I am doing low carb, taking 5 metformin & 2 glicazide per day and still my readings are between 10-16 throughout the day. The nurse is saying if there is no significant improvement by next Thursday then it’s going to be insulin injections. So what Im asking is - are there any other options such as the non insulin injections that I’ve heard of but don’t know anything about as I really don’t want to go down the insulin route and I want to be prepared when I see the DN & DR with other suggestions
Many thanks
We are not doctors so any advice we give may be incorrect for you. Also I am giving info here from the T2D perspective.
Gliclazide is a sulfonylurea, which means it acts to force the pancreas to give out higher levels of insulin, but if that insulin is not effective, ie. by having high levels of Insulin Resistance, then insulin injections will also probably not be effective treatment, If your pancreas is not producing sufficient insulin anyway, then insulin replacement therapy will work, and there really is no substitute for exogenous insulin,
There are other diabetes meds that work by making the kidneys filter our more glucose into the urine, and make you pee it out, but not sure if these will be enough to deal with. the high bgl levels you report. These are the -gliflozin class of meds.
There is another class of med called the -gliptins, such as sitagliptin. These act to inhibit the DPP-4 enzyme that may be blocking the production of insulin in the pancreas. These are under review under the Black Triangle warning since they may be linked to an increased risk of pancreatic cancer,
Then there are the ones you may be thinking of which are the insulin incretin mimetics that are injected to pretend to be the GLP-1 hormone thus triggering extra insulin production from the pancreas. These are the Victoza and Byetta injections They do not themselves replace insulin, merely control the switches that make it happen ( like a battery jump start.)
There may be others but these are the ones I am aware of that are used when a sulfonylurea drug like Gliclazide does not work. It depends on what is causing your bgl levels to be high even on low carb as to which might be effective.
You need to do your own research on these treatments and others may come along to give further clues and experience
There is an expensive test that can be done to estblish what level of insulin you are producing naturally. It is called the C-peptide test, but seems to be rare that doctors will prescribe it, It is also reliant on having access to a lab that can perform the analysis. It is available privately, and some here have gone for it in the past. It would tell your GP if insulin is appropriate to replace insulin, but if you have high levels of insulin then a different approach may be indicated.
Unfortunately, the NHS is very keen just to switch in the insulin treatment without doing this test, which is why some Insulin Dependant T2D have been able to stop their injections when following a Low Carb diet.
How long have you been doing an LC diet? How low is low? How much protein are you eating a day since protein acts like carbs too so can push up bgl.
I know of one instance where a T2D reported doing LC diet religeously, but still had high bgl levels. Turns out they were addicted to Tic Tacs, and consumed several packs a day, this negating their LC work.