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gliclazide help

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nolanjoe92

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Hi all , i was diagnosed with type 2 beginning of November last year with a Hba1c of 135 . I had my review two weeks ago and have managed to get this down to a Hba1c of 51 . i was delighted with this result ! my nurse said she would like me to try manage without gliclazide to see if i can keep bloods stable on metformin alone. I have tried the past week to do this but even after a low carb meal eg.15 carbs for an entire meal my bloods are still around 11mmol 2 hours after jumping up from usually in the 4s or low 5s . I feel tired and hungry all the time as i am unable to eat enough to fuel or fill my body . they have also advised me to put some weight back on as i was very poorly when diagnosed and dropped from 93kg to 70kg(yes i am type 2 ) i am now very skinny as im 6ft 1 and they suggested i try to get back to a comfortable weight around 80kg would be a good bmi .
Now my problem i hear alot from my medical team about long term affects of gliclazide and how it wears out whats left of my pancreas prematurely is this true ? i was on 80mg in morning and 40mg in evening before i stopped taking it ? as now i feel id rather take the risk of staying on gliclazide than the negative effects of my blood sugars been high and not been able to eat enough food . my worry is if possible id like to avoid or delay relying on insulin for as long as possible as this keeps been mentioned if i stay on glicizade for too long .

Long story short has anyone got any personal experiance eg how long have you been on gliclazide and what would your advice to me be ?

i felt i really had a hold on my diabetes but now i feel like im back to square one and feeling really demotivated with how hard this seems to be without medication .i have accepted diabetes is a part of my life now and i must respect it but really want to get my balance back in my life if that makes sense

Thank you in advance for any help or opinions it really is a great help to speak to peple here who have experienced so much more than me .
 
Can you tell us what you eat in a typical day? Personally I can't cope with 15 grams carbs in one go.
 

My Dr did say that Gliclazide squeezes the last drops of insulin out of the pancreas. I don't get on with it anyway. Ask your Dr about Dapagliflozin. It dumps glucose out via the kidneys.
 
type two paul said:
My Dr did say that Gliclazide squeezes the last drops of insulin out of the pancreas. I don't get on with it anyway. Ask your Dr about Dapagliflozin. It dumps glucose out via the kidneys.
Click to expand...
Dapagliflozin is an SGLT2, so I think that many would prefer to risk Glic.
 
Like @xfieldok , 15 grams of carbs in one meal would basically floor me. My heart would go haywire, my legs would be rubber, hot flashes and such... Not fun, and requiring a very brisk walk to get it back down, while I keep feeling weird even when i'm seeing fives again. I usually stick to 20 grams per day or under, which effectively comes down to about 10 grams a day, or thereabouts. Since you have no weight to lose, you could do this: Eat three meals a day, and three snacks, but keep all of it low carb and high in (good) fats. Fill up on meats, eggs, cheeses, avocado, poultry, fish, olives, above ground veggies... Snack on cheeses, pork scratchings, olives, you know, the stuff that keeps you full and far from hunger and won't spike your blood sugars. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might help, as could dietdoctor.com, this place's website (diabetes.co.uk , not .org) and Dr. Jason Fung's the Diabetes Code. Just whatever you do, don't go for intermittent fasting to get your blood sugars down, because you'll lose more weight that way and that's not what you want right now eh.

As for Glic, it only gave me hypo's, but then, there was so much going on at the time I was on it, I might've missed other side effects. And yeah, it does wring out a pancreas... Not something you want to do, I'd guess!

Good luck!
Jo
 
I have no personal experience of Glic (or other T2 medications), but I know several forum members who put weight on while taking Glic since it helps raise your Insulin levels.

Your reaction to a low carb meal seems unusual assuming it was just 15gms of carbs of a low GI type and you had some good animal based fats (or Olive oil) and protein in that meal.
Are you trying to do a Low Carb Calorie restricted diet? Or just a Low Carb High(er) traditional Fats Way Of Eating, or Low Carb, Moderate traditional Fat High(er) Protein Way Of Eating?

For me a meal with 15gms of low GI Carbs would be right around my maximum for any ,meal since I normally aim for 20gms but up to 50gms of low GI carbs per day.

All I can say is don't fear traditional fats, use them plus more protein to fill up with when hungry.
Assuming you are a Type 2 and don't have some other Diabetes variation, then when/if you become fat adapted then you will have lots of energy because you will have access to all your stored body fat (a lot of energy even if you are skinny).
But it's important not to restrict Calories while trying to get Fat Adapted or you will be hungry and tired all the time.

