I had an HbA1c of 99 and faced insulin therapy PDQ, and that was with max dose Gliclazide already on board (320 mg a day), but then I discovered LC dieting, mainly LCHF at that time, and started eating to meter. Within 3 months I was reducing my Glic dose and my BP meds and kicking my statins into touch. I did not need insulin therapy and still don't. I have reduced my glic dose down to 40 mg a day now, and halved my Metformin, and last week my GP declared me Normal. So for me the choice seems to have been well worth it.HbA1c has risen to 70mmol/mol and the doctors want to put me on glicazide. I get the impression that this may make my pancreas wear out quicker.
Should I ask for insulin? Or am I getting ahead of myself?
Possibly not. Depends on level of insulin resistance.Would the same theory apply to a type 2.
Very sound advice - to a type2. @scarred is LADA, however. Their immune system kills their insulin producing cells. Eating low carb makes you need less insulin, no matter if it comes from your body or from the fridge, but you still need insulin. Gliclazide can squeeze out your pancreas to force it to give you insulin, but for a LADA it comes to an end eventually, at which point they definitely need insulin from the fridge, as there's nothing left in the body.I had an HbA1c of 99 and faced insulin therapy PDQ, and that was with max dose Gliclazide already on board (320 mg a day), but then I discovered LC dieting, mainly LCHF at that time, and started eating to meter. Within 3 months I was reducing my Glic dose and my BP meds and kicking my statins into touch. I did not need insulin therapy and still don't. I have reduced my glic dose down to 40 mg a day now, and halved my Metformin, and last week my GP declared me Normal. So for me the choice seems to have been well worth it.
I have as a result of the LC diet changes managed to reduce my weight, my girth, my wardrobe contents, and consequently my Insulin Resistance. This latter means that I am no longer caning my beta cells, and although I use 1x glic tab still, I am comfortable with that and I now have a vastly improved insulin response that allows me to eat a more carby diet than I was, and not put on weight. So I do not fear burnout myself, but time will tell. I have been T2D for over 15 years now, and feel much better
Either therapy is viable. I find using glic allows me to be more relaxed.
The OP is being offered Gliclazide, which is similar to but not the same as Glipizide.Would the same theory apply to a Type 2?
I'm on Glipizide 5mgs twice a day but I'm finding it difficult to anticipate when the effect will kick in, so when to prepare meal and eat etc. First thing in the mornings is the worst as, as soon as my feet touch the floor, my glucose levels shoot up (I use Freestyle Libre - extravagant but my best motivator I've found)
So, currently, as I normally wake up around 4am (only 3 hrs sleep - normal for me), I've been taking my Glipizide at that time, as it takes around 3 hrs, or more, to have any effect. So, I then have been getting up around 7am. This strategy seems to have helped initially but, once downstairs, levels start rising again, not getting back down until around 12md. Also, before my evening meal, I try to take Glipizide around 5pm, and eat around 8pm
By the way, I'm on LCHF, so cheese, eggs or ham for breakfast. Any activity will send my BG levels up, too. I'm thinking I need to see the GP to discuss this and see what he has to suggest. I don't mind injections - I do my own Vit B12 injctions, subcut/orange needle so insulin, at low dose, might give me more control, to my thinking. I'll be interested to read how this thread progresses.
I agree, my advice is as a T2D and not so relevant to someone with LADA. I wonder why they were prescribed this drug if their progression is more strongly mapped out than mine.Very sound advice - to a type2. @scarred is LADA, however. Their immune system kills their insulin producing cells. Eating low carb makes you need less insulin, no matter if it comes from your body or from the fridge, but you still need insulin. Gliclazide can squeeze out your pancreas to force it to give you insulin, but for a LADA it comes to an end eventually, at which point they definitely need insulin from the fridge, as there's nothing left in the body.
I've had LADA for a couple of years now and I've had all the tests. The progression to insulin is inevitable as the beta cells stop working.I agree, my advice is as a T2D and not so relevant to someone with LADA. I wonder why they were prescribed this drug if their progression is more strongly mapped out than mine.
