Glidipion

myracat said:

Hi again
So no one has replied! No side effects so far BUT this morning he had the most horrendous temper tantrum (panicking about insurance) and went ballistic before his breakfast could this be a blood sugar thing?

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Sorry about that but I've never heard of that particular medication.. not qualified to comment.. if he has very high blood sugars it could well contribute to temper.. is he measuring his blood sugar levels at home?

What kind of diet has he been following whilst trying to control blood sugar levels?

Apparently this drug is the generic version of Pioglitazone (Actos). I have seen Pioglitazone and Actos mentioned on the forum before, but can't comment as I know nothing about it.

https://www.drugs.com/uk/glidipion.html

myracat said:

he is limited to cheese and meat which he finds boring and he wants eg a sandwich at lunchtime

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A sandwich with cheese and meat in it? .. salad? there are lots of reduced carb options that aren;t simply cheese and meat although I find that quite adequate.

If it were a choice between his health and a sandwich which would he choose though..?

Maybe he needs to ask the doc for a C-Peptide test to to rule out T1 or LADA as you say he's underweight and has a pretty high HbA1c.

Edit to add.. it would be a good idea for him to join up here as even with the best of intentions second hand advice is never quite as helpful as first hand.

myracat said:

Hi I don’t think he would come on here, it was a PC related task that started the wobbly this morning. He likes a simple life. Yes he has a ham and salad sandwich and a yoghurt or fruit at lunchtime. I estimate his daily Cals out at around 5,000

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Well, his current diet is not doing his health any favours, so he really needs to get his head round how dangerous diabetes can be when it isn't controlled. If he is determined not to go down the drug route, then his only option is diet, and that means far less carbs (no bread). For lunch he could have cold meats, chicken thighs, other cold cuts, cherry tomatoes, cheese, salad stuff. His yogurts need to be plain unsweetened full fat yogurts (Greek yogurts are good) with a couple of chopped up strawberries or half a dozen raspberries added. Fruit in general is a poor idea - there is far too much sugar in it.

Have a look at this site
https://www.dietdoctor.com/low-carb/60-seconds

and the food lists
https://www.dietdoctor.com/low-carb/foods#foodlist
https://www.dietdoctor.com/low-carb/foods#foodtoavoid

If he insists on 5,000 calories (a huge amount, even for a man with his job) then most of these calories need to come from protein sources and fats rather than carbs.

You might ask him if he will consider sandwiches that use lettuce instead of bread.

Hi @myracat he can eat plenty of calories without the carbs and although being allergic to eggs limits the options a bit there is still plenty of choice. Have you looked at the Diet Doctor website or app? https://www.dietdoctor.com/?s=Egg+free&st=recipe&lowcarb[]=keto
They have egg free options such as cheese and ham roll ups and keto tuna salad.

Edit to add: Whoops just seen Diet Doctor already suggested in a previous post. Must be a good idea!

Hi
As others have said, this is pioglitazone 15 mg ie low dose
In PROACTIVE trial, this decreased the rate of heart attack and stroke in folk who had previously had these. It probably decreases the incidence of dementia, and probably improves fatty liver. It does not cause hypoglycaemia and can be used with very poor renal function. In ADOPT rosiglitazone controlled glucose levels longer than metformin or sulphonylurea,

The bad points are that it can cause fluid retention, so keep looking at the ankles, and can cause dramatic weight gain. It can also cause anaemia via several mechanisms and has a slight risk of a peripheral fracture, so make sure adewuate vitamin D in diet (tablets/capsules) or sunshine ie guess. The risk of bladder cancer is uncertain and so if there is an increased risk, the increase in risk is very small.

I think that it was the bladder cancer that made the french ban Pio; although a francophile, I would not totally trust their judgement and I wonder if they are influenced by others- for instance they continued to use Mercator (made by a French company) for several years after other countries banned it with several deaths and much morbidity from the stuff.

We are not allowed to recomend treatment here; I seem to recall that pio is one of the NICE frontline drugs because it is generic and hence cheap. And there are good reasons to use it. It sounds as if weight is not a problem, which is a little unusual for someone with T2DM

The other member of the class, rosiglitazone, was withdrawn when it was shown to increase the risk of heart attack, stroke etc by Steve Nissen. althogh has been re-introduced follwoing the findings of no increased risk in RECORD. Troglitazone was banned when 1 in 60,000 americans developed liver failure and died on it. But there is now a lot of experience with pio since it has been around since at least 2000, so there should not be any unpleasant surprises from the stuff.

best wishes

The active job probably contributes to the low weight, but an HBA1c of 124 new units is pretty high; when does he next see the doctor? I'd be surprised if one oral agent controlled his glucose levels if already on diet and exercise
How long has he had the diabetes?
Sorry, this is not particularly helpful
Best wishes

myracat said:

Hi all
OH just come back from GP with a prescription for Glidipion I have read the side-effects and it doesn't look too good. Anyone else on here take these? Goodle says they are banned in France. He was trying to be drug free, cannot tolerate Metformin or Glyclacide, is slightly underweight and has been trying to control his diabetes with diet.He is active in his job as a removal man and furniture dealer. He hasn't had a blood test for ages and has come back with HbA1C of 124 and a very bad temper! Any advice please?

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Sorry to hear about your friend's condition. He needs to see a doctor as soon as possible and get tested and, if possible, referred to a consultant endocrinologist who will evaluate him thoroughly and build a proper treatment program for him. From the sound of it, he will probably need to be treated with insulin to bring his HB1AC down as well as regular medication. Piaglitazone, the main compound of the drug you mentioned, is indeed problematic. As a previous reader already noted, two other drugs in this group have been withdrawn from the market. Glidipion, or Actos, to use the other brand under which it is marketed, is still prescribed but people need to be monitored closely when they're on it.

Another option is the new group of drugs called SGLT -2 (Sodium CoGlucose transporters). There are three drugs currently available in this category, Forxiga, Invokana, and Jardiance. They apparently work by increasing the pace of removal of sugar from the blood through the kidneys, which is then excreted in the urine. They are also becoming available in combination products, together with other drugs such as Metformin. At any rate, your friend should be having his medical condition checked ASAP.