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Gliclazide PLUS what else?

Patch

Well-Known Member
Messages
2,981
Location
Bristol
Type of diabetes
Treatment type
Insulin
I'm on 80mg of gliclazide once a day. Used to take Met SR too, but decided to stop because of the side effects.

What other treatment can be used in conjunction with Gliclazide? I've got high Trigs (5.1), so Byetta and Victoza are out of the question.

The Dr. wants to put me on over night insulin, but I've refused so far because I can't afford to put any weight on.

Is anybody combining Gliclazide with any other oral medicines to lower/control BG?
 
Patch said:
I'm on 80mg of gliclazide once a day. Used to take Met SR too, but decided to stop because of the side effects.

80mg is only a quarter of what you can take. Max dose is 320mg daily.

What other treatment can be used in conjunction with Gliclazide? I've got high Trigs (5.1), so Byetta and Victoza are out of the question.

Don't know why the Trigs level has anything to do with you not getting Byetta or Victoza as they are both bg lowering drugs.



The Dr. wants to put me on over night insulin, but I've refused so far because I can't afford to put any weight on.

Gliclizide can have the effect of making you gain weight especially in higher doses.

Is anybody combining Gliclazide with any other oral medicines to lower/control BG?

Many people combine Gliclizide with other oral medications to keep control of their diabetes.

Next line of treatment is to add a Glitazone such as pioglitazone or rosiglitazone.

After that a DPP-4 inhibitor such as sitagliptin or vildagliptin.

Only then would you get Byetta, Victoza or insulin.
 
Have you tried carb control?
Hana
 
Thanks for the responses.

Hana - I do lo-carb, but I still have trouble with the dawn phenomenon. I've been lo-carbing for around 7 years now, and I'm sure I've become more sensitive to carbs, so what little I do eat tends to cause spikes.

Sue - I specifically asked my doctor about the Gliclazide doses, and he said that 80mg was the max. I'll speak to him again shortly. I certainly HAVE put on weight since starting Gliclazide, around 1/2 stone, and it's ALL around my belly. :x Can you point me in the direction of any documentation that states high trigs doesn't effect the use of Byetta/victoza? The information I have read states that elevated trigs put Byetta & Victoza users at higher risk of Pancreatic Cancer, Pancreatitis and other diseases of the Pancreas.


Thanks again for the responses - I really appreciate it!
 
Patch.
Do you have the source for the information that you quoted. We can then check it out better once we check the database here, regarding the Trig's info. At the moment we do not have anything ....?

Ken
 
http://www.byetta.com/Pages/index.aspx

http://www.victoza.com/

http://www.diabetesselfmanagement.com/B ... s_warning/

http://diabetes.webmd.com/news/20071016 ... creas-risk

http://www.drugs.com/victoza.html

Loads of info if you Google for it... The following statement comes up over and over again:

Inflammation of the pancreas (pancreatitis) may be severe and lead to death. Certain medical conditions make you more likely to get pancreatitis. Therefore before taking Victoza, tell your healthcare provider if you have had pancreatitis, stones in your gallbladder (gallstones), a history of alcoholism, or high blood triglyceride levels.
 
Patch said:
Sue - I specifically asked my doctor about the Gliclazide doses, and he said that 80mg was the max. I'll speak to him again shortly.


From BNF59 so the doctor should have a copy on his desk!!

Dose
Initially, 40–80 mg daily, adjusted according to response; up to 160 mg as a single dose, with breakfast; higher doses divided; max. 320 mg daily
 
Further to that I have delved into the archive and found this from 2007.
It's not clear if Byetta caused the 30 reported cases of acute pancreatitis.

Most of those patients -- 27 out of 30 -- had other risk factors for acute pancreatitis, including gallstones, alcohol use, and severe hypertriglyceridemia (extremely high levels of triglycerides)

Twenty-two of the patients improved after discontinuing Byetta. Symptoms of acute pancreatitis returned when three of the patients started using Byetta again, according to the FDA.

Hypertriglyceridemia is a risk factor for pancreatitis and it accounts for 1 to 4% of cases of acute pancreatitis. Although a few patients can develop pancreatitis with triglyceride levels >500 mg/dL, the risk for pancreatitis does not become clinically significant until levels are >1000 mg/dL.[1,4,5] More importantly however, hypertriglyceridemia is typically not an isolated abnormality. It is frequently associated with other lipid abnormalities and the metabolic syndrome (abdominal obesity, insulin resistance, low high-density lipoprotein (HDL), high triglyceride, and hypertension), which are linked to coronary artery disease.

As far as I can make out it it is only a risk factor if the levels are massively high, not just elevated. something that you should really discuss with the GP or Consultant. The levels given in the abstract above are in mg/dl. when converted they read between 5.6 mmol/l and 11.3 mmol/l Trigs.

That would also apply to the Victoza question too.

I have been on Byetta for 17 months and have never had Trigs above those levels. I noticed that it does say a risk for the high levels can be a high fat diet........

Ken
 
Patch.
Basically what you are quoting is all in the public domain and has been for some time now. Nothing is really new. The risks are well documented. In your initial comment about the risks I thought that you had come across something new ? Really, it is just telling me what I already knew and had researched some 17 months ago before I started to take Byetta.

