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New to Gliclazide and confused.

C

chrissieworne

Well-Known Member
Messages
180
Hi all.

Have just started 40mg of Glic as have had to come off Met as stomach probs so bad even with the SR version.

So far these are also upsetting me but I am sticking with it....something worries me. The stomach cramps are bad, could I take something like Buscopan to help??

Also, I hit 4.2 today...this is completely new to me. 4 hrs prev I had lunch and after 90 mins was at 14 !!! when i checked again 2 1/2 hrs after I was so shocked to be that low, so fast! I wasn't feeling very well either. Of course I am used to recently running double figures.

What seems to happen is at 2 hrs I am high but in the follwing 2 hrs it drops like a rock.

The DN explained hypos to me and gave me a leaflet, I followed her advice to carry my meter at all times and test if I feel "different", she said if at 4 or below take action with glucotabs follwed by starchy snack or meal. She also said test before driving and never drive below 5.

Is this rapid drop okay? I am a bit worried if I don't have enough carb i'll get hypos but on other hand I know if I eat a lot of carb I run high to start with.

Can anyone advise me please?

Thanks Chris
 
Hi

One way to tackle the hypo problem would be for you to eat a smaller carb value meal so that 90mins later your bg levels won't be so high but because they drop like they do, you eat a small carb snack about 2.5hrs after the meal. This should balance you out a bit better.
 
Glitlazide for me
I find its Better to take at least 20min before my main meal or breakfast
Gp told me to do this

Try this and see if that helps

Regular glipizide is usually taken once or twice daily. It works best if taken 30 minutes before breakfast. The extended-release form is taken just once a day with breakfast.
Click to expand...

http://diabetes.emedtv.com/glipizide/glipizide.html

Bob
 
I too take my glic about 20 mins before my food the advice from iHs is good too - my day goes like this -

take glic & met in morning then breakfast at 8 with 20g carb
10.30 a 10g carb snack
12.30 lunch with 20g carb
5pm another glic +met dinner with 30 - 35g carb
9pm snack with 10g carb

occasionally I will be up all night with my son - if this happens I have a 10g carb snack about 3 am - if I don't I find my BS drops too low then I dump - plus I am starving :lol:

I find spreading the carbs out during the day means I usaually stay between 4 and 6.5 rather than yoyoing between highs and lows

I test to see if I need the snack - somedays I don't - it depends on my activity/stress level - how long I have been awake etc
 
Not quite sure why Glipizide is mentioned and how that is taken as I believe the drug Chrissy is taking is Gliclazide ? Both sulphonylureas I know but different drugs, doseage etc.

Some medicines work best if they are taken at a specific times of the day. Getting the most benefit from your medicine can also be affected by what you eat, when you eat and the times at which you take other medicines. According to the BNF 61 which is the prescribing 'bible' the dose and when it should be taken is as follows :

Dose
• Initially, 40–80 mg daily, adjusted according to response; up to 160 mg as a single dose, with breakfast; higher doses divided; max. 320 mg daily
Click to expand...

If you want to change those times etc then you should discuss it with your GP. When I was on Gliclazide I used to take it just before a meal as I had been instructed. Seemed to work fine although I am sure we all have our own particular way of taking things once we get used to them.

I too wonder what the amount of carbs were you had before the 14+ reading, if it was a fast acting carbs/juice it would spike you and then because it was fast acting would quickly drop afterwards. The idea is to get a proper balance by eating things which don't lead to spikes and making sure that your levels remain stable, or at least as much as possible. I think iHs's advice was a good way forward. Avoid the highs and lows if at all possible...........

Again, a drug needs to be given time for you to get used to it.
 
Alway best to ask your GP

I have also looked on MY Gliclazide PIL its says Take as prescribed by your doctor before meals with glass of water.

I believe the paper below is what my GPs advise was based on however it was on a NHS site on his PC that link i can not find , This seems to read exactly the same.

