Reduce Insulin or Gliclazide?

Hi @Jennet. I'm so sorry you're having such a difficult time at the moment. Getting diabetes doesn't exactly fill anyone with joy but getting it on top of cancer sounds to me like it's adding insult to injury. Do you actually have a T1 or T2 diagnosis, or have you just been told diabetes?

I'm not convinced that it's the insulin in itself that's causing you to gain weight. I'd argue that it is the high circulating insulin (part injected and part whatever you produce) plus high blood sugars that are doing it. Typically new T2s produce lots of insulin, because you are insulin resistant and the insulin doesn't work as well as it should. And taking gliclazide just pushes your pancreas to make more insulin, so I'm not sure that there is that much difference between the two. (And if you are T1 and not T2 then insulin is the way to go, because your pancreas isn't up to producing much insulin at all.)

Forum rules put me in a spot here, because we're not allowed to advise on medication doses and I think recommending gliclazide over insulin (or vice versa) pushes quite close to the edge. Moreover, I genuinely don't know what is best, though I would tend to do what my nurse says unless I had good reason not to. But I would urge you to try to keep your blood sugars under control, as high levels will both make you feel worse and give your body a harder time. If it were me, I would prioritise blood sugar control over any possible weight gain.

Jennet said:

Porridge and soup and cheese, with sourdough bread at the moment.

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They are all fairly high carb unfortunately, so I can well believe that you are having to inject for them.

Jennet said:

The steroids spike my blood sugar so I have to inject more insulin when I’m taking those (every 3 weeks).

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Steroids can actually cause diabetes on their own, so this is not at all surprising.

Jennet said:

Is it alright to have a pudding sometimes because I feel so miserable on chemo and that cheers me up?

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What kind of insulin are you injecting? Most of the insulin users here actually inject insulin according to what we eat, so we inject more if we have a pudding. You look like you are on fixed doses at the moment, which have less flexibility, but you could ask your nurse if you can adjust them to allow for a pudding.

Maybe some of the other posters can suggest things that you might like that are a bit lower carb. Full fat Greek yoghurt with berries??? 90% or 95% dark chocolate?

Lots of virtual hugs.