Gliclazide and normal diet.

[Concordjan]

I started yesterday. I halved the breakfast carbs, did away with rhem all together at lunch and had a moderate amount at dinner. Altogether about 60 for the day and I felt a lot better for it. My morning reading this morning was 4.8.

That's brilliant, well done.

 

[Nicksu]

Much improved. Getting off steroids if you have been on them for a while is never a quick thing. You have to wean yourself off them. Gradual reduction is the key - maybe dropping 5mg every week or two but listen to your body - you may have to slow your reduction depending on how you feel. My largest dose was 60mg when I had a huge MG flare up. I developed diabetes because I have been on long term steroids. It does get better - believe me - though its a rude shock to be diagnosed. I went the same way - low carb - and have lost over 3 stone now - and my BS levels are great and I am off Gliclizade now.

keep your chin up and don't stress yourself.

 

[Garway]

Much improved. Getting off steroids if you have been on them for a while is never a quick thing. You have to wean yourself off them. Gradual reduction is the key - maybe dropping 5mg every week or two but listen to your body - you may have to slow your reduction depending on how you feel. My largest dose was 60mg when I had a huge MG flare up. I developed diabetes because I have been on long term steroids. It does get better - believe me - though its a rude shock to be diagnosed. I went the same way - low carb - and have lost over 3 stone now - and my BS levels are great and I am off Gliclizade now.

keep your chin up and don't stress yourself.

Thank you, I am feeling much more positive today.

 

[Garway]

@Garway

Hello Elizabeth and welcome to the forum To supplement the excellent advice you have received so far, here is the Basic Information we give to new members and I hope you will find it useful. Ask more questions when you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 147,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

Thank you Daisy, I thought I had replied to you but can't see my reply. I am still learning how to do things. This information is very useful and I shall keep referring back to it.

 

[Nicksu]

Thank you, I am feeling much more positive today.

Glad you are feeling better - I know a lot of people (including myself) feel a bit cr*p when they drop the level of carbs in your diet quite considerably - but it does improve things hugely long term. Its a case of readjusting what you want to eat - and as everyone says - eat to your meter - testing will show you what things you can and can't eat - porridge is one of these odd ones - some can eat it and some can't. I don't indulge myself (not a porridge fan even pre-diagnosis) - but I do eat oatcakes - no more than a couple at a time (and covered with full fat cream cheese and a bit of smoked salmon) as a snack when I get the munchies. Yum! It's not about what you can't eat - but finding what you can eat which won't hike your BS levels and which you enjoy! It makes it more likely you will stick to the right things.

 

[pleinster]

I started yesterday. I halved the breakfast carbs, did away with rhem all together at lunch and had a moderate amount at dinner. Altogether about 60 for the day and I felt a lot better for it. My morning reading this morning was 4.8.

 

[Sid Bonkers]

Well, rusty or not, for me that is the best most understandable explanation of what's going on. Thank's Sid. Now they just need to find a way to get these steroids down quickly.

Thanks Garway I did have a quick google after I posted that and found this that explains it in detail, the first few paragraphs especially, definitely worth a read and will help you understand what cortisol does and what steroids do.http://www.todaysdietitian.com/newarchives/111609p38.shtml

 

[Garway]

Glad you are feeling better - I know a lot of people (including myself) feel a bit cr*p when they drop the level of carbs in your diet quite considerably - but it does improve things hugely long term. Its a case of readjusting what you want to eat - and as everyone says - eat to your meter - testing will show you what things you can and can't eat - porridge is one of these odd ones - some can eat it and some can't. I don't indulge myself (not a porridge fan even pre-diagnosis) - but I do eat oatcakes - no more than a couple at a time (and covered with full fat cream cheese and a bit of smoked salmon) as a snack when I get the munchies. Yum! It's not about what you can't eat - but finding what you can eat which won't hike your BS levels and which you enjoy! It makes it more likely you will stick to the right things.

So far, so good. I wasn't able to get hold of the diabetes nurse and will have to wait untill after Easter to talk to her so at the moment I am winging it. I have done some serious carb cutting and I think I am round about 80 ish at the moment. I am hoping I can take some porridge and have halved it so far. I have found some high protien bread, Livlife and Hi Lo which means I can make a sandwich and have lots of veg and protein for dinner with a bit of carbohydrate thrown in. I am already feeling so much better and it must be better for the infection risk so I shall keep at it, blood sugars are much improved.

