Gliclazide and Heart Failure

[Bluetit1802]

possibly. I may be confusing it with eGFR which is kidneys.

The heart ejection rate is the rate the heart pumps out the blood into the main blood stream. This is measured with an echocardiogram (ECHO - which is similar to an ultrasound scan, and takes about 15 minutes)

 

[Bluetit1802]

@Oldvatr I do know 100% that certain drugs/medications do affect this ejection rate. One I was given for 12 months when having cancer treatment was one such drug, and as it was well known it caused the ER to fall and cause heart failure, I was given an ECHO every 3 months during this treatment. So there are drugs that cause this problem - clearly I have no idea about Gliclazide. I know this isn't helping you!

 

[Oldvatr]

@Oldvatr I do know 100% that certain drugs/medications do affect this ejection rate. One I was given for 12 months when having cancer treatment was one such drug, and as it was well known it caused the ER to fall and cause heart failure, I was given an ECHO every 3 months during this treatment. So there are drugs that cause this problem - clearly I have no idea about Gliclazide. I know this isn't helping you!

Think this study answers some questions, and may explain why my kidneys failed after the enhancing dye used in my angiogram. Seems to class all sulphonylureas with the same brush, even after saying that the 2nd generation like Glic or Glip are not so problematic, so maybe this is where my consultant gets his info.
https://academic.oup.com/ehjcvp/article/2/1/32/2397843

The other studies I have seen agree with this one for the first gen ones, but say Glic stands out as being protective, Will discuss with consultant on ward round tomorrow. Its academic at the moment, but I think we need to know with some conviction which way to regard Glic, which many of us use.

 

[Oldvatr]

Finally Resolved. Heard from the Consultant who stopped my Glic. He says it was simply due to me not needing it, and that if I need it in future then there is no contraindication with heart failure or the meds I am on. See GP if required. So this thread can close now, I have the answer I was seeking.

Gliclazide is NOT a factor in heart failure, and studies show it may be be protective against CVE.

 

[Bluetit1802]

I wonder if they did an insulin test to make him decide you don't need it? Otherwise how could he be sure at the time he made that decision?

 

[ickihun]

Get Well Soon. @Oldvatr

I know this is a boring answer but your heart attacks may be genetic in your case, as of your diabetes too.

Have you considered contacting a genuine Gene screening company?
Are all the other risk factors for heart attack been eliminated?
If insulin resistance your only risk then keep at it. Unfortunately for life and regardless of how many good hba1cs is achieved.

I'm wondering in your case if the unnecessary glac tablets could be the cause? A med ingested when the body has no need for it?
Although the opposite thought is glac hasn't left your pancreatic cells yet so your still benefiting from it. I believe some drugs can take over a month to be clear in your system.
Was both of your heart attacks whilst taking glac?

Out of my experience from taking glac it just stopped working on reducing my bgs and I thought due to my body building up a resistance. Like any med but glac I took for years with metformin too.
I have mild heart disease/atherosclerosis but it may be worse now due to less walking/running/cycling/swimming and no metformin.

I was able at one point to reduce most of my mixed insulin then started with chest pains. I've discovered mainly due to underactive thyroid reacting to low carb diet and bad sleep from low iron and a fraction too much levothyroxine.

Never a heart attack but very severe palpitations from fast heart beat. Increased betablocker has helped enormously. I was told being on bisoprolol originally may have prevented an attack. (given decades ago by a fantastic GP)

I wish you a peaceful rest and a hugely beneficial op.

Pesky IR may be the causation, even in remission, maybe?

Please keep posting. I haven't posted much lately myself due to typing difficulties from a trapped nerve in my neck.. too now.
I find your posts fascinating and hugely helpful.
When is your op? Mine should be July, latest. Of course such different ops but I wish you a speedy recovery and increased activity levels too.

 

[Oldvatr]

Not essential IMO. I am confident I will be able to control now esp when I get home. Recently I have been pushing the boundaries, and not frightened myself with the exception on the two occasions I ate vegan food, My levels did drop significantly even when I was off all my meds quite naturally, and so that and the fact that exogenous insulin did nada for my bgl when I was in crisis shows I really do not need external insulin. Since Glic was the med in question, then this acts by boosting internal insulin production, so it would not work at all if I was insulin deficient. I am sure I have a working pancreas, and it was IR that was my problem.

