• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Drug Cocktail

majortom

Member
Messages
8
Location
Shrewsbury
Dislikes
Drugs!
Hi Folks
I'm a newbie to this site although have lived with Type 2 for over 8 years. Have tried diet control for a few years (and failed), now on Metformin SR 2 x 500 twice daily, Glixclazide 1 x 80mg once daily plus blood pressure tabs and statins. HbA1c in August 9.5 so diabetic nurse referred me to diabetic consultant. He has put me on Sitagliptin (yet to be prescribed and taken) and also suggested I up my dose of Gliclazide to 2 x 80 daily to help with hypo's.

On reading the mountain of extremely valuable info' on this site I haven't come across anyone mentioning that they take metformin, gliclazide AND sitagliptin. The latter always seems to be a substitute for gliclazide. Is anyone else on a similar cocktail? :?
 
Hi Tom and welcome to the forum :) I'm afraid I can't help you with information about your cocktail of drugs as I don't take all of them - only Metformin, blood pressure tabs and statins, but if there are any members who take that combination, or some of those drugs, I hope they will answer you soon when they see your post. You could have a look at this forum where you will find information about each individual medication.

viewforum.php?f=26

I know you have had diabetes for 8 years but we give out this information to all new members and I hope you will find it both interesting and helpful. Hopefully this will help you to lower your levels. Ask as many other questions as you like as you are sure to get an answer.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find well over 30,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates
A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips
The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
Hi Tom, I don't take gliciazide but I do have glimepiride which is from tne same clss of drugs as well as metformin and sitagliptin,
I have been taking sitagliptin for over a year and within a short time I was able to reduce my glimepiride. In fact I stopped taking it altogether and would like to have continued that way
but asked to be put back on the minimum dose {1mg} purely because I have HBA1Cs every few months which,unfortunately, means some contact with the Diabetes nuse in my practice.

As I have responsibility for a couple of people wih mental health issues my routine may often be disrupted and althiough my levels {HBA1C} are now about 6 I know the slightest rise would be attributed to "natural progresssion " of the disease as she is dying to put me on insulin!

You may well find that once the sitagliptin {good for spikes} kicks in,
you may be able to leave off the gliciazide.

I know what you mean about the "cocktail". I think that the longer you have been T2 the more likely you are to have been prescribed a coctail. They try something new but are then afraid to remove the tried and tested drug.

Good luck wih the sitaglyptin I have found it very effective.
 
Hi

I am on the same drug regime i.e. Met, Glic and Sitagliptin. All three drugs have a different approach to managing BS so each can help. I have found that Glic doesn't have much effect for me whereas Sitagliptin does. Glic stimulates the Pancreas to create more insulin whereas Sitagliptin suppresses a DPP-4 enzyme that in turn suppresses insulin production. I'm inclined to agree that taking Glic and Sitagliptin may not be ncessary depending on the exact type of DB you have. I have in fact reduced my Glic by 1 tablet and may take even less. You mention upping the Glic to reduce hypos? Surely the reverse applies. Glic can induce hypos in some people and you will see warnings on the web. This is unlikely if Sitagliptin has been added by your GP as, by definition, Glic has failed to work adequately in producing enough insulin?
 
Hi tom
I'm also on a cocktail of drugs,i have type2 for over 8 years now and i take metformin 850mg 3 times a day,verapamil,ramipril,simvastatin.I also take warfarin because i keep geting blood clots. I was taken glixclazide 3 times a day but was taken of that and i now take insulin novorapid 3 times a day and levemir at night. I have found i can control my diabetes alot better since i came off glixclazide and insulin give me better control of my bg.
I wish you well with your cocktail and hope all goes well for you.
Mike
 
Hi All
Many thanks for the speedy and informative replies to my post - the one thing that prompted me to join the community and post a query after living with D for 8 years was the level of support and assistance the community gives each other on coping with the illness.

I have not focussed on managing my condition as much as I should have done over previous years, hence my gradual slide - I was even offered insulin at the consultant appointment I had recently, but want to stay off injections for as long as possible.

My problem is that I am now trying to do too much at once, after years of negelect, being far too stoic with my diet and taking tablets religiously. I'm also testing my BS far more regulalry to get an understanding of the effectc of medication and diet - something which I have never taken seriously. (Having a family that tells me that my new found focus is a tad OCD doesn't help!).

Daibell, I stand corrected re my oringinal post, my HbA1C and spikes of over 10mmol/L on fasting being the reason for upping the Glic - the hypo's have just got worse since doubling the dose but I'm now monitoring what I eat and when I take the tablets to level out my BS.

Many, many thanks for these replies once agian, I shall bore eveyone with Sitagliptin effects when and if!
Glenn
 
Back
Top