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Retrieve&list_uids=2373640&dopt=abstractplus

Based upon the experimental evidence we propose the tentative recommendation that gliclazide is best taken 30 minutes before breakfast.
Click to expand...

Also noted in BNF effects of sulfonylureas possibly enhanced by NSAIDs (antiinflamaty)

I do this and it seems to work well for me
I stick to three meals a day with the odd apple mid meals

I take 2x80 Gliclazide one with breakfast the other with my evening meal


Bob
 
I to had terrible problems with metformin and am on gliclazide. I was put on it when in hospital and was told to take it just before my meal. I had stomach cramps for about 3 days, then they stopped. It did take awhile for my BG levels to settle and i still get ocassional high and lows.
 
Sometimes low blood glucose levels (hypo) can happen when taking Gliclazide. This can sometimes be when you do a bit more exercise than normal, take meals at irregular times, eat less than usual, or miss meals altogether........or maybe meals which are too low in carbs so you end up having a surfeit of Insulin (because Gliclazide forces your Pancreas to produce Insulin regardless of food intake) which will lower your Bg levels and no Glucose from foods etc in your system to be dealt with..... :?: Hence the reason why it is advised to be taken just before a meal.

I have seen the advice regarding when to take the drug in the previous link but as it is old 20+ years(1990), also based on a trial of only 8 Patients, and also doesn't seem to have any further more up to date references where it may have been followed up with a more scientific trial, I would tend to discount that one........however, if it works for some then so be it. :|
 
Best to Ask your GP

Just for interest found few newer UK ref to Gliclazide 30min before meals
So i can see why my GP came out with the advise for me

The Last link from NHS Borders has a nasty note rec for BG testing ? :?

http://www.gp-training.net/protocol/endocrine/diabetes/diabprot.htm
Suphonylureas - (take 30 mins before food) Hypos, weight gain.
Click to expand...

Its right at the bottom of page sec on Gliclazide
http://medweb.bham.ac.uk/easdec/prevention/HBA1c & type 2 diabetes.htm
Dose: initially, 40-80 mg daily, adjusted according to response; up to 160 mg as a single dose, with breakfast; higher doses divided; max. 320 mg daily. Ideally gliclazide is taken 30 minutes before a meal.
Click to expand...

http://www.learnonline.nhs.uk/NR/rd...elinesfortheuseofOralHypoglycaemicAgents1.pdf
Gliclazide Start dose 80 mgs – maximum dose 320mgs. Dose above 160mgs to be given in divided doses.
To be taken 20-30 mins before food (no longer as potential to cause hypos)
Click to expand...

http://www.nhsayrshireandarran.com/uploads/5296/Diabtab.pdf

http://www.bordersdiabetesnetwork.s...ts/pdf_file/0013/11722/Man_Type2_Diabetes.pdf
Doc Date 2010
Sulphonlyureas will have fallen to a low trough before breakfast it may be sensible to
advise taken the dose 30 minutes before breakfast
Click to expand...

Mind you this doc also says :evil:
 
I take it from that you will be taking it 20-30 mins before your meals then........ :wink:

I always follow this advice from just one PIL (patient Information Leaflet)

Always take Gliclazide tablets exactly as your doctor has told you. If you are not sure, check with your doctor or pharmacist. These tablets should be taken with a glass of water before meals. The tablet can be cut in half.
Click to expand...

Now other brands tell you that you should take it during a meal ? Before a meal ? The BNF tells you just before a meal........ If it works.....who cares......

As a matter of interest I used to use Gliclazide when I was on it on an Ad-Hoc basis so if my levels were highish it would bring them down. In my area it still is advised just before a meal....shows how there is always conflicting information around if you want to search the Net....... Lots of good info there but you pays your money and makes your choice. So confusing, especially for newly diagnosed........however as the links all refer to information which is different to the March 2011 BNF 61 I still prefer to follow GP's instructions.....if he says 20-30 min before that's fine, if he says just before meals that too is fine. Everybody is different in their responses to various drugs. What may work for one may not work for others. I don't think anybody has to justify what they do.

