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Need a bit of advice re gliclazide

lovinglife

lovinglife

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6,586
Type of diabetes
Type 2
Treatment type
Diet only
Today I have been for my latest results –all really good – I have hit my 10st weight loss mark, YAY!! :D :D

My question is – my HbaC has gone down to 41 (5.9) – at the moment I take 1x500mg metformin twice a day and 1x80mg Gliclizide twice a day.

My doctor has reduced my glic to 1x 80mg in the morning only, I questioned this as I thought it would be better to split the dose to 40mg in the morning and 40mg at evening meal, But he said no take it all in the morning. I am a bit worried that just taking the whole lot in the morning will mess up my good control and I will be high after my evening meal. I am currently sticking to 1400 calories a day with about 90g of low GI carbs. I have tried to go lower carb than this but just cant cope with it for various reasons I wont go into now.

So what would you do – take the 80g all at once with breakfast or split the dose between breakfast and evening meal?

Thanks in advance
LL
 
Re: Need a bit of advice re gliclizide

Congratulations on your results. :clap: I think you should do precisely what you suggest. I was encouraged by DN and consultant at diagnosis and subsequently to juggle the amount and timing of sulfonylureas like gliclazide in order to keep my BGs as steady as possible. I find that variations in health, diet, stress, other meds etc often mean that bits of tweaking are required. I have always explained this to doctors and consultants and they have never had any problem with this. It would be interesting (well not really -- being sarcastic here) to know why your doctor thinks it important to take all 80mg in the morning -- in my case this would increase chance of an afternoon hypo but also mean higher fasting levels.
We all need to find good working relationships with doctors and to take their advice where appropriate. In this case, though, you have clearly thought things through properly and he hasn't -- I see no danger whatsoever in following your own instincts and splitting the dose. Good luck!
 
Re: Need a bit of advice re gliclizide

It's not for me to suggest you make any changes without discussion with the doc but I would have thought splitting it would possibly make more sense but it depends on your meal pattern. I believe Glic's effects last for up to 10 hours in the body. I guess the doc might say that taking it in the evening might be too late to help? My dose when I was on it was split am/pm but it was 2 x 80gm tablets each time.
 
Re: Need a bit of advice re gliclizide

I have got my hba1c down to similar levels on a reduced carb diet and on exactly the same quantity of tablets. As my weight reduced and I took more exercise I started to have onset of hypo symptoms on a couple of occasions. Dealt with them both very quickly without any problems but BG levels had dropped below 4.

As I test my own levels I have stopped my Glic now for two weeks and no further hypo symptoms. My BG levels staying below 7 as well so guess diet is working well.

Am not suggesting you do the same but just wanted to add my experience so you can decide how you approach your GP.

Keep us informed as you progress.


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Re: Need a bit of advice re gliclizide

I was old by a Diabetes consultant that all meds should be taken in the morning. Purely for !patient convenience' Perhaps your doctor is of the same mind?
I have always done the same thing as desidiabulum does and have never had a problem wih my HCP's disgreeing. In fact they have always been pleased that I had my own ideas and was proactive in my own treatment as much of what they suggest for timing is merely suggestion based on incomplete knowledge of a patients circumstances. iIts a mater of trial and error.
You will find that they will usually advise you to do anything to avoid hypos .
If you managing the condition well in your own way to suit your own lifestyle and the figures support this , why should anyone object?
 
Re: Need a bit of advice re gliclizide

lovinglife said:
Today I have been for my latest results –all really good – I have hit my 10st weight loss mark, YAY!! :D :D

My question is – my HbaC has gone down to 41 (5.9) – at the moment I take 1x500mg metformin twice a day and 1x80mg Gliclizide twice a day.

My doctor has reduced my glic to 1x 80mg in the morning only, I questioned this as I thought it would be better to split the dose to 40mg in the morning and 40mg at evening meal, But he said no take it all in the morning. I am a bit worried that just taking the whole lot in the morning will mess up my good control and I will be high after my evening meal. I am currently sticking to 1400 calories a day with about 90g of low GI carbs. I have tried to go lower carb than this but just cant cope with it for various reasons I wont go into now.

