Medication

Sunflowersfairy said:

Hi everyone
Just looking for some advise, I have been diagnosed with type 2 diabetes for the last 5 years this is currently managed with Metformin and Aloglipton. Recently had bloods taken and they are now at 69 (previous year was 50) to my knowledge I haven’t changed anything however I am now being given the choice of two medications in place of the Aloglipton, these are Empagliflozin and Glicazide. Just wondered what people’s experiences are with these medications and whether anyone has any opinions on which they would try?
Thanks

Click to expand...

Personally, I am a fan of Gliclazide. I am wary of Empagliflozin since it belongs to a class of medications that have some serious side effects associated with it. I am attaching the current FDA warnings which for some reason tend to be better informed about negative events in their yellow card system,, and the NHS and NICE do not always pick up on these dire warnings for UK users,
https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/204629s023lbl.pdf

I find Gliclazide to be relatively benign, and a simple med to adjust and understand. It requires a working pancreas so it will only work if you are producing your own insulin. It is triggered by the act of eating sugars and simple carbs so will do nothing for getting a high fasting bgl level down if taken between meals. It lasts for about 4 hours, so any hypo's that it may cause are time-limited and self-correcting so it is a relatively safe med.
It is quite effective, and I find for me it can drop my sugar level by 4 mmol/l on just a 40mg dose. I did start on 320 mg dose and whittled it down as I got control over my levels using LCHF diet, and I am happy to use it at the low dose because it allows me the ability to have some extra carbs with my meals. It also allows my GP to support my self test habit by providing strips.

Sunflowersfairy said:

Hi everyone
Just looking for some advise, I have been diagnosed with type 2 diabetes for the last 5 years this is currently managed with Metformin and Aloglipton. Recently had bloods taken and they are now at 69 (previous year was 50) to my knowledge I haven’t changed anything however I am now being given the choice of two medications in place of the Aloglipton, these are Empagliflozin and Glicazide. Just wondered what people’s experiences are with these medications and whether anyone has any opinions on which they would try?
Thanks

Click to expand...

Have you though about a dietary approach rather than more medication? Many of us use it to put T2 into remission.

Were you really diagnosed at 22 ?
Very young for T2 has anyone ever tested your endogenous insulin production with a c-peptide test?

Sunflowersfairy said:

Hi

I’m currently trying to adjust my diet to help (I haven’t really got a clue of the best way to do this) I’m a little confused as different professionals are telling me different things so I don’t know what kind of diet is best for me to be following?

Thinking about it, I may have been diagnosed longer than that- around 20. The GP at the time of diagnosis commented that he thought I was too young and many people along the way have said the same thing. To my knowledge I haven’t had the test that you have mentioned.

Click to expand...

If you are T2 then many of us look on it as an "allergy" to carbohydrate in our diets so cut back as much as possible.
Many have great success and can put T2 into remission following this way of eating often becoming drug free in the process.
If you have some excess weight to lose it can often help with that too.
www.dietdoctor.com is a great resource when starting out as is the book "The Diabetes Code" by Dr Jason Fung.

Sunflowersfairy said:

Thanks for the information.
Sorry, can I just check what you mean by LCHF, new to the forum and since being diagnosed I haven’t really been given much information from GP (they don’t see me unless it’s for yearly reviews).

Click to expand...

LCHF= Low Carb High(er) Fat diet. The fat content is elevated to compensate for the loss of caloric energy in the reduction of the carbs. It is there to protect against our bodies scavenging muscle tissue to compensate when blood glucose levels are low, and is especially relevant to keto diets.

As an extra bonus, high fat hits the saity button that means we feel satisfied for longer, and can often drop one meal a day from our busy lives, You will see OMAD mentioned in some posts and this means One Meal A Day. I myself use TWOMAD. I do not feel the need to snack in between meals,

If you are not intending to go full keto, then the fat only needs to be elevated slightly just to provide saity since scavenging is not normally an issue on just Low Carb, which I why I use the term higher rather than high fat. One important point that Newbies struggle with is moving away from the NHS low-fat advice. There is mounting science to support the statement Fat does not make you Fat. Studies also show that proper fats do not cause heart problems or strokes.

Sunflowersfairy said:

Thanks, I will have a look at the book with lowering my carbs, how many roughly is acceptable?

Click to expand...

"Acceptable" is a variable number that can really only be determined through experimentation and blood glucose testing before and after meals.
The absolute amount of carbohydrate we need for life is zero but that can be viewed as slightly too extreme (although its almost the way of eating I personally follow).

Hi. I was on full dose Gliclazide for long time before it stopped working due to my beta cells dying. This drug has few side effects and can certainly make the beta cells produce more insulin if you have any left. Dosage is critical to avoid hypos. I would advise anyone diagnosed as 'T2' when young particularly if they not over weight to have GAD and C-Peptide tests done to check for T1 instead of T2. Misdiagnosis is common as many GPs just guess T2 as mine did.