Gliclazide

Amyj30 said:

Could anyone give me anything positive regarding Gliclazide?

I’m started taking it for type 2 diabetes. 80mg twice daily plus I also take 10mg Empagliflozin.

I’d just like to know if anyone is currently on it and if they have anything positive to share? Such as avoiding insulin due to taking it or getting very good control?

Im already doing keto and losing weight.

Thanks

Click to expand...

Hi,
No I'm not on glicizide but I know of it
The drug is used as a temporary method of reducing blood glucose levels, and along with Empaglifozen, your doctor is trying to get control of your hba1c.
Along with dietary, carbs and sugars reduction, good exercise, you should be able to do it.
But, there is a need to keep testing, and be aware of going hypo at some point, then a reduction of dosage or coming off the drug altogether.
It does work, but of course, if you get side effects, speak to your GP!

I have used gliclizide in conjunction with metformin and it worked to reduce my Hba1c considerably. The reduction in blood glucose made me far less tired and allowed more exercise to be taken. Whilst abroad on an extended trip I started to experience regular nighttime hypos and decided to reduce the gliclizide in order to prevent them. When I returned I had stopped gliclizide entirely and was in remission. So for me it helped control blood glucose, allowing me to more easily exercise and put myself into remission. All in all it worked for me. One caveat, if you wish to follow a similar path you must have and use a blood glucose monitor even if, like me, you have to self fund it. Regular hypos are not a good thing and need to be dealt with with care.

Amyj30 said:

The diabetic nurse mentioned that might pancreas might be getting “tired” and that perhaps insulin would be beneficial. Is there a way they could actually check how my pancreas is functioning? I’d like to see my hba1c in 3 months ideally when I’ve been on keto for much longer and been on this medication but I’m not sure if any of that will help of my pancreas may be “tired” . Thanks

Click to expand...

There is indeed a way to tell whether your insulin production is insufficient. It's called a cpeptide test, and measures how much insulin you are producing, though you may need to up the amount of carbs you eat before you do the test (check with the doctor before they do the blood test). However I'm not sure whether GPs are allowed to order this test, it may need to be ordered by an endocrinologist...

They normally do a cpeptide test when they think there's a chance that a person may be a slow onset T1 (LADA), whose diabetes is caused by lack of insulin production rather than insulin resistance (T2). They often combine it with a GAD test which checks whether you have antibodies that are present if your immune system is attacking your pancreas. But long term T2s can progress onto insulin either because their insulin producing cells have been damaged by long term high sugar levels (possibly what your nurse meant by a tired pancreas?) or because they are so insulin resistant that the pancreas just can't produce enough insulin to cope. (There may be other reasons, I am not a doctor or a T2, so happy to be corrected by those more knowledgeable).

My father moved on to gliclazide from metformin without any ill effects and was on it for several years before going low carb reduced his levels and his doctor took him off diabetic medication. (He's on a ton of drugs for other medical issues). His current hba1c of around 55 might warrant meds if he were younger, but as he's 91 his doctor would prefer that he didn't have to worry about hypos (he's prone enough to falling as it is). Mind you, I don't think he got any hypos while he was taking gliclazide.

My understanding (possibly incorrect from what @Bittern is saying) was that NHS guidelines state that they have to give you a meter if you are on gliclazide, so you can check for hypos. I suggest that you ask about one if they don't offer it to you automatically. My dad ended up with several different meters and a plethora of strips, none of which he used until he came to visit me and I encouraged him to test while he moved to lower carb.

Good luck.

I’ve been on & off it since last May, alc down from 128 to 47
Now on 20mg a day & this keeps my blood sugars stable, any more & have hypos
Only thing that’s worked for me, metformin raises my rhr & does nothing for blood sugars, had an adverse reaction to alogliptin & that did nothing for blood sugar either
Still eat fairly low carb, but have no weight to lose & not insulin resistant
Don’t know if this helps
Good luck

Blood sugars dropping is a good sign, that the current regime is working and doctors will not prescribe insulin just for the hell of it if other medications and/or lifestyles are working. I've not used it but from what I read here it can be complicated so simple is best. Insulin can also be life changing and life preserving so you should not worry about having to use it.

The clinicaly accepted Hba1c and consequently blood glucose levels are, in the NICE, protocols, dependant on age and capacity and rise with age. So the level at which your consultant will push insulin will depend on your age and Hba1c. You need to have a discussion with him/her about your progress thus far. If Hba1c and blood glucose are improving and weight is dropping it should be possible to defer insulin, if it's offered, for say 3 months to let things settle and see where you are. Most consultants I have met want to use as few and as mild drugs as will answer the clinical and mental needs of their patients.

So don't worry consultants usually, in my experience, listen to a well made argument.

I personally didn’t get on with Gliclazide because it made me get terrible hypos (I was regularly <2.5mmol) and put on a huge amount of weight (about 10kg in a month). But that’s not a reason to be worried about taking it: should those things arise, you can discuss it with your doctor and come off it again (the hypos resolved the following day and I think the weight came back off within a couple of weeks, with no change in diet)

Note that Gliclazide itself does not cause weight gain but it enables the body to have more insulin and metabolise the carbs. If you do gain weight that you don't want then you need to reduce the carbs.

Amyj30 said:

I have a monitor and check my levels morning, evening and throughout the day. I’ve completely turned my diet around. I’ve been running high for a few years and that’s what’s making me worried I won’t be able to avoid insulin. Is it possible to just need insulin for a period of time to give the pancreas a “break” then come off it again if you’ve lost considerable weight and stay following keto ect? The medication has definitely bought my blood sugar readings down so is that a good sign it’s working for me? Sorry for all the questions, still waiting to be seen at the hospital clinic x

Click to expand...

Because you have to eat, the likelihood of your giving your pancreas a break is highly unlikely. However, fasting and going into keto, will also have an effect on how your pancreas becomes more efficient and effective, because if you do lose weight and that in turn improved your insulin resistance and your insulin response, your insulin levels will slowly become more less tired. It will also improve your hba1c levels.
Don''t be surprised by a lack of good advice and information, at the clinic, as they have to follow NHS rules!