Drug therapy for type 2...what next

[Hrw1959]

Hi, I was diagnosed with type 2 on the 19th September, 2012. My doctor put me on Gliclazide, 160mg morning and 80mg at tea time. He told me that the dose is 160 mgs twice daily max. Does anyone know what is normally the next step if this is not effective. My BG level is still on average 12 so it's likely he will put me on 160mg twice daily, but I am a bit worried as to what he will have to do if this doesn't help.

 

[MaryJ]

Hi

Are you wanting to not increase meds?

what's your diet?

Mary x

 

[hallii]

And weight and excercise?

 

[Hrw1959]

Hi,
I am on a lot of medication for my other health problems, i.e. epilepsy, asthma, neuropathy, chronic pain and bowel problems ( I have no large bowel) and therefore am a bit wary about taking more meds although I will if its necessary. I am wheelchair dependant and cannot do much excercise and am trying to lose weight. Unfortunately I cannot tolerate fruit and veg and have to follow a zero fibre diet. I also have high cholesterol.

My doctor has been very good and I know he won't put me on medication just for the sake of it, but, I just wanted an idea of what to expect next. Any ideas would be much appreciated. Many thanks.

 

[Daibell]

Hi. Gliclazide stimulates the pancreas to produce more insulin which it will do if it has enough cells remaining. It is more relevant for those T2s who aren't over weight and hence probably insulin resistant. Normally Metformin would be the start for this but your particular physical condition may have caused your doc to take a different path. If Gliclazide doesn't deliver and Metformin isn't an option then a further choice is Sitagliptin or one of the injectables including insulin. Diet is the number one consideration so do keep the carbs low and low-GI. Be aware that if the Gliclazide does work it can cause hypos so use the meter to observe your BS.

 

[catherinecherub]

Hi,

This might be of some use to you, it explains the meds that are used for Type2.
http://healthguides.mapofmedicine.com/c ... etes2.html

How did it go with the dietitian? It is not easy for a person in your position to be able to control diabetes with such a limited food choice. Has your G.P. agreed a target for your HBA1c?

 

[Hrw1959]

Hi Catherine, my appointment with the dietitian went ok. She said that although I sort of ate the same thing nearly every breakfast and lunch, it was ok. I have to have carbs at each meal and eat as much cauliflower and bits of salad that I can tolerate. I have to have a banana each day, the only fruit I can eat. She also said to continue testing by BG levels 2hrs after meals to see how what I am eating affects it.
I asked about the effect my seizures ay have on my BG levels and she said that it would spike then probably drop suddenly, therefore my Carers have to be trained to check my levels and administer either glucose/ lucozade/ dextrosol if I go hypo.

I am seeing my gp tomorrow and will ask him about my HBA1c.

I have had my retinal scan and there is no damage, but I will have to see my optitian because I cannot see out my glasses as my vision gets really blurred when my BG level gets high.

Thanks for the link, I will have a look at it now. I really appreciate your advice.

 

[Hrw1959]

Hi. Gliclazide stimulates the pancreas to produce more insulin which it will do if it has enough cells remaining. It is more relevant for those T2s who aren't over weight and hence probably insulin resistant. Normally Metformin would be the start for this but your particular physical condition may have caused your doc to take a different path. If Gliclazide doesn't deliver and Metformin isn't an option then a further choice is Sitagliptin or one of the injectables including insulin. Diet is the number one consideration so do keep the carbs low and low-GI. Be aware that if the Gliclazide does work it can cause hypos so use the meter to observe your BS.

Hi, thanks so much for the advice and information. I have to follow a restricted diet and need to eat carbs at every meal, I am trying to choose the right ones that I can eat. As I am unable to tolerate any fibre and very limited fruit and veg, it makes things so difficult.

I know my doctor won't put me on any medication unless he has no other choice, but, I have to say I am concerned that I may have to go on insulin so soon. I really was surprise that I was put on tablets so soon, but as I cannot excercise much due to being in a wheelcar and have a restricted diet, he had to put me on Gliclazide.