Your experiences please

[actsing]

My first hello on this forum. I was diagnosed with type 2 approximately four years ago and put on metformin 500 twice a day. After weight loss and this med, my blood test showed constantly good results. So much so that my GP experimented by taking me off all meds for a couple of months. However his hunch that I could beat Type 2 was wrong and I had to return to Metformin. I have recently changed again onto taking 40mg GLICLAZIDE after having declared that I was fed up with the bloating and gas I experienced on the years of Metformin. I am wondering now if the fact that Gliclazide gives me unpleasant symptoms if I go too long without a meal and also that I don't seem to be able to lose weight is soon going to force me to return to Metformin.
Anyone else have any similar tales?

 

[Liam1955]

@actsing - Hello and Welcome to the Forum. I will tag @daisy1 who will provide you with some basic information. Ask as many questions as you want - someone will come along and answer.

 

[daisy1]

@actsing

Hello and welcome to the forum Here is the information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[urbanracer]

My first hello on this forum. I was diagnosed with type 2 approximately four years ago and put on metformin 500 twice a day. After weight loss and this med, my blood test showed constantly good results. So much so that my GP experimented by taking me off all meds for a couple of months. However his hunch that I could beat Type 2 was wrong and I had to return to Metformin. I have recently changed again onto taking 40mg GLICLAZIDE after having declared that I was fed up with the bloating and gas I experienced on the years of Metformin. I am wondering now if the fact that Gliclazide gives me unpleasant symptoms if I go too long without a meal and also that I don't seem to be able to lose weight is soon going to force me to return to Metformin.
Anyone else have any similar tales?

When you write ' if I go too long without a meal ' - do you mean that you are becomng hypoglyceamic?

 

[Neohdiver]

I have recently changed again onto taking 40mg GLICLAZIDE after having declared that I was fed up with the bloating and gas I experienced on the years of Metformin. I am wondering now if the fact that Gliclazide gives me unpleasant symptoms if I go too long without a meal and also that I don't seem to be able to lose weight is soon going to force me to return to Metformin.
Anyone else have any similar tales?

I have not personally taken gliclazide (or any of the other sulfonylureas) - and my doctor would need to do a lot of arm twisting to get me to. Just to get my biases out there up front.

Our healthy glucose metabolism is a perfectly balanced on-demand system. When carbohydrates come in, your body takes stock and says, "Hmm . . . I need X quantity of insulin to help transport that glucose where it needs to go, and pumps out quantity X pretty much instantaneously to pair with the glucose and transport it across the blood vessel walls so it can go where it is needed to provide energy. When you are insulin resistant (Type 2, primarily), your body may well send out quantity X of insulin but insulin resistance means that it doesn't work very well. As a result the glucose increases in the bloodstream faster than the insulin can remove it (the spikes) - and it takes longer to clean up the remnants (dropping to your baseline much more slowly). When you are insulin insufficient (Type 1, from the start, and often Type 2 in later stages), your body may know you need quantity X, but it isn't able to produce it, so it sends out less (or none at all) to pair with the glucose.

Either way the quantity of glucose overwhelms the insulin - because the insulin doesn't work well or there isn't enough of it, or both.

Metformin works on insulin resistance (although our understanding of exactly how it does that is changing). It makes the insulin we have work better.

Sulfonylureas work on the opposite end of the problem by coaxing the pancreas to make and secrete insulin.

You'd think both would solve the problem - but there are risks associated with having too much insulin (added insulin or the sulfonylureas) that are non-existent with medications that merely make the insulin that is present work more efficiently (like Metformin). Because our natural insulin production system is an on-demand system, a "dumb" system that continuously adds insulin even when there are no carbs coming in is not the best substitute. When the added insulin (produced continuously - rather than on-demand) does what it does best - helping the glucose out of the bloodstream to where it is needed for energy, it can take too much out. The "dumb" steady-state secretion system doesn't understand that your blood glucose is not intended to go below a certain level. It's like the old (US?) joke about the boy scout helping a resistant little old lady across the road - it just keeps helping the blood glucose across the road (blood vessel walls), whether it needs/wants to go or not. The result can be a hypo. Just guessing from the timing of your side effects that that might be what you're talking about.