 

[Garway]

Thanks Garway I did have a quick google after I posted that and found this that explains it in detail, the first few paragraphs especially, definitely worth a read and will help you understand what cortisol does and what steroids do.http://www.todaysdietitian.com/newarchives/111609p38.shtml

Thanks Sid.

 

[Garway]

Update

I have kept to lower carbs and have felt a lot better for it. A typical days blood readings have been
before breakfast 4.8, before midday meal 7.8, before evening meal 5.8, and before bed 7.9
" 4.9 " 6.3 " 7.4 " 5.4
This is whilst taking 40 Gliclazide each morning.

I do have a problem in that I am still losing weight and I have been told to raise the Gliclazide to 80 in the morning and 'eat normally' as before. I tried it and my after midday meal readings were 13.1 and 16.2 one and two hours after which made me feel ill. Today I am going to experiment by taking 40 at breakfast and 40 at lunch to see if it makes any difference to the number of carbs I can tolerate. I seem pretty safe untill lunch time when the steroids, still high, click in, so my thinking is a small increase in carbs at lunch and dinner may stop me losing weight annd the additional Glicazide taken then will cope with the increase.

Thank you for everone's help, I really appreciate your advice and any further comments.

 

[Bluetit1802]

Let us know if your plan works.

 

[Garway]

Let us know if your plan works.

Not really, I think I will have to do my own thing. Because of kidney damage I can't take too much protein so I am contemplating going full fat, lower protein, slightly higher carbs but still under 100 and stick to 40 gliclazide twice a day. Diabetic nurse rang today and seems quite happy with blood sugars of 10/11/12/14,but I'm not. I hope this is a sensible plan.
The good news is that My steroids are at last going to be reduced 5mg a fortnight untill I get down to 20 and the hope is I will feel much better as they go down but it may be a rough ride as I have been high dose so long.

 

[pleinster]

Not really, I think I will have to do my own thing. Because of kidney damage I can't take too much protein so I am contemplating going full fat, lower protein, slightly higher carbs but still under 100 and stick to 40 gliclazide twice a day. Diabetic nurse rang today and seems quite happy with blood sugars of 10/11/12/14,but I'm not. I hope this is a sensible plan.
The good news is that My steroids are at last going to be reduced 5mg a fortnight untill I get down to 20 and the hope is I will feel much better as they go down but it may be a rough ride as I have been high dose so long.

You are right not to settle for the figures your nurse is happy with. I am sure you will get your levels lower than that, and that's good news about the steroids (nasty little villains of the piece..but sadly necessary in other ways)...that will only help. I hope you can get them reduced further. I was on 25g prednisolone for ages (the cause of my diabetes) and as it got reduced, two things happened - my blood sugar dropped and my the appetite which had been dramatically increased by the drug faded. It wasn't until I got the dosage down to 5mg that it stopped having an uncontrollable impact. Good luck.

 

[Garway]

I have just realised that I have no idea of how to start a new question. I got myself into a real mess last night and had a blood pressure of 185/105. At 8.52 it was 113/58 but between then and my high reading I realised I had not taken my second 40 gliclazide at lunch time so I took it then which was some time after my evening meal. Throughout the night I could not get my bp to return to normal which was very scary as I take Rivaroxaban. What I want to know is can Gliclazide cause high blood pressure? This morning, after taking all my tablets my blood pressure normalised after taking my steroids and having something to eat. Is Gliclazide known to raise blood pressure?

On twice a day Gliclazide eg. before breakfast 4.3, before midday meal 5.9, one hour after10.8, two hour after 8.9, before bed 4.8. I drink a lot of water. I am wondering if I should go back to one a day or stop it altogether. There is always going to be a mid afternoon rise with steroid induced hyperglycemia I think. Without Gliclazide I was losing weight, now it has stabilised.

I would appreciate any information that could throw a light on this.