I must assume that the LADA dx is only recently been confirmed by the lab tests for GAD and c-peptide, and that the use of an oral med is a temporary stopgap to bring high sugars down quickly before the proper ID training and support could be arranged. The worry from burnout from this drug is probably not going to have much impact in the timescale.
Well it depends if no cells and with insulin gives overall better control than the mad on/off honeymoon phase stress on the tablet. Also if some cells then more adventurous if a cure to be developed as at least some life to help rather than none if killed off by Gliclizide?I've had LADA for a couple of years now and I've had all the tests. The progression to insulin is inevitable as the beta cells stop working.
To squeeze the beta cells with glicazide or not is the question. What is the benefit of protecting the few remaining producing cells? Prolonging the honeymoon phase?
And yes I'll be discussing this with a professional too.
We are all different. I provided some info and my own experience to help the thread author make their decision. I'm glad you have found a method that works for you.Does anyone actually have a proper study report that confirms sulphonylureal drugs kill beta cells or lead to progressive loss of insulin secretion? I have done a load of searches on this subject, and all I can find is forum discussion and blogger spiel and some very biassed reporting in the press. There has certainly been folklore discussion on this matter, but there seems to be no study that actually confirms it. I can find the likes of Bernstein, Mercola, and Jenny Ruhl expounding this hypothesis, but none of them actully refer to evidential proof of the assertions. It seems that the hypothesis relies on the assumption that the drugs force or squeeze more insulin out of the pancreas so must be making the cells work harder thus depeleting their lifespan. But there are many other things that damage and destroy these cells. This is what I found
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900074/
1. Zhang et al. Second-Line Agents for Glycemic Control for Type 2 Diabetes: Are Newer Agents Better? Diabetes Care 2014;37:1338–1345
https://www.ncbi.nlm.nih.gov/pubmed/1425152
I suspect that until recently the progression of T2D towards insulin therpy being necessary was something that was inevitable and so a scapegoat had to be discovered to hang the blame on. This is the 'T2D is a progressive disease' mantra, which many of us here can now challenge.
The recent discoveries into the effect of NAFLD on insulin resistance show that this is a major stress on the pancreas, and now that it seems to be potentially reversible, then this may remove the progessive march of T2D towards self destruction (according to the media and Panorama).
To me NAFLD is far more harmful than my drugs, and hyperglycemia is also potentially fatal, so using glic to fight both these conditions makes sense to me, and in the absence of proof otherwise, I am content to continue using them.
There is a general rule of thumb that thread questions like the OP posted will evoke certain predictable responses. Those forum members who use insulin therapy will urge the OP to ask for insulin treatment, and those like me who use orals successfully will bang the drum for orals. At the end of the day, the OP has a choice for their near future since both treatments are viable at reducing hyperglycemia, but it is almost certain that in time they face an ID future. I do too, but hopefully not for some time to come. I am also of the opinion that either treatment regimes can be used to extend the beta cell production for some time and it comes down to the OP choosing which way of treatment suits them best in terms of quality of life. The current use of orals as offered by GP buys time for proper treatment training to take place which is a temporary benefit,We are all different. I provided some info and my own experience to help the thread author make their decision. I'm glad you have found a method that works for you.
At the end of the day, the OP has a choice for their near future since both treatments are viable at reducing hyperglycemia, but it is almost certain that in time they face an ID future.
Hi. Neither insulin nor the typical diabetes tablets such as Glic or Glip cause weight gain but the carbs you eat may do if you eat too many. The meds enable the body to metabolise the carbs which it couldn't do otherwise.I have T2 and have just started on insulin after 9 years of low carb success then major burnout and needing the helping hand of insulin.
So I'm biased. Here is some info on the pros and cons of insulin for T2 (I realise you are LADA not T2 but some of the info is still accurate):
http://www.phlaunt.com/diabetes/15478720.php
I have only ever taken Metformin and I hope to come off it eventually because I don't think the benefits are worth it, But I will ask my doctor and nurse.
I don't want to ever take the other meds as I'm sure they will cause even more weight gain as well as some serious side effects and risks. To me, insulin just makes more sense.
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?
We use cookies and similar technologies for the following purposes:
Do you accept cookies and these technologies?