Of course, if hypos aren't the unpleasant side effects you're experiencing, feel free to ignore this post

 

[muzza3]

Hi @actsing

Welcome to the forum. While I could not give you advice on your meds I would say that I would not give up on the idea of getting taken off them. The keys are self-testing so you can control the levels yourself and diet. So I would recommend that you get a meter if you do not have one or use it if you do. A lot of members use Low Carb High Fat diets with a lot of success to control their levels. This site runs a course in LCHF and there is also lots of information in the forums on the same topic.

If you have any questions at all be sure to post them
Cheers

 

[actsing]

When you write ' if I go too long without a meal ' - do you mean that you are becomng hypoglyceamic?

Hi - yes the symptoms that appear are a physical shaky feeling anxiety and mild dizziness occasionally a headache

 

[urbanracer]

Hi - yes the symptoms that appear are a physical shaky feeling anxiety and mild dizziness occasionally a headache

Do you check your blood sugars when this happens, if so what are your readings?

 

[actsing]

I have not personally taken gliclazide (or any of the other sulfonylureas) - and my doctor would need to do a lot of arm twisting to get me to. Just to get my biases out there up front.

Our healthy glucose metabolism is a perfectly balanced on-demand system. When carbohydrates come in, your body takes stock and says, "Hmm . . . I need X quantity of insulin to help transport that glucose where it needs to go, and pumps out quantity X pretty much instantaneously to pair with the glucose and transport it across the blood vessel walls so it can go where it is needed to provide energy. When you are insulin resistant (Type 2, primarily), your body may well send out quantity X of insulin but insulin resistance means that it doesn't work very well. As a result the glucose increases in the bloodstream faster than the insulin can remove it (the spikes) - and it takes longer to clean up the remnants (dropping to your baseline much more slowly). When you are insulin insufficient (Type 1, from the start, and often Type 2 in later stages), your body may know you need quantity X, but it isn't able to produce it, so it sends out less (or none at all) to pair with the glucose.

Either way the quantity of glucose overwhelms the insulin - because the insulin doesn't work well or there isn't enough of it, or both.

Metformin works on insulin resistance (although our understanding of exactly how it does that is changing). It makes the insulin we have work better.

Sulfonylureas work on the opposite end of the problem by coaxing the pancreas to make and secrete insulin.

You'd think both would solve the problem - but there are risks associated with having too much insulin (added insulin or the sulfonylureas) that are non-existent with medications that merely make the insulin that is present work more efficiently (like Metformin). Because our natural insulin production system is an on-demand system, a "dumb" system that continuously adds insulin even when there are no carbs coming in is not the best substitute. When the added insulin (produced continuously - rather than on-demand) does what it does best - helping the glucose out of the bloodstream to where it is needed for energy, it can take too much out. The "dumb" steady-state secretion system doesn't understand that your blood glucose is not intended to go below a certain level. It's like the old (US?) joke about the boy scout helping a resistant little old lady across the road - it just keeps helping the blood glucose across the road (blood vessel walls), whether it needs/wants to go or not. The result can be a hypo. Just guessing from the timing of your side effects that that might be what you're talking about.

Of course, if hypos aren't the unpleasant side effects you're experiencing, feel free to ignore this post

Many thanks for your very eloquent reply!! As my official blood results after going without meds was still showing that I was officially still Type 2 (although not sky high) - therefore needing some help from meds, your info shows me what I already suspect that Metformin is more suitable for me firstly because of the way it works, but importantly because it does NOT cause hypos. Thanks again.

 

[actsing]

Do you check your blood sugars when this happens, if so what are your readings?

I confess I do not check sugars chiefly because I was advised that I didn't need to. But recently I decided that the NHS motive is purely economical and I have recently bought a testing kit. However it does not contain many strips/bayonets and so the spending begins!

 

[actsing]

@actsing - Hello and Welcome to the Forum. I will tag @daisy1 who will provide you with some basic information. Ask as many questions as you want - someone will come along and answer.

Hello back and thank you. I am not in fact new to diabetes fact wise as I was diagnosed about four years ago and tend to research all relevant info. But I feel I have made a mistake in attempting to improve the annoying stomach side effects of Metformin and possibly moved from 'frying pan' to fire by taking Gliclazide instead especially if it is a barrier to weight loss.

 

[Crimsonclient]

OK after reading the replies you have got I have a couple of things to add. Go back to the GP or dsn and ask for 2 things
1 ask to go on to SR meformin as this will help with the wind and bloated feeling.
2 if you stick with the gliclizide ask for a meter and test strips being as gliclizide causes hypo's you have to test your blood sugar. If they refuse tell them that you are concerned about having a hypo whilst driving. There are legal requirements when it comes to this

 

[chri5]

Hi @actsing, from my own personal experience I can confirm that gliclazide can cause hypos and weight gain.

