Frustrated and struggling

[Mable83]

Hi, long story but here goes.. I was diagnosed with gestational diabetes 7 years ago. I was given the all clear when my daughter was born and then diagnosed with type 2 a few months later. After continuous increased HBA1C results and increased medications, I am now taking maximum Metformin (2g per day) and maximum Gliclazide (320mg per day). I am 34 with a healthy BMI of 24.2, I am active and eat a healthy balanced low carb diet. I recently had a GAD antibodies test where the results were positive at 181. My waking blood sugars are reading at 13.8-21.2 constantly despite low carbs. I am getting to the point where I am scared to eat. I am very aware of what poor control of diabetes can do. I have an appointment with the diabetic nurse in a few weeks as my Doctor doesn’t want to do anything with regards to my meds until I have seen her. I have read that if I am not type 2 and instead type 1.5 that Gliclazide can destroy any beta cells that I may still have and I shouldn’t be taking these. I’m getting really frustrated and worried now. I constantly feel rubbish. Please help

 

[Juicyj]

Hi @Mable83 I was diagnosed at 23 weeks with gestational diabetes, picked up during a routine blood test, went straight onto insulin, then after birth went and 2 years later after a week of losing alot of weight and usual peeing and drinking tons symptoms was diagnosed type 1 and went straight onto insulin. It sounds like you need insulin therapy asap, I wouldn't waste any time, go straight into A&E, those high blood glucose levels need to be managed, your doctor sounds convinced you are type 2, yet the uncontrolled BG levels and your GAD test indicate otherwise, and with a type 1 diagnosis the potential for DKA is there so A&E will be able to determine the best course of action to get your BG levels under control, I personally wouldn't wait for any appointment that could prolong this, getting seen as a priority is important now. Sorry I don't know enough about Gliclazide to know what it's side effects are.

 

[Alexandra100]

I have read that if I am not type 2 and instead type 1.5 that Gliclazide can destroy any beta cells that I may still have and I shouldn’t be taking these.

I found the following on Jenny Ruhl's website (she is referring to Gliclazide among others):

"Do These Drugs Cause Beta Cell Burn-out?
There is some question about the wisdom of forcing exhausted and already dysfunctional beta cells to produce yet more insulin. Dr. Richard K. Bernstein is a firm believer that these kinds of drugs cause beta cells to burn out and die and counsels people with diabetes to avoid them. However, there is little experimental data available to evaluate this possibility.
Some argue that since the UKPDS data shows a similar decrease in blood sugar control in patients taking sulfonylurea drugs and Metformin, the sulfonylurea did not cause additional damage to beta cells.

A study published in 2008 shed some light on what might actually be happening with sulfonylurea-related beta cell burnout.:

Diabetes in Control: Mechanism for Sulfonylurea Treatment Failure in Type 2s Link to full research article: HERE.

If the suggested mechanism is in fact why beta cells burn out, burn-out might be avoided by cycling on and off these drugs."

This sounds to me as if you have at any rate no need to worry about beta cell burnout in the short term.