As far as I am concerned I have read all the information out there about both Byetta and also the newer Victoza. Yes there is a well documented risk, however it needs to be put in perspective. There are millions of users of the drugs who have not had a single problem. It is something that prospective and current users should be aware of, not something to be frightened of.

There is a certain website who recently have rubbished Victoza, without anybody there really knowing anything at all about it. Just posting links to the 'scare stories', frightening people. The same people who might benefit from either of the drugs we are talking about here.........but then apparently all drugs are 'poisons'.......things no sane person should take.......it needs to be remembered that not all of us can do things by diet and exercise alone, however much we would like to. However hard we try. It just doesn't work that way.

I use Byetta and when I first was asked if I wanted to go on it I read everything I could get my hands on. I saw all if the stuff about side effects and checked out each and every one. I had a couple of minor ones, the serious ones I believe do not warrant me stopping Byetta. I was warned fully about the 'supposed' risks of Pancreatitis.......I calculated it was an extremely low risk and that the symptoms had been well explained to me personally by my endo, and are also in the PIL (patient information leaflet). The same with the other risks that things had shown up in rats and mice. I know about them.

Now there are some sites on the net whose resident 'guru's' have picked up on the info that you, are I suppose, concerned about. Some of the sites rubbish the drugs because of that......their choice, but many of them haven't actually checked out how many people actually have benefited from Byetta, how many are actually doing well on Byetta, how many who have had no problems in respect of the reported side effects, some which COULD be serious. They seem to just want to rubbish the drug.......why ? It is effective. I am one who has had great benefit from it. So I am biased in that respect.

I look at things, I hope rationally, and I don't believe some of the comments made about Byetta in particular by people who really only see a 'scare story' rather than the positive side of the drug.
Another website, has several comments from the 'well respected' 'guru' which I have found to be factually and medically incorrect. I even pointed this out to the 'lady' who owns the site........she has yet to correct the mistakes on the blog, even after twelve months it still remains on view. I am sure she thinks she is right and will not back down.......even though it is totally wrong. Still she must know what she is talking about, mustn't she.......she is well respected ???

There are many drugs on the market which have reported side effects which if you read the list are scary ! If you think you are going to get every one, well that is what some people tend to do. Me, I just note them in case I ever do. Doesn't usually happen that way though. There are some who suffer with certain everyday drugs, drugs that millions of people never have any problem with at all. There will always be some who do get the side effects, that doesn't mean we should be scared to take something. It just means be aware of the risk, make your mind up if you are a positive thinker.....or one who always sees the 'dark side' and thinks, "That is going to happen to me !" I am a positive person, always have been.

I recently had to take a course of treatment for Cancer. Some of the drugs I was given could have killed me if I believed everything I had read about the possible side effects. I knew what the risks were and I didn't really have much choice........damned if I did.....damned if I didn't. Now that treatment was successful, so I was one of the lucky ones. If I had believed all the 'horror' stories I could probably be dead by now because I would have thought that there is no way I would take a 'risky' drug. The drugs helped cure me, they were effective......despite the scare stories.

All of what I have said here also relates to the Victoza I think. I only know what I have read and researched about it. I have read the thread on here where actual users of the drug post. In the main most are getting good results from it, are happy to continue using it. Most know and are aware of any risks. They, like me evaluated that risk and made a decision to use the drug. A wise move I think.

All I know is that if I had to go through treatment options again.......I would take either drug if it was offered. I personally believe they are effective, they do more than just lower your Bg levels, suppress appetite etc........Byetta gave me my life back. So, look at the positives Patch.......there are far more than the 'supposed' risks. It really does all depend on your choice........and your outlook on life...... :)

If you think about it life is full of risks, crossing the road, driving a car, flying, you name it there are associated risks which could if taken to extremes .....kill you. Now I cross the road, I drive.....
It doesn't stop me doing those things......it shouldn't stop us doing those things. Personally, I am sure that you are far more likely to be killed crossing the road or driving than die from using either of these drugs.

Ken
 
Have you read my original question? I'd hoped to get some simple answers relating to combinations of treatments. I'd happily take Byetta OR Victosa (I'd love to lose some weight!) - but my PCT doesn't want to prescribe me anything more than what I'm already on...
 
Patch.
Of course I read your OP :roll: Simple answer is that Sue posted about the combi drugs available and the increased doses which are also available to you. We collaborated on that reply to you. You have mentioned about Byetta and Victoza being out of the question......I don't see any valid reason why ?? If somebody else wants to give you other answers that is up to them. I wrote what I wrote.......

Patch wrote, "Can you point me in the direction of any documentation that states high trigs doesn't effect the use of Byetta/victoza? The information I have read states that elevated trigs put Byetta & Victoza users at higher risk of Pancreatic Cancer, Pancreatitis and other diseases of the Pancreas.

I also read your supplemental comment quoted above about Byetta and Victoza which was basically giving information from the net telling people that they were harmful and also the connection with high Trigs ? That is what you posted. I therefore answered that as well. Giving factual information for the benefit of ALL members. Some of whom might have been 'frightened off' by the scare stories. It is an open Forum after all.

In any case is it the PCT who won't prescribe more or the GP, all because of costs no doubt.

Ken
 
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