 

[dbr10]

My first hello on this forum. I was diagnosed with type 2 approximately four years ago and put on metformin 500 twice a day. After weight loss and this med, my blood test showed constantly good results. So much so that my GP experimented by taking me off all meds for a couple of months. However his hunch that I could beat Type 2 was wrong and I had to return to Metformin. I have recently changed again onto taking 40mg GLICLAZIDE after having declared that I was fed up with the bloating and gas I experienced on the years of Metformin. I am wondering now if the fact that Gliclazide gives me unpleasant symptoms if I go too long without a meal and also that I don't seem to be able to lose weight is soon going to force me to return to Metformin.
Anyone else have any similar tales?

I can't understand this mania doctors have with taking people off a medication which is clearly working. Gliclazide is a Sulfonylurea which, as I understand it, stimulates the pancreas to produce more insulin. More insulin often means weight gain. It is not recommended by Dr Bernstein because it is obviously forcing an already damaged pancreas to produce more insulin. In doing so it may accelerate beta cell burn out. And weight gain will increase insulin resistance. There is supposed to be an increased heart attack risk with this type of drug too. It does not appear to have much to recommend it. Jason Fung actually suggets SGLT2, acarbose and metformin in that order. Of course, Sulfonylureas are cheap, but I am sure that that in no way influences the decision to prescribe them.

 

[Liam1955]

@actsing - Metformin may help Type 2 Diabetic's lose weight as it lowers the appetite. Whereas Gliclazide made me put on weight (1stone) in just under a month. I read that you have purchased a blood glucose meter - can I ask where from?

 

[Daibell]

Hi. As some others have said do ask the GP for Metformin SR (Slow Release) which will avoid the bloating problems. GPs don't prescribe it as standard as it costs just a little more. As a generalisation a T2 with some excess weight may benefit more from Metformin rather than Gliclazide as insulin resistance is likely to need to be overcome rather than stimulating the pancreas to produce even more insulin thru Gliclazide. Someone who is slim may not be a T2 anyway but a Late onset T1 and be thin due to lack of insulin and Gliclazide may then be of help. Putting on weight with Gliclazide is most likely due to having too many carbs and if it causes hypos the dose is probably too high (but at least it would indicate the pancreas is working).

 

[actsing]

I can't understand this mania doctors have with taking people off a medication which is clearly working. Gliclazide is a Sulfonylurea which, as I understand it, stimulates the pancreas to produce more insulin. More insulin often means weight gain. It is not recommended by Dr Bernstein because it is obviously forcing an already damaged pancreas to produce more insulin. In doing so it may accelerate beta cell burn out. And weight gain will increase insulin resistance. There is supposed to be an increased heart attack risk with this type of drug too. It does not appear to have much to recommend it. Jason Fung actually suggets SGLT2, acarbose and metformin in that order. Of course, Sulfonylureas are cheap, but I am sure that that in no way influences the decision to prescribe them.

Thank you for this. You have supplied facts that until now I only suspected due to instinct. I am going to discuss this with my GP asap.

 

[actsing]

OK after reading the replies you have got I have a couple of things to add. Go back to the GP or dsn and ask for 2 things
1 ask to go on to SR meformin as this will help with the wind and bloated feeling.
2 if you stick with the gliclizide ask for a meter and test strips being as gliclizide causes hypo's you have to test your blood sugar. If they refuse tell them that you are concerned about having a hypo whilst driving. There are legal requirements when it comes to this

Many thanks I will definitely go back to the GP and request to return to Metformin SR.

 

[actsing]

Hi @actsing, from my own personal experience I can confirm that gliclazide can cause hypos and weight gain.

many thanks - my instincts, the constant tiredness and what sometimes seemed like day long hunger pangs and the 'scales' creeping upward have all convinced me that you are right. I have an appointment next week, but in the meantime I have commited one of the ultimate 'sins' as a patient. I still had a fairly new supply of Metformin SL so you can guess what I've done! I am not prepared to spend even another week worrying about how long it is since I have eaten each day and CERTAINLY not going to continue watching the pounds that I shed creep back on!

 

[Scimama]

Hi @actsing do you follow any diet plan to assist you in blood glucose control?