Edit to add: Just to underline my post above: Last night I had a bgl reading of 11.6 but it was taken by the nurse at bedtime, and was only 1 hour after eating supper (which included mashed potato, and a large blackberry crumble with custard) and was half an hour after a nightcap of drinking chocolate. So I am not entirely surprised at this. However my morning fbg was 5.7. I am only on Metformin (reduced dose) and that drop is far greater than could possibly be attributed to the Metformin. It can only be from my own insulin.
In answer to @ickihun , I actually stopped my Glic over a month ago, with a two day re-instatement before the doc stopped it again 2 weeks ago, The half life of Glic is 6 hours, and it does not need to build up like Metformin to take effect.

 

[Oldvatr]

I changed a couple of my posts earlier, but that was by edit, and consequently did not show up in Recent Posts. Just to recap. My Glic was stopped by the consultant simply because I did not need it as my bgl has recovered. I wish to make it clear that the research I did, and which was followed up by at least 3 doctors here, did not show ANY association between Glic use and heart failure, So in that respect it seems to be safe, and may even be protective.
What the consultant who performed my angiogram told me was that my atherosclerosis is due to many years of heavy smoking, drinking, and poor glycemic control on bad diets. He was certain that my recent event was going to happen any time, and I am at risk of another until I get my new plumbing. This is why I remain an inpatient here in hospital.

He saw no evidence of any recent growth that could be due to my LCHF diet, My current CVE is most probably connected to a concurrent bacterial infection of my lung, accompanied by high adrenalin levels and high blood glucose making sticky blood. I am on increased blood thinners now.

I do not have heart problems showing in my family tree, so I am not genetically predisposed - anyway, I got it now, so that would be academic IMO and I cannot lock the stable door....

 

[ickihun]

I changed a couple of my posts earlier, but that was by edit, and consequently did not show up in Recent Posts. Just to recap. My Glic was stopped by the consultant simply because I did not need it as my bgl has recovered. I wish to make it clear that the research I did, and which was followed up by at least 3 doctors here, did not show ANY association between Glic use and heart failure, So in that respect it seems to be safe, and may even be protective.
What the consultant who performed my angiogram told me was that my atherosclerosis is due to many years of heavy smoking, drinking, and poor glycemic control on bad diets. He was certain that my recent event was going to happen any time, and I am at risk of another until I get my new plumbing. This is why I remain an inpatient here in hospital.

He saw no evidence of any recent growth that could be due to my LCHF diet, My current CVE is most probably connected to a concurrent bacterial infection of my lung, accompanied by high adrenalin levels and high blood glucose making sticky blood. I am on increased blood thinners now.

I do not have heart problems showing in my family tree, so I am not genetically predisposed - anyway, I got it now, so that would be academic IMO and I cannot lock the stable door....

IMO smoking is your biggest risk. Then bad glucose control. Then bad diet but luckily for you not an adolescent with genetic heart failure.
Thinking of giving up smoking or I'm guessing you have done already since your diagnosis of diabetes?

Are you having stents or needing a more evasive bypass?
Wow, we are a pair if so. Different bypasses but both new rewiring.

 

[ickihun]

Not essential IMO. I am confident I will be able to control now esp when I get home. Recently I have been pushing the boundaries, and not frightened myself with the exception on the two occasions I ate vegan food, My levels did drop significantly even when I was off all my meds quite naturally, and so that and the fact that exogenous insulin did nada for my bgl when I was in crisis shows I really do not need external insulin. Since Glic was the med in question, then this acts by boosting internal insulin production, so it would not work at all if I was insulin deficient. I am sure I have a working pancreas, and it was IR that was my problem.

Edit to add: Just to underline my post above: Last night I had a bgl reading of 11.6 but it was taken by the nurse at bedtime, and was only 1 hour after eating supper (which included mashed potato, and a large blackberry crumble with custard) and was half an hour after a nightcap of drinking chocolate. So I am not entirely surprised at this. However my morning fbg was 5.7. I am only on Metformin (reduced dose) and that drop is far greater than could possibly be attributed to the Metformin. It can only be from my own insulin.
In answer to @ickihun , I actually stopped my Glic over a month ago, with a two day re-instatement before the doc stopped it again 2 weeks ago, The half life of Glic is 6 hours, and it does not need to build up like Metformin to take effect.

If I had no insulin with such foods my bgs would be triple yours.

BTW. Congratulations on getting in remission.