Indeed when I started Low Carb, I was eating more Calories than before because of the increased fats in Eggs, Cheese, Fatty cuts of meat and fish etc. But I still lost some weight on that even though I was only bordering being overweight. Once fat adapted I added Time Restricted eating (aka Intermittent Fasting/ Skipping Breakfast) to that Way Of Eating , naturally reducing my Calorie intake without either Hunger or Tiredness. More recently I have been in weight maintenance mode having dropped from 170lbs down to 147lbs.

If you want to put weight on you probably need to increase either/both animal/fish based Fats and Protein rather than adding Carbs.

Finally try to 'eat to your BG meter'; 2 or 3 meals per day, no snacks aiming for a rise from bfore a meal to 2hrs after of a maximum of 2.0 mmol.
We all react slightly differently, so test meals with different foods and different types and quantities of Carbs until you can accurately predict how your body react to a meal.
 
When I first started, I went keto. I did have a snack box prepared. It contained pieces of cheese, walnuts and olives. Once I got into ketosis my appetite went I didn't need it any more.

Ian is right, the sooner you can stop snacking the better.
 
Hi. From what you say it's possible you are not T2 but late onset T1 (LADA) so ask the GP for the two tests for that. I was on Gliclazide for several years ending up on a dose of 320mg per day (!) with no effect. My GP didn't spot that showed I had a failing pancreas so do get the tests done. The Glic had no side effects for me but I'll never know whether is hastened the demise of my pancreas. My GP initially refused me insulin but finally offered it and I stopped the Glic. So, I would not stay on it for too long and move to insulin if you turn out to be LADA. A typical T2 can generally do OK with Metformin and a low-carb diet. If not then LADA becomes likely. Note that if you gain weight with Glic or insulin then you will be having too many carbs. I didn't gain weight as my beta cells had gone AWOL so couldn't metabolise the carbs.
 
nolanjoe92 said:
Thank you in advance for any help or opinions it really is a great help to speak to peple here who have experienced so much more than me .
Click to expand...

I think the type of carb can make a difference. When I started low carb I just cut out bread, potato, rice and pasta. I have some PC software that allows me to enter any food and the weight to get up to ten things like carbs, cals, fat, cholesterol etc. So I know that I was eating less than 50 gms of carb a day, all of which would be in the vegetables that I ate and I ate a lot.

If I eat a slice of bread, multigrain for example, which is 11 gms of carb, my BG will go up dramatically, from 6 to 12 (I've tried it). If I was to eat a slice of bread every day, it's almost as if it has an accumulative effect because I would be unable to get my BG below about 9, so I have to be very strict.

Going low carb and no bread/pasta/rice/potato I was able to get rid of gliclazide, januvia and atorvastatin (cholesterol dropped as well).
 

NolanJoe - My knee jerk reaction would be it could be it is taking a little while for your body to get used to the new regime, without your Gliclazide.

Our bodies like to run to habit, and that also means the enzymes and hormones we use for digestion and metabolism. We often see someone who has been successfully managing their T2, often just with diet, who then has a carb heavy meal, then experiencing a disproportionate blood sugar result (i.e. high).

Were I in your shoes, I might try to give it a little longer - maybe another week or so, and really concentrate on managing my diet. If you are hungry, best not to have more carbs, but consider more protein or fat - meat, cheese or eggs? They are nutritious, filling and usually very low carb, so will have a modest, if any, blood glucose response.

Of course, it's very simple for me to say, and maybe less easy for you to do.
 
I was given Gliclazide whilst waiting for my test results anti gad and cpeptide to come in, they were wondering whether I was MODY, I found it worked really fast and made me feel unwell. It did improve my blood sugar readings. It is long acting within the body..I switched to Repaglinide when I saw the consultant, and this was so much better for me personally. It is short lasting, around 4 hours and I took it before each meal, and you squeeze out bit of insulin. I was told usually the treatment plan is you take the insulin producing tablets for as long as they work, then it’s on to insulin. I took Repaglinide for 3 months with a drop in my hba1c to 59 which for me was brilliant and I felt so much better than I had for about 2 years. In January my numbers started to rise and after a few too many virus and immune system taking a hit I couldn’t keep my blood sugars down any more. Sitting at 12-24. They doubled the dose and the doubled again with little effect. So I started insulin around 2 weeks ago. Nurse said to me they can’t say when the tipping point is, could be month could be years. I assumed I’d have years on that med doing it’s thing, but evidently not! I was told late onset type 1 though as my results where strongly positive antibodies. If it’s autoimmune then at some point it’ll happen. Type 2 isn’t autoimmune, have they done cpeptide to see how much insulin you make? Best of luck on your diabetes journey, and finding a med and plan that works for you. Acceptance is key, I agree and know how that feels! Each time you get used to something, it seems to shift. My main goal is good levels and feeling well.
 
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