 

[Bluetit1802]

I have just realised that I have no idea of how to start a new question. I got myself into a real mess last night and had a blood pressure of 185/105. At 8.52 it was 113/58 but between then and my high reading I realised I had not taken my second 40 gliclazide at lunch time so I took it then which was some time after my evening meal. Throughout the night I could not get my bp to return to normal which was very scary as I take Rivaroxaban. What I want to know is can Gliclazide cause high blood pressure? This morning, after taking all my tablets my blood pressure normalised after taking my steroids and having something to eat. Is Gliclazide known to raise blood pressure?

On twice a day Gliclazide eg. before breakfast 4.3, before midday meal 5.9, one hour after10.8, two hour after 8.9, before bed 4.8. I drink a lot of water. I am wondering if I should go back to one a day or stop it altogether. There is always going to be a mid afternoon rise with steroid induced hyperglycemia I think. Without Gliclazide I was losing weight, now it has stabilised.

I would appreciate any information that could throw a light on this.

Have you read the leaflet that comes with your tablets?
This is the on-line version
https://www.medicines.org.uk/emc/medicine/31622

It mentions that you may experience high blood pressure.

also http://www.ehealthme.com/ds/gliclazide/high blood pressure/

 

[AndBreathe]

I have just realised that I have no idea of how to start a new question. I got myself into a real mess last night and had a blood pressure of 185/105. At 8.52 it was 113/58 but between then and my high reading I realised I had not taken my second 40 gliclazide at lunch time so I took it then which was some time after my evening meal. Throughout the night I could not get my bp to return to normal which was very scary as I take Rivaroxaban. What I want to know is can Gliclazide cause high blood pressure? This morning, after taking all my tablets my blood pressure normalised after taking my steroids and having something to eat. Is Gliclazide known to raise blood pressure?

On twice a day Gliclazide eg. before breakfast 4.3, before midday meal 5.9, one hour after10.8, two hour after 8.9, before bed 4.8. I drink a lot of water. I am wondering if I should go back to one a day or stop it altogether. There is always going to be a mid afternoon rise with steroid induced hyperglycemia I think. Without Gliclazide I was losing weight, now it has stabilised.

I would appreciate any information that could throw a light on this.

@Garway - Would you like this post transformed into a new thread for your query? I can do that for you, if that's what you would like.

Just let me know, but please do use my name with the @ symbol before it to ensure I receive a notification you've responded to me.

 

[pleinster]

I have just realised that I have no idea of how to start a new question. I got myself into a real mess last night and had a blood pressure of 185/105. At 8.52 it was 113/58 but between then and my high reading I realised I had not taken my second 40 gliclazide at lunch time so I took it then which was some time after my evening meal. Throughout the night I could not get my bp to return to normal which was very scary as I take Rivaroxaban. What I want to know is can Gliclazide cause high blood pressure? This morning, after taking all my tablets my blood pressure normalised after taking my steroids and having something to eat. Is Gliclazide known to raise blood pressure?

On twice a day Gliclazide eg. before breakfast 4.3, before midday meal 5.9, one hour after10.8, two hour after 8.9, before bed 4.8. I drink a lot of water. I am wondering if I should go back to one a day or stop it altogether. There is always going to be a mid afternoon rise with steroid induced hyperglycemia I think. Without Gliclazide I was losing weight, now it has stabilised.

I would appreciate any information that could throw a light on this.

Hi. I was prescribed Gliclazide when first diagnosed. This was doubled after couple of weeks. I had been on meds for high blood pressure for years..and it made no difference at all. If it does increase BP, I would have expected to see some personal and very direct evidence of it...that said, we all differ...and there are lots of things which can raise BP (not least of all stress..and..including...inaccurate one off readings on BOP devices!). Sadly for me (or happily as it turns out), Gliclazide did very little to reduce my blood sugar levels either! This was not helped by a daily spike over a few hours from the steroids I was on. Reduction of the steroid and reduction of carbs in my diet did far far more for me than the Gliclazide. I would, however, suggest discussing it with your GP. I have very recently had high diastolic levels (ie. the bottom figure...c. 135/105) and have had my beta-blockers increased (ie. atenolol). I have been off blood pressure meds for about 18 months now. Not sure of the exact cause but I have had a number of small infections recently and I am on a lot of other meds (to prevent renal transplant graft rejection)...the one thing I can be sure hasn't caused it - is Gliclazide.