Metformin & glicazide

Ladylaurax said:

My diabetic nurse upped my dosages to 5 metformin per day & 2 glicazide a day. She said if there wasn’t any significant improvement in the next two weeks that we would need to look at other avenues as they won’t prescribe anymore metformin

What other non insulin options are there? Is there a non insulin injection (I’m sure I read that somewhere)?

Many thanks

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Yes there are many my husband is on bydureon its once a week.job done there are others that are once or twice a day ask your gp or diabetic nurse.

Look at what you eat.
Cut out as much carbs as you can. Carbs = glucose.
I have done this and I am not on any meds.
Read reversing your diabetes by Dr David Cavan

Hi check lchf is ok with the meds your on. Can cause hypo with some meds

Jenniewren1958 said:

Hi check lchf is ok with the meds your on. Can cause hypo with some meds

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I’ll second that. I took my gliclazide yesterday morning then restarted LCHF, had great readings all day but then had a 3.5 overnight, which woke me and scared the life out of me. It’s really important to keep a good check on your levels if low carbing and using gliclazide. If you keep getting low results, see your doctor and either reduce the meds or scrap altogether.

I can only emphasize that if LC works for you, and you are lucky, then it is like being normal, ordinary - and taking medication for diabetes works on you exactly as though it was being taken by a non diabetic person - and the longer you stick to eating low carb foods the more normal you become, and the more affected by what is becoming an inappropriate treatment.

Jenniewren1958 said:

Hi check lchf is ok with the meds your on. Can cause hypo with some meds

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Yes, Gliclazide and LCHF has increasing possibility of hypo. I was on a very similar regime (4*met. 4*Glic) and it happened to me several times as the diet reduced my bgl. I manually reduced my Glic then told doctor when I stabilized to get my scrip altered officially, The beauty of Glic as opposed to insulin, is that the oral med is time limited and I found the hypos were relatively benign and manageable without crashing out like my T1D buddy. I would advise you to do the hypo awarenes course offered by this site so you can take the necessary actions to recognize the symptoms and treat. I had my first hypo on the very day I completed the course, and had gone to the chemist to buy some glucose tabs in case. So I was well prepared when it happened.

I found that I could drop by 10 mmol/l in a bgl reading within an hour of eating LC diet when I was on 4 glic a day. I am now on 1 tab a day and reduced Met to 3 and I rarely go low. But I never gave myself a fright while adjusting to LCHF.

I used to get my 4hr post prandial reading to above 5 mmol/l before going to bed to make sure the Glic had finished doing its thing, and that there was no risk of a nightime hypo, just to be safe. I would eat carbs if I was lower at this point.

If you are prepared, then there is low risk from using LCHF, and it should allow you to come off some of your meds. It may take a month or so to stabilise but I have been using an LC diet for over 2 years now, and I am going to have an LC Xmas with my family, (who also use the same diet since I cook for them, and there is no option), However, we all benefit from it and my wife has lost 3 stones without being limited or banned from carbs since she is not diabetic.

I also have used lchf diet since joining aug 17. 2 stone lighter. Off all meds

Firstly "low carb" may not be enough, consider "strict very low carb" e.g. under 20g of carbs a day and limited protain. As you got a meter hypos should not be a real risk, as the can reduce the does of Gliclazide if you often get readings below 7, then talk to your nurce about it. (However I don't think there is much risk of you doing that well without warning.)

If you really wish to get good result, how about no carbs or sugger of any type over the next 2 week to see what it does to your BG levels. Also try to have as long as possible between the last meal of a day and the first meal of the next day. Rememer you check your BG often and take action if it gets down to 5, or is often below 7.)

As to drugs, SGLT2 inhibitors may work for you talk to your GP/nurce about them.

Have you been tested to confirm you don't have Type1?

Ladylaurax said:

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

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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.

Ah - that is not low carbs when you are eating so many high carb foods - puffed wheat, as a grain, is a concentrated one at over 80 percent carbs, so you are having 32 gm of carbs just from that one item, then you add an apple - and is the yogurt low carb? The broccoli green beans peppers and onions are good but all contain carbs, so does the pear, so I'd advise that you evaluate all the foods you are consuming and see just how many grams of carb you are having a day.
It might explain why your levels are not dropping despite the tablets.

Ladylaurax said:

I am definitely type 2 as they thought I was type 1 at first and did a test for anti bodies.

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Half of people with type1 never test positive for anti bodies.

Try not having the puffed wheat and apple, replacing them with full fat yogurt, also avoid the quark and pear. See what the results are like after two weeks. (Milk also has lots of carbs in them, so don't use mutch milk, as double cream has little carb, consider suing double cream instread of milk in drinks.)

Testing BG at breakfast is very odd, as our BG often go down regardless of what we eat, but that does not tell us anything about the food being OK.

Ladylaurax said:

@ringi
Seriously!? So how do you know if it’s type 1 or type 2?

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There is a test that shows how much inslin your body is making, most people with Type2 have a insulin level in the first few year that is way above normal. People with Type1 once it is fully developeted make no insulin of their own. (Type2 is when our body ignores the inslin we make.)

There is also type 1.5 and type 3c, in both of these people make some of their own insulin but not enough.

So often there is no way for a doctor to tell what type someone has, and it is just educated guess work, that is then reviced based on how someone's body responds.

How about adding up the amount of carbs, in grams, you are eating, and then evaluating the worth of the advice you have had from various sources?
My own experience after 13 months of being type two diabetic is that eating an absolute maximum of 60 gm of carb a day I have normal blood glucose my energy is good, my weight is dropping, I feel twenty years younger, and my Hba1c is 41. I count myself very lucky that there is no need for medication. Of course, if it was required, then I'd have to take the tablets or whatever is required, but so far, so good.