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<blockquote data-quote="Bebo321" data-source="post: 1600492" data-attributes="member: 68730"><p>Ooooh [USER=437905]@Sawds[/USER], </p><p>Do you really need to be taking gliclazide? That certainly explains the hypos and I’m surprised your HCP is unsure why it is happening. Obviously, I can’t really comment on your specific situation because I am not qualified to and don’t know your medical history. You should understand however that gliclazide forces the pancreas to release more insulin than it normally would. This is to counter insulin resistance (the higher levels of insulin help shunt glucose into cells and out of the bloodstream).</p><p>Your muscles have the greatest impact on blood glucose levels, and within your muscle cells the main transporter for glucose is the GLUT4 transporter. I don’t want to get too technical, but ordinarily these little transporters are stimulated by insulin (when insulin is present they proliferate in number and rush up to the surface of your muscle cells). The great thing is (and this will help you to understand why you’re having hypos) these GLUT4 transporters are also stimulated and proliferate in number with muscle contraction (exercise). For people without diabetes, their pancreas shuts off insulin production almost as soon as they begin to exercise. This is to allow for the fact that the muscles have this in-built ability to take up glucose without insulin being present. This situation only changes if a blood glucose rise occurs due to liver glucose release from a stress response (elevated heart rate). The point is, that your body has a heightened sensitivity to insulin because of these extra glucose transporters (increased sensitivity can last for up to 48hrs) so if you are taking a drug (gliclazide) that overrides your body’s natural checks and balance you can get into trouble - your muscles are already gobbling up glucose, so adding excess insulin may result in a possibly rapid and unpredictable fall in blood glucose.</p><p>I have a couple of pieces of advice - the first is to look up the work of Kraft and hyperinsulinemia. Try to understand that elevated insulin levels are not something to encourage - indeed, if you are deliberately trying to bounce low blood glucose levels back up with a sugary drink you will only make matters worse by exacerbating insulin resistance. </p><p>Secondly, have a read yourself around diabetes drugs to understand how they work. On gliclazide you are heading on the path towards burning out the beta cells you have. If you’re not on metformin, read up on how it works, because it could be a suitable fit. </p><p>Make sure you really are following a low carb diet (it’s easy to miss hidden carbs) and get back to your doctor armed with your information and talk it through. It’s unlikely they will know about muscle glucose transport with exercise (it’s a fairly specialised field), but if you explain it to them they should understand and determine if your current prescription really is the best choice.</p></blockquote><p></p>
[QUOTE="Bebo321, post: 1600492, member: 68730"] Ooooh [USER=437905]@Sawds[/USER], Do you really need to be taking gliclazide? That certainly explains the hypos and I’m surprised your HCP is unsure why it is happening. Obviously, I can’t really comment on your specific situation because I am not qualified to and don’t know your medical history. You should understand however that gliclazide forces the pancreas to release more insulin than it normally would. This is to counter insulin resistance (the higher levels of insulin help shunt glucose into cells and out of the bloodstream). Your muscles have the greatest impact on blood glucose levels, and within your muscle cells the main transporter for glucose is the GLUT4 transporter. I don’t want to get too technical, but ordinarily these little transporters are stimulated by insulin (when insulin is present they proliferate in number and rush up to the surface of your muscle cells). The great thing is (and this will help you to understand why you’re having hypos) these GLUT4 transporters are also stimulated and proliferate in number with muscle contraction (exercise). For people without diabetes, their pancreas shuts off insulin production almost as soon as they begin to exercise. This is to allow for the fact that the muscles have this in-built ability to take up glucose without insulin being present. This situation only changes if a blood glucose rise occurs due to liver glucose release from a stress response (elevated heart rate). The point is, that your body has a heightened sensitivity to insulin because of these extra glucose transporters (increased sensitivity can last for up to 48hrs) so if you are taking a drug (gliclazide) that overrides your body’s natural checks and balance you can get into trouble - your muscles are already gobbling up glucose, so adding excess insulin may result in a possibly rapid and unpredictable fall in blood glucose. I have a couple of pieces of advice - the first is to look up the work of Kraft and hyperinsulinemia. Try to understand that elevated insulin levels are not something to encourage - indeed, if you are deliberately trying to bounce low blood glucose levels back up with a sugary drink you will only make matters worse by exacerbating insulin resistance. Secondly, have a read yourself around diabetes drugs to understand how they work. On gliclazide you are heading on the path towards burning out the beta cells you have. If you’re not on metformin, read up on how it works, because it could be a suitable fit. Make sure you really are following a low carb diet (it’s easy to miss hidden carbs) and get back to your doctor armed with your information and talk it through. It’s unlikely they will know about muscle glucose transport with exercise (it’s a fairly specialised field), but if you explain it to them they should understand and determine if your current prescription really is the best choice. [/QUOTE]
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