We wouldn't want to confuse Chrissy any further now would we.......
 
hi
are you eating properly as i have found my glics were overworking when i had a spell of time that i was'nt getting enough food wich to be honest never give it any thought however a quick visit in an ambulance to A+E got me reminded on the points of my diet . Hope it helps and try not to strees to much as this also can affect your levels .
Hope this helps JF :wink:
 
Always have taken it that way :roll: Doctors Orders 20<>30 min before meal twice @ day

With experiment found I will be tad hirer or slower too come down with known foods
same happens, the odd time I forget or the meal is ready to eat earlier ,then need to take just before

Metformin I always Take Mid Meal
 
Chrissy.
Somewhere along the line your question about Buscopan got sidetracked. :roll:

There are several contra-indications regarding the use of this drug so you would need to discuss it's use with your GP (who knows your medical history and is aware of any complications) or regular Pharmacist to avoid any possible problems. Too many to list here.......I don't want to alarm you by singling out a particular drug.
 
Ok back on track Buscopan:

Best advise would be to go back to see your GP

I Think you may be taking Amitriptyline? This is a tricyclic antidepressant may interact

http://www.medicines.org.uk/guides/buscopan/pain
 
Hi all, phew, what a response

Well, my DN said to take it with food at whatever was consistently my largest meal of the day, this is really evening meal so that's what I have been doing. I also take Mebeverine 20 mins b4 meals for IBS. Really I shouldn't think I should take the Buscopan as well. The tum probs I am having is constant trapped gas I know that sounds funny but it is very painful, I look 8 months gone till it disperses which can take hours. It will not move so I feel as though my whole torso front and back is in a straight jacket !! Heat helps but not much else. Believe me, if it's known to man I have tried it and that includes some stange positions to force it out !!! My GP I am sure thinks I am exaggerating but prob is this is what happened with the Met. That's reason for coming off. This is why I am becoming worried as I am so praying this will ease in a few days.

Thanks for all your advice, this med is definitely making a difference and I am actually struggling to eat as much as I was as my appetite has gone down!! Since my post I have experimented a fair bit and have tested a lot and have found potato and bread are main culprits for the spikes. Crispbread seems okay.

I am still higher first thing in the morning than at night by about 2.0 so am going to try having a biscuit before I go to bed and see what effect that has. :?:

Am not on the Amitriptyline any more, it made me terribly dizzy but luckily am managing pain okay with the Co-codamol when needed and have found an excellent freeze gel which is pricey but works well when needed.

How long does it normally take for side effects to subside if I am lucky??

Again, thanks so much for your help, I felt so low today as Mother's Day and miss my son so much and spent most of it in tears and feeling sorry for myself!! I think I am low anyway what with recent surgery etc.

Will persevere and see how it goes.......

Thanks again, Chris. xx
 
Hi all, update. Was in terrible pain all last night and saw GP as emergency this morning, he thinks I have severe Gastritis, possibly triggered by the Metformin and that my stomach as over-recated to the Glic. He has stopped my Ranitidine, started me on Lansoprazole and referred me for an enoscopy to be sure of things. He is also referring me for a Pelvic scan to rule out any gynae issues. Am secretly worried about that one, but he said it only because I am just post-menopausal and its to check my belly distension is down to the Gastritis and not any thing else.

He advised me not to stop the Glic under any circumstances.

Scaringly, he said if I get as bad as last night again to got to A&e because they would probably give me the Lansprazole via intravenous drip to settle things down....

I took first tab this morning and am feeling a lot better actually so fingers crossed!!

Meanwhile my BG are settling and last night although I felt awful I had one rich tea biccy before bed and first thing this morning my BG was lower than usual.

Thanks for your support

Chris.
 
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