to go, i.e sulforylureas, I believe Glic to be in this category I am now a little worried that my poor little pancreas is going to get battered to death before I get my proper diagnosis I have not been offered any other drug mainly cuz I am told that the other drugs are for people that struggle with their weight and have other health issues

Does anyone have any advice on this please?
Lorri

 

[xyzzy]

Yes some of us have that opinion of Glic and the other sulforylureas that stimulate the pancreas. Presumably if you are reading Bernstein you are low or very low carbing already? If you are doing that and are newly diagnosed and need Glic to control your BG's then in my non professional opinion it does sound like you are more likely Type 1.5 LADA than Type 2. There are other non stimulating drugs for example Januvia. It works by stopping the take up of glucose by the blood. Whether or not it is any more suitable only your doctor or hospital consultant can really advice.

 

[hanadr]

Ultimately, it matters less that you have a correct diagnosis than that you get correct treatment. It's part of the prejudice of our society that T2 is irretrievably linked to obesity. You may still be T2. Not all T2s are obese, just as not all obese people have T2
I'd always say to any diabetic [even definite T1s] to try Bernstein's diet advice. In some cases [of T2] it can remove the need for any medication and even for those that MUST have medication, it can minimise the doses needed.
I keep looking for any evidence that a VLC diet is harmful. I know it hasn't harmed me in several years. I have consistently failed to find anything.
It can be difficult to stick to at first, but it becomes habit.
Hana

 

[hanadr]

PS. I was on gliclazide some years ago and now wouldn't touch it. Check out the side effects.
Hana

 

[phoenix]

If you have LADA (ie slow onset T1) there is little evidence on the best treatment,
This Cochrane review, whilst stating that the review is very limited because it represents "very early days of our understanding of the best way to treat LADA." suggests that

there does seem to be evidence from this review that the drug sulphonylurea (like glibenclamide or glyburide, gliclazide) could make patients insulin dependent sooner and it does not control blood sugar as well as insulin

and

, this review demonstrates that insulin treatment may be preferable compared to sulphonylurea treatment

http://summaries.cochrane.org/CD006165/ ... -in-adults

 

[lorri1]

Thanks all. I am and always have been a VLC (even before I was diagnosed) so not a problem for me at all. The only thing that made my BG's go lower was the Glic. I am very impatient with waiting for the hosp app which is why I keep asking questions on the forum, hoping I can come to some conclusion myself, right now I am thinking it could be LADA. Unfortunately I don't have any choice but to take the Glic untill the hosp app, it's got to be better than having extremely high BG's while I wait surely?

Lorri.

 

[dib]

Hi again Lorri,
Quite surprised you have been given Glic with your profile, my DN prescribed a 40mg daily dose for me as a trial and as it made no difference at all to levels took me off it. I am now on 100mg Januvia daily as a last ditch attempt before going onto insulin, apparently it works by helping what insulin you have got circulating to carry on working for longer so doesn't hammer your pancreas. It is having a slight effect on peaks after food but not enough to get me under the NICE guidelines, so I expect to be starting insulin in the next month or so. I have had time to get used to the idea now so I think in a way it will be a relief, at least I will be able to relax the diet regime a little and enjoy my food again.
Hope you get your proper diagnosis soon and let me know if you have to go on to insulin it would be really useful to compare notes.
All the best
dib :thumbup:

 

[lorri1]

Hi Dib lovely to hear from you. well as I mentioned it has been increased to 120 as the lower doses did nothing at all, I haven't been offered anything else and I wouldn't know enough about the other meds to argue, I am just happy that my BG's have come down but not happy about the fact that it could be battering my pancreas but what can I do? I get the impression that I may end up on insulin but what do I know? lol. Would love to know how you get on with it? I worry about weight gain on insulin...have you heard that?

Lorri

 

[borofergie]

Dr Bernstein and in the section of meds it says that the drug that make your pancreas make more insulin is not the way to go, i.e sulforylureas, I believe Glic to be in this category I am now a little worried that my poor little pancreas is going to get battered to death before I get my proper diagnosis

You need to remember that Bernstein (as much as I love him) is pretty old-school on lots of things. I've read elsewhere that insulin-stimulating drugs aren't as negative as he paints them to be.

 

[jopar]

Bernstein is pretty old school indeed...

You will not catch Bernstein recommending an insulin pump to a T1 diabetic his reasoning are pretty lame and screams that he's rather stuck in years gone by!

His stick in the mud attitude I think is based on several reasons..

1, he's solution is built around what works for him with kit he uses and is comfortable using!
2, that to use new technology or drugs, actually undermines his 'solution' which he promotes and earns a living from to be the only 'solution' for diabetic control!

It wouldn't surprise me if his food regimes are in the main based upon what he enjoy's eating, and hence why he's never either himself or employed somebody to adapt his book for different cultures or countries, so the dietary recommendations of what foods are suitable etc are actually available in that particular country/culture!

Perhaps if he did keep up with the times, and/or adapted his book then it wouldn't come across as the only 'solution' he claims it is!

Going back to your OP

A VLC diet doesn't guarantor that you either avoid or require a low input or certain type of medication, there are many variables that determines what and how much medication you might need to maintain control what ever diet you'll on..

 

[Sanober]

Hi. Hope you get on the right treatment soon.

I was low carbing because I was told T2 and in normal weight range. However my blood sugar would still rise considerably and wouldn't budge for ages. Glic didn't do anything. When I was diagnosed T1.5 I was told to stop the Glic and to start insulin.
I am still particularly Carb and insulin sensitive. It's early days yet so a bit of fiddling about still going on.
!
I'm on more average carbs although I've started lunches where i dont need to take insulin, so i can rest from it h.i i didntknow VLC was Ok for slim type 1 / type 1.5? Will you not get skinnier?

I like reading people's experiences rather than folk like Bernstein.

 

[lorri1]

well I haven't put weight on no but I haven't lost anymore either, so that's good. But I'd rather be too skinny and keep my BG's low....or at least untill I get sorted with the hospital, I can put weight back on later hopefully . Thanks everyone for their comments I will take a note of the other meds and speak to the doc about them.

I still find it all a little confusing....lol what with low carb , insulin resistant...being slim etc etc the mind boggles lol

Your right tho this forum has been invaluable Sanober

Lorri.

 

[smidge]

Hey Lorri!

They do sometimes try to keep LADAs on Glic for as long as possible to avoid insulin. However, there is growing evidence that it speeds the progression of LADA into full Type 1. Insulin, on the other hand, gives your pancreas a break and often allows it to recover its function a bit for a while. Glic didn't work at all for me, but if it had, I'd still have chosen to go onto insulin because I think the benefits outweigh the drawbacks for those with LADA. They say progression to insulin is inevitable with LADA, so why postpone it? For me it has been the best thing I've ever done. I would advise you to read as much as you can around all your options so that yoou can be prepared to have an intelligent discussion with the consultant when you finally see him/her - once they know you have some knowledge of your conditon and options, they usually engage better with you, presenting you with choices etc rather than just making their own minds up.

Take care.

Smidge

 

[lorri1]

Hey Smidge , was hoping you'd read my post, I really appreciate your time. I know that you have been through a similar experience. I am hoping to be able to have an intelligent discussion :lol: at best just a discussion! no seriously I will try and get as much info together before I go, I am gaining more and more knowledge everyday thanks to you guys.

Just in the last couple of days I have felt extreme tiredness, I am not sure if it's the medication or my body adjusting to the lower BG's? mainly I feel like I have no strength or energy in my legs to even get up the stairs, everything is a real effort?..... it's quite frustrating when things seemed to be getting better for me

Lorri x