Gliclazide

[acs1951]

I am a bit confused about the use of this drug. I was diagnosed as probably T2 in July. My reading was 124 and so i was given 80g of Gliclazide tablets per day. A month later this was doubled to 2 x 80g. Last month it was halved to 2 x 40g and on Monday was stopped altogether.
My 3 month HBAC1 reading is now 44 which is I am told too low for needing Gliclazide. The nurse said Metformin was not an alternative as I am in the middle of the BMI chart and do not need to lose weight. I have to see what happens as to how much the blood glucose levels increase and go back in January. I presume it takes a few days for the lack of drugs to take effect as my BGC is still hovering around 4 today.
So please what does this tablet do and is there a reason why I needed lots of it in the aututm but might need a different drug now?
Andrew Smith

 

[Guzzler]

Have you changed your diet at all? Gliclazide is a glucose lowering drug and as you have lowered your levels (very well done) further use of Glic would lower your bg levels too far for safety.
Metformin is a mild appetite suppressant which also helps with liver dumps and has some effects on protecting organs.

 

[Brunneria]

Are you in the UK?

Generally the NHS guidance is that T2s don't need medication if they can maintain a blood glucose level of less than 53 (HbA1c test) on diet and lifestyle. So yes, I can understand why your nurse says you don't need the two drugs you have been on. Having said that, a lot of health care professionals seem to leave people on Metformin even if their blood glucose goes down to your level. It is often discussed with the patient.

Her reasoning/excuse that you don't need Metformin because you don't need to lose weight is a little weird. Not everyone loses weight on Metformin. Have you lost weight since diagnosis? Is she perhaps concerned that you have lost weight rapidly?

What changes have you made to diet and exercise/lifestyle since diagnosis? These can often have a larger impact than the medications, depending on your dedication and ethusiasm, of course.
I bet you are fascinated to see what happens to your bg results at your next test!

 

[Daibell]

Hi and welcome. I have to be careful here as it's not for me to say what meds you should have but perhaps I can explain what those two tablets do. Gliclazide stimulates the pancreas to produce more insulin and is normally used if it's suspected your pancreas has a lower insulin output than normal. It can cause weight gain if you eat too many carbs whilst on it as any additional insulin helps the body use the carbs. Metformin is usually the first drug of choice for T2s. Many are on it and I still am even as a T1 as it has some protective properties for the heart. It reduces the liver's output of glucose a little and helps a bit to reduce blood sugar. My understanding is that it never affects weight gain by any measurable amount and that was true for me. Other's may care to comment. It's a very safe drug. For some it causes bowel problems for a week or two but if that continues then there is a Slow Release version (Metformin SR). Metformin starts to work over a few days. Gliclazide usually works within the day. I hope that helps. May be that with a low carb diet you don't need any meds at all.

 

[ringi]

To see if you will benefit from Metformin you need a "fasting insulin level test" along with a fasting BG test on the same sample of blood. This will allow your insulin resistance to be worked out. Metformin is a very effective and safe treatment for high insulin resistance, as it makes our body more responsive to the insulin. (But remember that insulin resistant is only harmful to us if we eat carbs or too much protein.)

(A lot of the complications of diabetes is due to high insulin levels, not high BG levels.)

But the NHS does not do fasting insulin level tests, hence the nurse has to guess if you are insulin resistant based on your BMI.

 

[acs1951]

Thanks for these replies. I had to do another bg test at 11am, 4hours after my slightly less than normal sixed oat flakes breakfast as i felt it going low. It was 3.8 so i treated with three jelly babies and will test again later.
I have made a concerted effort to reduce intake of carbs by changing to the Lidl High Protein rolls, cutting out potatoes, making my own soups for tea, no sausage rolls, chocs, biscuits or cakes etc. I am basically trying to keep to under 150g carbs per day of mostly low GI food with plenty of extra protein. The tablets made me put on a couple of pounds in weight.
I am in the UK. ACS

 

[TheBigNewt]

Thanks for these replies. I had to do another bg test at 11am, 4hours after my slightly less than normal sixed oat flakes breakfast as i felt it going low. It was 3.8 so i treated with three jelly babies and will test again later.
I have made a concerted effort to reduce intake of carbs by changing to the Lidl High Protein rolls, cutting out potatoes, making my own soups for tea, no sausage rolls, chocs, biscuits or cakes etc. I am basically trying to keep to under 150g carbs per day of mostly low GI food with plenty of extra protein. The tablets made me put on a couple of pounds in weight.
I am in the UK. ACS

That's a good carb intake goal. Sounds like you might get away with just diet no pills at least for awhile. Plenty of Type 2s here at the VA clinics get off pills with diet and weight loss.

 

[Hammer1964]

acs1951, I too was on Gliclazide 80mg a day then reduced to 40mg a day and then taken off it with a HbA1c of 37. (I am one of those slim T2 with no need to lose weight but lost a stone) put on Metformin and suffered a lot so put on Metformin SR and still suffering and loosing weight (slowly). I aim for no more than 80g of carbs a day, no longer eat pasta, rice, white bread. My DN does not want me to come off Meds, I of course have a different opinion and will be giving it at my next meeting next week.

 

[LittleGreyCat]

Well done for coming off the Gliclazide.
I would consider discussing the use of Metformin again because it is generally held to help with several things and have little or no adverse effects.
It is a mild appetite suppressant but isn't a wonder weight loss pill. I think your DN is a little confused or did not explain well.
It may help to lower your carbohydrate intake further - perhaps slowly down to below 100 g per day - because carbohydrate is the main source of blood glucose. Everyone seems to have a different level at which they stabilise their BG but lowering carbohydrate is usually beneficial.

 

[acs1951]

Thanks LittleGreyCat and I have had a very low carb day to see what happens. Before meals readings were 6, 5.8 and 5.9. This seems pretty good to me and seems seems to validate claims that somewhat less than 150g carbs is the way to go. Acs