how long before medication should start to work?

Hi Geofry and welcome to the forum. I am sure you are feeling quite shocked at this diagnosis and the changes this will bring to your life, we all know how you feel, and I was in similar shoes a couple of years ago. Metformin is a good drug but its not going to bring your levels down lots or super quickly, some of that is in your hands. What a lot of us have found on this forum is that reducing carbohydrates in your diet has a more profound effect on your blood sugar. What this means is cut back on (or in my case out) bread, rice, pasta and potatoes. It sounds life changing and it is but I have got used to this new way of eating and really enjoy it. So for family meals I will serve the family pasta or rice but will replace my portion with broccoli or cauliflower. A couple of nights ago I made a curry and for my portion I stirred in a generous helping of green beans.

The thing to get your head around is the fact that your body converts all carbs to sugar and the whiter the carbs the quicker your body does this, so it might be that toast for brekkie might be a no - no. The best way to tell is to test. Test before you eat and then 2 hours after - your reading after should be around 7.8 - 8.0. If bread makes you spike - which many of us find, its best to reduce or remove this from your diet.

I'm sure it feels daunting but there is so much info on this forum - I only joined in July but since then I have got my BG and my BMI down to levels I am really happy with. Have a read about people who use insulin also, it may be that you will need this so information will really help you to cope with this.

Good luck

I agree with everything that Fraddy said, it is all about the carbs (and especially refined carbohydrates like sugar and flour).

The problem that you're going to have to deal with is that you can't simultaneously be "low-carb" and "low-fat" without losing weight, which you can't afford to do. This means that you're going to have let go of "low-fat" and concentrate of "low-carb", which can seem like a huge step after all the years of false anti-fat propaganda that the Government and NHS have subjected us to over the last 30 years.

When you are ready, I'd suggest reading this:
http://www.nytimes.com/2002/07/07/magaz ... all&src=pm

Hi Geoffry

There are tests the doctor can ask for to show if you are T1 or T2. Ask him to organize a c-peptide and GAD test. It is simply not good enough for him to just guess you are going to need insulin "soon" that's totally outrageous and out of order in my opinion. The bottom line is you do not sound as if you meet a lot of the T2 criteria, yes you are mid 40's but you are not overweight and are currently losing weight which is a classic symptom of late onset T1. Did your GP test for ketones in your urine as that would also be an indicator. If you are losing weight AND you are an undiagnosed late onset T1 then the disease is damaging you and needs to be dealt with as swiftly as possible.

All of us who use Metformin see that it will reduce levels by at most 1 or 2 points. Glicazide acts by stimulating your pancreas to produce more insulin. If it is having little effect then it would imply you are not producing a lot of insulin. In the initial stages of T2 insulin production is normally not the major issue and the pancreas is producing insulin but the body fails to use it effectively. Consequently by taking Glicazide the pancreas is told to produce more insulin which compensates somewhat for the bodies inability to use the insulin its producing correctly.

As Fraddycat has said you can help yourself by reducing your carbohydrate intake BUT effectively this will only work if you are really T2 and producing some insulin. Trying to control late onset T1 by diet is not an option. You need to get the doc to resolve what kind of diabetic you are first in my opinion. If it turns out you are bog standard T2 then a low carb regime is undoubtedly the best option in mine and many other members opinion as it allows us to control our T2 condition with minimal medication.

If your doc doesn't seem to want to take the issue seriously then ask to be referred to a consultant at your local hospital.

Good luck, keep asking questions and let us know how you are getting on.

borofergie said:

I agree with everything that Fraddy said, it is all about the carbs (and especially refined carbohydrates like sugar and flour).

The problem that you're going to have to deal with is that you can't simultaneously be "low-carb" and "low-fat" without losing weight, which you can't afford to do. This means that you're going to have let go of "low-fat" and concentrate of "low-carb", which can seem like a huge step after all the years of false anti-fat propaganda that the Government and NHS have subjected us to over the last 30 years.

When you are ready, I'd suggest reading this:
http://www.nytimes.com/2002/07/07/magaz ... all&src=pm

Click to expand...

I agree 100%. And with fraddycat's comments on food types. I happily ate all the foods that said no or little sugar without realising it was the carbs getting me up into the teerns with my blood sugar levels. Flour based products were worse for me than sugar! ou do need to check your diabetes type as well though as xyzzy says; you can't tackle it properly without knowing.
You also need to get more strips and test more often. If you can't get enough on prescription, buy the SDcodefree meter on amazon, strips for it are only £7 for 50. The meter itself is cheap as chips too.

And as the others have said - you need to keep a very close eye on it, because if you really do have T1 then you'll get very poorly without insulin (no matter how few carbs you eat).

Although I don't have any personal experience, it seems to me that insulin isn't such a bad thing, especially for someone with a very low BMI.

I agree with the others that you may well have LADA (late onset T1). Your GP is wrong in saying you are T2 but it's auto-immune. Auto-immune diabetes is a T1; late though it may be. You can initially partially control it by a low-carb diet but if you are a T1 you will have to increasingly reduce your carb intake with corresponding weight loss. If Gliclazide doesn't help much then that's an indicator; my Gliclazide has little effect for example although I'm not a confirmed LADA. Sitagliptin may be better in the short-term than Gliclazide as it extends the time the pancreas does produce any insulin after meals rather than prodding non-existent cells. Interesting how GPs vary. Mine refused to give me insulin last year saying it was a 'last resort' and added Sitagliptin which has helped a bit. So, do consider going through Sitagliptin first before insulin (see the current NICE guidelines) unless your Hba1c continues to go high.

Metformin has the same effect in both type I and type II diabetics.. it works by increasing insulin sensitivity and decreasing the amount of glucose that the liver releases throughout the day. Gliclazide works by stimulating the pancreas to produce more insulin.. this will work for a time in a newly diagnosed type I however at some point due to the body attacking the pancreas it will lose so much function that the glicazide will no longer be effective.

Your best bet is to get correctly diagnosed as soon as possible.. if you are type I then you will need to go on insulin straight away.

Hi. Perhaps to answer your question on length of time to act. Opinions vary but I would expect Metformin to work within a few weeks if you are an insulin resistant T2 and perhaps a bit sooner if you are relying on the reduction of glucose output by the liver. I would expect Gliclazide to work within a few days as it works directly on the pancreas. These are just my opinion but GPs views also vary a lot. My GP said it would take up to 6 months for Sitagliptin to work but it had an effect within 2 days......