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Gliclazide

Discussion in 'Diabetes Discussions' started by Steve57, Aug 15, 2009.

  1. Steve57

    Steve57 · Member

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    Hi Everyone

    I was diagnosed T2 five years ago when fasting BG levels rose above 7.

    For the last three years I have been on Metformin 850mg twice a day and Pioglitazone 30mg once a day. Hba1c has consistently been 6.1 or 6.2 during this time.

    At my annual review in April this year I mentioned that I was getting fed up with stomach problems, frequent diarrhea etc. My doctor said this was the Metformin and replaced it with 80mg Gliclazide once a day. Over the following two and a half months I have been constantly tired/fatigued and have experienced a few shaky moments where my BG's have fell below 4.

    I have just had another hba1c test as a follow up to the change in medication which has come back as 6. My doctor is satisfied with this result but due to the 'shaky' moments has switched me to Gliclazide 30mg M/R. When he told me this I thought he was reducing the dosage but having referred to the internet I find this is the slow release version of the previous medication. He doesn't think that the tiredness/fatigue is due to the Gliclazide which I find surprising since it started immediately after the change from Metformin. He has asked for further blood tests to see if there is another cause.

    Has anyone else had similar problems with Gliclazide??


    Thanks

    Steve
     
  2. cugila

    cugila · Master

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    Hi steve.

    Here is an extract from the Patient Information leaflet for Diamicron (Gliclazide 30mg MR)

    In the first few weeks of treatment the risk of having reduced blood sugar levels (hypoglycaemia) may be increased. So particularly close medical monitoring is necessary.
    Low blood sugar (Hypoglycaemia) may occur:
    - if you take meals irregularly or skip meals altogether,
    - if you are fasting,
    - if you are malnourished,
    - if you change your diet,
    - if you increase your physical activity and carbohydrate intake does not match this increase,
    - if you drink alcohol, especially in combination with skipped meals,
    - if you take other medicines or natural remedies at the same time,
    - if you take too high doses of gliclazide,
    - if you suffer from particular hormone-induced disorders (functional disorders of the thyroid gland, of the pituitary gland or adrenal cortex), - if your kidney function or liver function is severely decreased.
    If you have low blood sugar you may have the following symptoms: headache, intense hunger, nausea, vomiting, weariness, sleep disorders, restlessness, aggressiveness, poor concentration,
    reduced alertness and reaction time, depression, confusion, speech or visual disorders, tremor, sensory disturbances, dizziness, and helplessness.

    As regards the doseage the 30mg MR is a much reduced dose compared to the 80mg standard Glic. It has the same effect as an 80mg tablet, just spread over a longer period of time. It is a lower dose.

    Ken.
     
  3. Steve57

    Steve57 · Member

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    Thanks Ken

    I was aware of the side effects of Gliclazide from the patient leaflets and began to take it before my main meal and carry jelly babies with me when out on long walks or golfing but the tiredness/fatigue has persisted whether my BG levels were in the 4's, 5's or 6's.

    I am heartened by ur last comment that the new Gliclazide 30mg M/R is a lower dose than the previous 80mg. Maybe this will relieve the tiredness, I'm only on my second day of the new tabs.

    Regards

    Steve
     
  4. sugarless sue

    sugarless sue · Master

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    Hi Steve ,as the half life of Gliclazide is 12 hours then the higher dose will be in your system still.Give it another few days and see if there is a difference in your fatigue levels.
     
  5. Steve57

    Steve57 · Member

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    Thanks Sue<:)

    Keeping my fingers crossed

    Steve
     
  6. fergus

    fergus Type 1 · Well-Known Member

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    Hi Steve,

    Did your doctor discuss any options other than Gliclazide as an alternative to Metformin?
    I have concerns over the long term effect of sulphonylureas such as Gliclazide to be honest.
    As an insulin-resistant type 2, your pancreas is already overproducing insulin and the Glic. will stimulate it to crank up production further still. While it may reduce blood sugar to begin with, over the longer term the stress on the pancreas can result in damage and loss of function.
    Did he discuss dietary strategies for reducing the requirement for insulin instead?

    fergus
     
  7. cugila

    cugila · Master

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    I have been on Gliclazide for at least two years and never found any problem with it. I was on the max dose of 320mg per day. It did help lower the BG numbers which I used to struggle with. The downside was it prompted weight gain. Since reducing my carbohydrate intake drastically I have gained better control of the BG levels and I now no longer take Gliclazide or even Metformin. Since coming off it I again have had no problems and all Bg levels are great. As far as my Endo is aware there is no damage to my Pancreas as a result.

    Ken.
     
  8. tulip87

    tulip87 · Active Member

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    Hi Steve,

    I take 80mg gliclazide twice a day, but did use to take the 30mg MR tablet (have had between 30 and 90mg at various points).

    Definitely have had "shaky" episodes and hypos on both sets of gliclazide. I had less hypos on the MR, but they lasted a lot longer (due to its longer action).

    I've not specifically had any tiredness... however I do find after a big hypo (<2.5) I am absolutely shattered and need a nap, so could it be related to that? Gliclazide has done wonders for my blood sugars though if it is manageable.
     
  9. Steve57

    Steve57 · Member

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    Hi Fergus

    Straight answer is no he didn't, although since being prescribed them I've been on the internet and learnt that Glit can flog the pancreas. It will be the subject of future discussions with him:<) Dietary strategies have never been discussed either other than with a dietician at the hospital just after I was first diagnosed as diabetic.

    Regards

    Steve
     
  10. Steve57

    Steve57 · Member

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    Thanks Ken

    I'm currently 5' 9" and 14st. I have wondered whether reducing carbs and losing a bit of weight might mean I can reduce medication or even get off it altogether. How low did you have to get ur Hba1c down to before ur GP was happy to stop Glit. and Metformin?? Are you now on diet and exercise alone??

    Steve
     
  11. Steve57

    Steve57 · Member

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    Thanks Tulip87:<)

    Difficult to tell if the low Bg's are causing the almost continuous tiredness/fatigue. If they are, then the effects of a low BG episode must be carrying over to the following day/days.

    It just seems strange that in the month before I switch to Gliclazide, I'm up and down the Lakeland fells, strutting up and down the fairways on the golf course and then within two days of switching meds I can hardly lift my head off the pillow in a morning.

    It's all a bit confusing:<)

    Steve
     
  12. rmorgan

    rmorgan · Newbie

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    Hi Steve

    Did you ever get to the bottom of this?

    I've just restarted on a very small amount of glic (long story of changing diagnoses!) and suddenly I find myself so so tired. However, I might have picked up a virus going round...
     
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