Gliclazide no longer working?

[markpj31]

Hi all,

Originally I was on maximum oral meds (2x80mg glicazide, 2x 1000mg metformin per breakfast/dinner) and 1x sitagliptin. I was taken off Metformin but gliclazide with meals and sitagliptin remain initially with 20units of Lantus at the start of the day..

I'm now on 2x gliclazide for breakfast, 20 units Lantus and 1x NovaRapid (4 units) for evening meal. My post-meal/before bed BSG has come down a lot (9-10mmol/l) but midday is awful over the last two days. Seeing as I'm eating the same thing daily, my BSG was 18 midday yesterday and 14.5 today. This makes me wonder if gliclazide is even working anymore?

 

[Antje77]

Originally I was on maximum oral meds (2x80mg glicazide, 2x 1000mg metformin per breakfast/dinner) and 1x sitagliptin. I was taken off Metformin but gliclazide with meals and sitagliptin remain initially with 20units of Lantus at the start of the day..

How long have you been using insulin?

This makes me wonder if gliclazide is even working anymore?

Gliclazide works by making the pancreas push out more insulin.
It might be worth seeing if you can get your C-peptide tested. C-peptide shows how much insulin you are producing yourself.

 

[markpj31]

How long have you been using insulin?

Gliclazide works by making the pancreas push out more insulin.
It might be worth seeing if you can get your C-peptide tested. C-peptide shows how much insulin you are producing yourself.

Thank you. Is this something that I can just ask my GP to add to my bloodtest?

 

[Antje77]

Thank you. Is this something that I can just ask my GP to add to my bloodtest?

It's not part of the regular blood tests requested by a GP, but I'm not sure if a GP in the UK can order one.
In the Netherlands it needs a referral, but things can be different between our countries.

1x NovaRapid (4 units) for evening meal. My post-meal/before bed BSG has come down a lot (9-10mmol/l) but midday is awful over the last two days.

What are you eating for lunch? Sounds like your body can't deal with that meal.

 

[Member496333]

My feeling is that Gliclazide may have squeezed the last breath out of your pancreas and that you’re simultaneously very insulin resistant. Obviously not a diagnosis or medical opinion of any kind.

 

[markpj31]

What are you eating for lunch? Sounds like your body can't deal with that meal.

The 14.5 and 18BSG where before lunch. Breakfast was 1 pork sausage and three eggs with a slice of wholemeal brown bread (15g carbs, 4g fibre). 4 hours later (when I was going to eat lunch) is when the BSG was that high so I didn't eat at all and pre-evening meal it was 11.

 

[markpj31]

My feeling is that Gliclazide may have squeezed the last breath out of your pancreas and that you’re simultaneously very insulin resistant. Obviously not a diagnosis or medical opinion of any kind.

I think you're right. I'm really active, 5 mile walks daily, exercise bike for 20mins too, as well as weights every 2 days. I thought all this was meant to reduce insulin resistance!?

 

[EllieM]

I think you're right. I'm really active, 5 mile walks daily, exercise bike for 20mins too, as well as weights every 2 days. I thought all this was meant to reduce insulin resistance!?

If it's only been a couple of days then there could be other reasons for the bg rise (eg infection) but I'd second @Antje77 's suggestion that you ask for a cpeptide test.

How long have you been T2?

 

[miahara]

Yes, I'll go with the Gliclazide hammering your pancreas theory as I'm fairly sure that's what happened to me. I was put on Glic' when first diagnosed and the meds and diet and exercise worked and I was almost classified as being in remission, but then my HbA1c started to rocket almost to the same level as at diagnosis. I pursuaded my GP who didn't really know much about diabetes to refer me to the diabetes clinic and an endocrinologist and I was put on insulin and I'm now jogging along with a steady and acceptable level of HbA1c.

 

[markpj31]

If it's only been a couple of days then there could be other reasons for the bg rise (eg infection) but I'd second @Antje77 's suggestion that you ask for a cpeptide test.

How long have you been T2?

Not feeling ill or no infections that I know of. I have been T2 officially for 10 years and probably 12 years unofficially

 

[markpj31]

Yes, I'll go with the Gliclazide hammering your pancreas theory as I'm fairly sure that's what happened to me. I was put on Glic' when first diagnosed and the meds and diet and exercise worked and I was almost classified as being in remission, but then my HbA1c started to rocket almost to the same level as at diagnosis. I pursuaded my GP who didn't really know much about diabetes to refer me to the diabetes clinic and an endocrinologist and I was put on insulin and I'm now jogging along with a steady and acceptable level of HbA1c.
View attachment 53481

I agree. I think I went through a honeymoon stage when I was first put on Gliclazide, my HbA1c went from 8,1 to 6.1 the moment I was put on it, then in about the same time as you, it started to creep up again to 8.3, although my last blood test prior to insulin being prescribed (Dec 2021) when I had covid was 7.3 which was went I was on metformin too - they took that away (which I'm glad about to be honest).

I'm still trying to get steady on insulin, waking up numbers are good, post evening meal are good, it's just midday that is the problem.

 

[Daibell]

Hi. I was on max dose (note 320mg) for a few years before it stopped working. As you are on insulin you don't need Gliclazide as well. When on Basal/Bolus insulin as you are, it's normal to have the Novorapid Bolus at each meal i.e. 3 times per day and to adjust the amount injected to be based on the carb content of the meal. I suggest you ask the GP/DN why you are on both Glic and insulin and why you are only having 1 Bolus per day when 3 is the norm. I would also ask for a C-Peptide test to check your insulin production level.