Slim T2 - Gliclazide long term

[Amiblue]

Hi,

I was diagnosed 6 months ago with an Hba1c of 135. I am very slim and was put on gliclazide, 40 mg at breakfast. I started a low carb diet straight away, thanks to this forum. Levels went down dramatically and are typically 5 ish in the morning and 6.5 ish 2 hours post prandial.
I have done antibodies, mody and c peptide tests and all show I must be type 2 despite being so slim. There is still a risk of being LADA of course..
So my questions are:
- have some of you been taking gliclazide for many years, like over 10 years? My doctor says there is no proof the pancreatic function will degenerate faster with it and that it is a safe and efficient drug to produce insulin.
- are they skinny T2 among you? If so, which treatment do you take?
- I was told metformin would not help me since I don't look insulin resistant. Any view on this link between weight and insulin resistance?

I currently feel really lost...so thank you in advance if you can help.

A.

 

[Rodney from Canada]

Hi,

I was diagnosed 6 months ago with an Hba1c of 135. I am very slim and was put on gliclazide, 40 mg at breakfast. I started a low carb diet straight away, thanks to this forum. Levels went down dramatically and are typically 5 ish in the morning and 6.5 ish 2 hours post prandial.
I have done antibodies, mody and c peptide tests and all show I must be type 2 despite being so slim. There is still a risk of being LADA of course..
So my questions are:
- have some of you been taking gliclazide for many years, like over 10 years? My doctor says there is no proof the pancreatic function will degenerate faster with it and that it is a safe and efficient drug to produce insulin.
- are they skinny T2 among you? If so, which treatment do you take?
- I was told metformin would not help me since I don't look insulin resistant. Any view on this link between weight and insulin resistance?

I currently feel really lost...so thank you in advance if you can help.

A.

Hi!
Was just curious if you had genetic tests done to rule out MODY, or if you were positive for antibodies?
I'm not currently on meds so can't help you on that front.
All the best!
R (Mody 3)

 

[Concordjan]

I've been on gliclazide for almost 10 years, was put straight on 40mg as not overweight. Meds steadily increased until I was on 4x80mg gliclazide plus 4x 500mg metformin plus alogliptin. Now follow lchf and reduced meds to just 3 tablets a day. Not sure if medication contributed to any degeneration but lchf has certainly enabled me to reduce the meds and achieve much better blood sugar levels. Good luck.

 

[DCUKMod]

Hi,

I was diagnosed 6 months ago with an Hba1c of 135. I am very slim and was put on gliclazide, 40 mg at breakfast. I started a low carb diet straight away, thanks to this forum. Levels went down dramatically and are typically 5 ish in the morning and 6.5 ish 2 hours post prandial.
I have done antibodies, mody and c peptide tests and all show I must be type 2 despite being so slim. There is still a risk of being LADA of course..
So my questions are:
- have some of you been taking gliclazide for many years, like over 10 years? My doctor says there is no proof the pancreatic function will degenerate faster with it and that it is a safe and efficient drug to produce insulin.
- are they skinny T2 among you? If so, which treatment do you take?
- I was told metformin would not help me since I don't look insulin resistant. Any view on this link between weight and insulin resistance?

I currently feel really lost...so thank you in advance if you can help.

A.

Amiblue - Although being overweight is often a clue the person is likely to have some degree of insulin resistance, it's not the whole story. The important bit is out mid-section. If we carry any weight around the middle it doesn't help.

There is an informal categorisation of folks of TOFI, which means thin on the outside, fat on the inside. I'm not suggesting you are in that category as I know nothing about you, just pointing it out.

According to Professor Taylor, at Newcastle, we all have a personal fat threshold which, if we breach it we become diabetic, and if we lower our fat levels beneath it, the diabetes tends to go away. I use the term "go away", because using words like reverse, remission or cure lead to lively discussions!

I was never very overweight, but where I did have a few extra pounds they were around my mid section. These days I am very slim, having cut back on my carb consumption.

Some folks do well on Gliclazide, however, most T2s learn, some sooner than others, that what we eat and drink is important if we want to limit the meds we take. Many find that they are able to trim back the meds quite a bit, or come off them. I have been fortunate not to have ever taken any diabetes medication.

Good luck with it all.

 

[Daibell]

Hi. I have always been slim but with a bit of internal fat. I was on 320 mg Gliclazide and 2000 mg Metformin for 8 years or so. I have always been listed as T2 as both my diabetes GPs were not good. I did get GAD and c-peptide tests done privately as I argued with my GP about my diagnosis. My GAD was negative but my c-peptide was near the bottom of the acceptable range (1.19 in a range of 1.1 to 4.4). Metformin did very little to help as I suspect any insulin resistance was low. Gliclazide helped for a year or two but eventually failed. I will never know whether it helped speed the destruction of my beta cells. Looking back I can see that I had a 10 year or so honeymoon period. I've been on Basal/Bolus now for 4 years and my shots have increased implying a new c-peptide test would show me below the bottom of the range. Your GP is right about the Metformin and we can only guess about the Gliclazide. So, you may well be, like me, a very slow LADA? I suspect a virus in my case as shortly before my diagnosis I offered myself to a local drug company as a drug tester but they rejected me as I had a high white cell count due to some unknown inflammation. I also had a slight background abdominal ache for a year or two. My blood sugar was normal yet within a year my HBA1c was up to 13%. So not just antibodies can knock-out the beta cells. Interestingly I have been going to the gym for 20 years or more. I had my BMI and body-fat measured 6 months ago and my BF was 29%. I increased/changed my exercise regime and my last BF was 17% whilst my BMI is unchanged at around 22. I assume I have swapped internal fat for muscle so don't ignore internal fat.

 

[Amiblue]

Hi,

Many thanks for your replies.
It really helps.
To clarify, both MODY and antibodies tests were negative. C peptide is low for a T2 but in the T1 outliers range. I will see my GP soon to get the exact results but he thinks the low carb diet is responsible for the low results.
We will have to keep an eye on it.
I also had abdominal pain and bowel issues for month before the diagnosis. We thought of gluten intolerance, but the test was negative.
Everything has settled down since I changed my diet, my lifestyle ( less stressful job and no more commuting) and moved house ( I suspect the VOC level was high in our previous one but I won't go into that subject)....but I got diabetes. So I agree that many factors can knock out the beta cells.
Not sure about my internal fat but my external one was never high and is definitely down to zero around my waist.
Anyway, it helps so much to learn about your experiences and to see some similarities.
Thanks again

Amiblue

 

[Brunneria]

Hi,

I can't comment on your situation, I am afraid, but thought you might be interested in the following:

Since April 2016 UK (well, English, don't know if everywhere does it) doc surgeries are supposed to have introduced online patient access to things like test results and selected info like vaccinations, etc.

It requires an application process, involving providing ID, a signature and so on, but once you are registered, you should be issued with a password, logon, and then be able to access your own info online. Just ask the receptionist and they should be able to advise you on the process.

I much prefer seeing the actual test results, able to compare them over time, and research them at home.

Apparently, there are a few surgeries who still haven't properly implemented this system, but if yours is one of those, just ask for copies of your results. My nurse used to happily print them off for me, during the appointment, so I could take them away with me.

 

[Daibell]

Hi. I agree with Brunneria about online results. I have online access and it means at my annual review I can see the DN knowing my results in detail and what to discuss; it helps both of us and saves time.

 

[Amiblue]

Thanks, I didn't know about the online option and will definitely inquire! Better than paper copies.