Type 2 Metformin vs Gliclazide?

Thanks for putting up this post, very relevant to me at the moment. Doc is thinking of adding a bit of glicazide to my canagliflozin as my blood levels shoot up very easily. Be interested to hear what people have to say as, like Ian I have worked quite hard to get my weight down.

Gliclazide has a completely different way of working than Metformin. Gliclazide stimulates the pancreas to produce more insulin. Metformin helps the liver reduce it's glucose output a bit and reduces your appetite a bit. Gliclazide only causes weight gain if you have too many carbs. I was on max dose for years with no weight or any side effects but I have a low-carb diet. The important thing about Gliclazide is to get the dose right and not to have more than you really need to control blood sugar.

The GFR issue means your kidneys aren't filtering properly and only working at 55% (currently). This is of concern, and I believe NICE recommends not to prescribe Metformin when there are known kidney problems as it can make matters worse.

Have you tried to control your glucose levels by diet? If you give this a go you may find you can manage with a very low dose of Gliclazide. Yes, you do have to self test before driving, and every 2 hours during a long drive, but if you want to take this disease by the scruff of its neck and control it by diet, you need to self test anyway.

When I say by diet (with the aid of some Gliclazide) I mean really cutting down on carbs

Ian9024 said:

Thanks for the reply. Having been diagnosed 3 months ago I've followed the GP and DSN lead so far although I have carefully adjusted my diet which has involved watching carbs, hence losing over two stone since diagnosis. I guess the answer is to try Gliclazide and see the reaction...

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Well done on that weight loss - that is excellent.

Maybe "watching" carbs isn't enough. You need to count them carefully and arrive at a number of grams you can tolerate. Your meter will help you to do this. Eat to your meter and you can't go wrong!

Hi @Ian9024, a third way is just diet and exercise. Your drop is similar too mine, look at my graph. On your current trajectory you will be either in the pre-diabetic or non diabetic range within your next 1 or 2 HbA1c's.

I would ask to see a Kidney specialist. My GFR went down also under Metformin (why don't these.... warn of this possible side effect). It cannot be coincidence that I have had an increase since ditching this. I did some research about what to eat for Kidney health. This is not an exhaustive list, as I have removed carby stuff:

Bamboo Shoots
Olives
Blackberries
Bell Peppers
Cabbage
Cucumber
Onion
Eggplant
Radish
Lettuce
Capsicum
Garlic
Ginger
Carrot
Turnip
Peas
Green leafy vegetables
Olive oil
Black Pepper
Fenugreek
Coriander
Bay leaves
Mint
Vitamin D
Fish

I would also try and take the pressure off of your kidneys by eating no more than twice a day and having an adequate amount of water. It is also important to reduce your blood pressure; for this I recommend the Camry hand grips (grip for 2 minutes, rest 2 minutes and repeat 3 times), and to eat 2 cloves of roasted garlic maybe 5 out of 7 days. Loosing weight will also help blood pressure, along with brisk walking.

Hope this helps but please see a specialist, insist on it.