Scary incident

[Hotglove]

I have been treated with Metformin for a few years now, but had a recent change to Ziclon (Gliclazide) I am on the lowest dose, 40mg once a day with breakfast.
At the end of Jan I weighed 13st 11lb, then I caught Covid, I was in hosp for 10 days and came out weighing 12st 5lb.
Covid was a massive wake up call and I determined to do all I could to lose weight and get fit, so I signed up with a PT and am doing one intense workout per week under her eagle eye and some meaningful exercise every day. Weight is now 11st 7lb and I have put on a significant amount of muscle.
I have drastically reduced carb intake and alcohol consumption (24 units in 5 months) and no longer have large spikes in BG testing 6 times per day typically ranges from 4.3 to 7.6
In my 3rd week of taking Gliclazide I forgot to take my morning pill, so I took it mid-afternoon, tested after about 30 mins and it was 3.1 which scared the hell out of me, immediately ate a few squares of chocolate and, after 30 mins, got 6.3.
I was alone in the house when the incident occurred so was really rattled by the experience, obviously I will never take the drug out of sync again and have written to my doctor with details of the incident and copies of my BG log plus other health details like Blood Pressure, breathing peak flow, heart rate, weight loss and so on.
I would like to diet/exercise into remission, so that is the target.
Any observations very welcome.

 

[bulkbiker]

Sounds like a serious conversation with your doctor about reducing or coming off the meds completely is in order?

 

[Hotglove]

Sounds like a serious conversation with your doctor about reducing or coming off the meds completely is in order?

Hi
I wrote to my doc for a number of reasons, 1. It is very difficult to get a face to face appt. 2. I wanted to make sure that I made my points clearly and did not forget any. 3. Medicos take things more seriously if there is a written record.
The letter was sent a few days ago, so I will give him a little longer before nagging.
As you say, the “Holy Grail” is to go med-free, I am having much greater success with the very low carb diet than any that I have tried to stick to in the past, Since Jan I have dropped 8” from my waist and gone from a situation where most of my wardrobe was too small to having to buy smaller jeans and shorts because the ones that were too small were falling off.
Truth is that I did not really study BG/nutrition properly, so did not understand the scale involved, “Cut down on carbs” used to mean, “2 slices of toast instead of 3, 5 potatoes instead of 6” now it means 2 slices of toast and 4 small potatoes a month, cauliflower rice, almond flour tortillas and so on.

 

[bulkbiker]

Hi
I wrote to my doc for a number of reasons, 1. It is very difficult to get a face to face appt. 2. I wanted to make sure that I made my points clearly and did not forget any. 3. Medicos take things more seriously if there is a written record.
The letter was sent a few days ago, so I will give him a little longer before nagging.
As you say, the “Holy Grail” is to go med-free, I am having much greater success with the very low carb diet than any that I have tried to stick to in the past, Since Jan I have dropped 8” from my waist and gone from a situation where most of my wardrobe was too small to having to buy smaller jeans and shorts because the ones that were too small were falling off.
Truth is that I did not really study BG/nutrition properly, so did not understand the scale involved, “Cut down on carbs” used to mean, “2 slices of toast instead of 3, 5 potatoes instead of 6” now it means 2 slices of toast and 4 small potatoes a month, cauliflower rice, almond flour tortillas and so on.

They should certainly be able to give you a phone appointment to discuss reduction in medication or coming off completely.
Personally I made that decision myself and with careful blood sugar monitoring never even started on meds (apart from 3 weeks of hell with metformin).
Sounds like you have the dietary changes required correct so I can't see any reason why the doctor should not be supportive of med reduction or cessation.
As someone who has low carbed for a number of years with much success I tend to treat anything the doctor says with some caution as the entire surgery medical team is way behind in terms of T2 thinking.
I was however finally noted as "in remission" last year even though my HbA1c levels had been sub 30 mmol/mol since 2016!

 

[Daibell]

Hi. I suspect you may need to stop the Gliclazide. It's main value is for T2s who don't have much excess weight and may have a failing pancreas. The fact that 40mg dose caused such low BS indicates your pancreas is producing insulin without too much trouble. Why were you swapped from the Metformin? I would ask the GP to possibly swap you back.

 

[Hotglove]

They should certainly be able to give you a phone appointment to discuss reduction in medication or coming off completely.
Personally I made that decision myself and with careful blood sugar monitoring never even started on meds (apart from 3 weeks of hell with metformin).
Sounds like you have the dietary changes required correct so I can't see any reason why the doctor should not be supportive of med reduction or cessation.
As someone who has low carbed for a number of years with much success I tend to treat anything the doctor says with some caution as the entire surgery medical team is way behind in terms of T2 thinking.
I was however finally noted as "in remission" last year even though my HbA1c levels had been sub 30 mmol/mol since 2016!

Having read some of the other posts on the forum (very sobering and cause to count one’s blessings) it is probably worth noting that my type 2 was picked up at a routine annual work medical. The only “symptoms” that I had were peeing more often (I had put that down to my age, 71) and getting grumpy when hungry. Given that I had never experienced a “Diabetic incident” the 3.1 after taking a pill out of time was truly alarming.

 

[EllieM]

Given that I had never experienced a “Diabetic incident” the 3.1 after taking a pill out of time was truly alarming.

Lots of virtual hugs. Hypos can be scary, specially when you aren't used to them. Did you get any symptoms when you had the hypo? (eg Shakiness, sweating, unusual hunger, confusion....) Hypos are a lot easier if you can recognise them.

 

[Hotglove]

Lots of virtual hugs. Hypos can be scary, specially when you aren't used to them. Did you get any symptoms when you had the hypo? (eg Shakiness, sweating, unusual hunger, confusion....) Hypos are a lot easier if you can recognise them.

Hi
No I simply realised that I had missed the morning pill, took a replacement mid afternoon, then, perhaps 30 minutes later did my, “before dinner” test and got 3.1 I have no idea how low it might have gone if I had not tested and eaten some chocolate to correct it.
Prior to being put on the Gliclacide I was on one blood test per year, followed by an annual checkup.

 

[EllieM]

No I simply realised that I had missed the morning pill, took a replacement mid afternoon, then, perhaps 30 minutes later did my, “before dinner” test and got 3.1 I have no idea how low it might have gone if I had not tested and eaten some chocolate to correct it.

That is a big concern, though I guess it's possible that the meter result was a glitch. If you drive, have you been told to always do a blood test before driving? Lacking hypo awareness while on hypo inducing drugs is cause for losing your driving license. (Though you get it back if you recover awareness.)
Driving and Hypoglycemia - Hypos (Low Blood Sugar) and Safe Driving (diabetes.co.uk)

 

[muzza3]

Agree with some of the other posters. You have good BG figures and as you are testing can keep an eye on your levels so would suggest you speak with Doc and see if you can trial dropping the meds

 

[Andydragon]

Gliclazide and low carb are not a good combination. Metformin generally doesn't cause hypos but Gliclazide can especially given your low carbing I strongly recommend you speak to your doctor as this might not be the best drug for you in your new regime. all of the low carb, exercise etc...

When my levels dropped that low, i had a repeat hba1c and was weaned off the drugs altogether. Hoping lasts but early days. But your info posted is something I would personally be opening that type of discussion with

You also probably should have skipped that dose rather than taking it when you said as per advice:

https://www.nhs.uk/medicines/gliclazide/