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Gliclazide

Hesha

Newbie
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1
I have been T2 for about 15 years, up until the last 6 months, it has been controlled by Metformin and diet. I can only tolerate 1 Metformin a day but that was working fine. In the last 6 months I have never been away from the nurse getting my blood sugar level checked. I eventually had to monitor my levels 4 times a day which has ended up with me being put on Gliclazide. Now, I've only been on it a week, so it maybe not long enough, but I've had no change to my blood sugar levels, they are still anywhere from 16.9 to 13.1. Does anyone know if this normal. Along with this, I just don't feel well. Almost every morning I wake up sweating and feeling very sick and it's usually 3 to 4 am. I check my blood sugar and it's in double figures. I have told the nurse about this and was told it was probably to do with the blood sugar, but I don't know.

Any replies to this would be good and interesting to read.
 
Hi @Hesha and welcome!
I can't answer all your questions, but can comment from my own experience of gliclazide medication which I was put on after my initial diagnosis. In my case it took about two months to get my plasma blood glucose down to a good level, though this also involved adopting a LCHF diet. The graph below shows how my average BG fell.

upload_2018-12-17_21-2-11.png
 
Hello and welcome,

How you are feeling sounds very much like high blood sugars to me. Your figures of 16.9 and 13.1 are not good, but I guess you know this. Medication works so much better if you follow a reduced carb diet. The more carbs you eat, the higher your levels will be. This is a simple fact. If you are able to tell us a typical day's food, we may be able to spot something that you could change or tweak a bit.

Tagging @daisy1 who has extremely good information for newcomers to the forum. Have a good read of it, have a good read round the forum, and ask as many questions as you like.
 
Medication works so much better if you follow a reduced carb diet. The more carbs you eat, the higher your levels will be.

Though don't you have to be careful reducing carbs when using Gliclazide as can't it make you go hypo? (or am I thinking about the wrong medication)
 
Though don't you have to be careful reducing carbs when using Gliclazide as can't it make you go hypo? (or am I thinking about the wrong medication)

Indeed you do need to be careful, which is when testing becomes so very important. As soon as blood sugars are approaching normal levels consideration has to be given to reducing the Gliclazide after discussing with the doctor/nurse.
 
Though don't you have to be careful reducing carbs when using Gliclazide as can't it make you go hypo? (or am I thinking about the wrong medication)
Yes. Gliclazide can cause hypos. If reducing carbs while taking the drug then you need to go fairly slowly and keep testing more frequently in order to assess how your body is responding
 
@Hesha
Hello Hesha and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful.

BASIC INFORMATION FOR NEW MEMBERS

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 235,000 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 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. Most of these are 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.
 
I have been T2 for about 15 years, up until the last 6 months, it has been controlled by Metformin and diet. I can only tolerate 1 Metformin a day but that was working fine. In the last 6 months I have never been away from the nurse getting my blood sugar level checked. I eventually had to monitor my levels 4 times a day which has ended up with me being put on Gliclazide. Now, I've only been on it a week, so it maybe not long enough, but I've had no change to my blood sugar levels, they are still anywhere from 16.9 to 13.1. Does anyone know if this normal. Along with this, I just don't feel well. Almost every morning I wake up sweating and feeling very sick and it's usually 3 to 4 am. I check my blood sugar and it's in double figures. I have told the nurse about this and was told it was probably to do with the blood sugar, but I don't know.

Any replies to this would be good and interesting to read.
Hi @Hesha, and welcome,

I'd be very interested to know what your diet looks like... Those numbers are high, (you shouldn't top 8,5, after eating), and it could very well be making you feel ill. And 15 years ago practically any diet perscribed meant "high carb/low fat" rather than the other way around: We're T2's, we don't process carbs out well. (Practically all carbs turn to glucose once ingested). If you lower your carb-intake, and up the fats, gliclazide could well become redundant. Maybe the metformin too. Just be very careful if you do reduce your carbintake, because as others have mentioned, hypo's are a possibility. Test, test, and test some more. (Before a meal, and 2 hours after the first bite, you shouldn't go up more than 2.0 mmol/l)..
Hope this helps!
Jo
 
I'm on gliclizide because I couldnt keep my numbers low enough without it even though I tried extremely hard :( - I did start out on max dose of 160mg twice a day and managed to get it down to 40mg twice a day. It takes a bit of hard work and lots of testing to get the balance of carbs and meds right.

Even though I take gliclizide I still have to stick to 70 - 80g carbs a day with no more than 25g a meal - it took a few weeks to get it right but persevere and you will get there. Like I said intensive testing is the key :)
 
Hi. Like you I'm surprised the Gliclazide isn't working. What dose are you on and do you have any excess weight? I ended up on 320mg/day for a few years which finally failed but it did initially work to some extent. It's possible you are a LADA coming out of the honeymoon period? I would insist on a C-peptide test to check your insulin output. I would also get some Ketone sticks to check your ketones as well as frequent tests of your BS. Go to A&E if any of these rise too far. I assume you are sensibly controlling the carbs? It sounds like your nurse may not be that knowledgeable about diabetes? BTW if you do have any excess weight then insulin resistance would prevent the Gliclazide working well so controlling the carbs would be vital.
 
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