So what would you do – take the 80g all at once with breakfast or split the dose between breakfast and evening meal?

Thanks in advance
LL
Click to expand...

Not many calories, and not many carbs, and spread over many hours?
You're covering the day from 8am to 6pm, with one morning dose, so I'm guessing you eat a fair amount of your food in the evening and later night, then, as you're thinking you need to boost your insulin release then as well? Say from 6pm to after midnight?
 
Re: Need a bit of advice re gliclizide

Thanks everyone for your replies, I have decided to split my dose and have begun today so will test and see how things go for a week.

I have a pretty set routine of breakfast at 6 lunch at 12 and dinner at 5.30 and a small snack at 10 before bed at about 12.30 - so I am of the mind that I have no glic left to cope with my evening meal if I take it all in the morning. I never really hypod unless I was doing something exta in my day - which is not often as I have a son with special needs so dont get much chance for extra exercise though I am manic in the house haha - usually about 5.5 fasting - about 4.5 before meals and about 6 2 hrs after

desidiabulum said:
It would be interesting (well not really -- being sarcastic here) to know why your doctor thinks it important
Click to expand...
I know you were being sarcastic here but thought I would tell you this anyway :wink: - the doctor I spoke to (who phoned me after my appointent with nurse) I have never met and doesn't know me or my lifestyle or my home situation at all which just makes me :roll: , as always the advice on here is invaluable - thanks guys :D
 
Re: Need a bit of advice re gliclizide

The other reason he may have cut your dose to one a day is to give your beta cells a rest. No point in needlessly wearing them out through the night when you're asleep, when they could be resting as well.
 
Re: Need a bit of advice re gliclizide

Another reason the GP may have for putting you on 1x 80mg/day is the (mistaken) belief that 80mg is the smallest size available. It's not!
I was repeatedly told by Boots , my GP & "Nursie Nightshade" that it only came in 80s, but the pharmacist at Asda easily sourced me 40s (Zircron 40mg) :thumbup:
 
Good point Fergus. I found this too. not with lic but with glimepiride -another sulfonylurea. I was on a large dose of it and when I eventually go the right advice about meds and started lowcarbing i was able to dispense with it altogeher for a time/

I have since found that should my mealtimes or exercise regime be interrupted for whatever reason my bgs shoot up and take a few days to come down.

I tried again with what I was told was the minimum dose of glimepiride - 2mg. This caused me to experience severe hypos almost immediately . I researched it myself and discovered that here was a 1mg pill . I asked the dr to prescribe this and she did. I also expressed my intenion of takng it only when necessary. As it acts so quickly for me she agreed to a trial of this and I have been taking it in this way for a few years and it works very well for me.

A previous GP had also encouraged me to experiment with the timing of the pills.Wih sulfonylureas less is always more ..
Its always best to get the drs agreement - there may be other factors, but tweaking times etc when you know what you are doing and how you react is the sensible thing to do. Ultimately you have to take control for yourself.

Imagine if we all followed medical advice slavishly.? Its a learning curve for the dr too.
 
Re: Need a bit of advice re gliclizide

FergusCrawford said:
Another reason the GP may have for putting you on 1x 80mg/day is the (mistaken) belief that 80mg is the smallest size available. It's not!
I was repeatedly told by Boots , my GP & "Nursie Nightshade" that it only came in 80s, but the pharmacist at Asda easily sourced me 40s (Zircron 40mg) :thumbup:
Click to expand...

That's right. 40mg Zicron (sp!) are also a good size, so with a pill cutter you can have 20mg doses, which could be useful if you are looking to reduce doses further. I was prescribed gliclazide precisely because it would enable me to cut the smaller dose.
 
Again though, stimulating the beta cells for longer than you need to allegedly accelerates their burn out. Even 80mg twice a day is borderline for one dose. Only when you get to 160mg it's recommended to spilt the dose.
I was on it briefly, once a day, but changed it for something that couldn't cause hypos. (Working at heights and driving), not sorry to be taken off to be honest.
If you're worried over it not lasting the day, ask for the slow release version. (But don't then cut it)
 
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