When to take Gliclazide

[Marvin]

I know I should have asked this question while I was still at the surgery, but it didn't occur to me then, and only dawned on me when I read the notes accompanying the Gliclazide tablets I was prescribed today. I have been Type 2 for four and a half years, diet controlled until early this year when I was put on Metformin as my BG had become way too high (HbA1c 12.3). Metformin brought this down to 9.7 and then increased dosage brought it down further to 7.9, where it is now. I was told I couldn't increase the Metformin any further, so have been started today on 80mg of Gliclazide once a day to be taken with my breakfast. My question is this: could I take this instead with my lunch or evening meal? The reason for asking is that my BG is always high first thing (usually 9-10mmol) but almost invariably between 5 and 7 just before lunch, the lowest it ever falls during the day. It seems to me that taking the Gliclazide with breakfast is going to make my BG fall faster at the very time when it normally falls fast enough anyway. When I need it is during the afternoon or evening, as the BG never falls back to pre-meal levels within two hours. Does anyone think it would be more sensible for me to take the Glicazide with lunch or evening meal instead of breakfast? The last thing I want is to go hypo late morning every day!

 

[Hobs]

When I was prescribed 80mg glic I was told by the GP to break it along the scored line and take it at breakfast and evening meal. It did not suit me so other meds were substituted.

 

[HLW]

I was told to take it with my largest meal, it worked amazingly and started working immediately, for a few days until they told me I had type 1 instead so had to be on insulin...

 

[Marvin]

Update on this one:
I was re-reading the leaflet that came with the Gliclazide and noticed that I was taking several drugs listed under "tell your doctor if you're on this". Presumably he already knew, as he had my notes when prescribing the Glic. But as he and the diabetes nurse are not available to ask at the weekend I popped down the pharmacy to pick the pharmacist's brains before taking it. Others may be interested to hear her comments. Apparently it is NOT recommended to take Gliclazide with an evening meal i.e. late in the day) because of the risk of hypos... hypos at night are not a good idea! She thought, given my pattern of BG fluctuation, that taking it with lunch was OK, but that I ought to start out taking it with breakfast, but keep a close watch on BG levels because the problem with the listed drugs is that some of them may mask hypo symptoms (notably beta-blockers and Angiotensin II antagonists, both of which I'm on). So her advice to me, taking Glic for the first time, was to test frequently, which I'm doing every hour or so rfor a couple of days. I've just had my lowest BG for months (5.3) one hour after lunch, so the initial signs are good, even if I'm a bit apprehensive about the possible "hypo by stealth"!