Glicazide reduction

[Jojoann]

Hi all. Hope you had a good Xmas? Just prior to Xmas I had what may have been an extreme diabetic hypo. The jury is out but I fitted and lost consciousness briefly. I was given fruit juice and my levels were up to 8 after this but no prior reading. My diabetic nurse has reduced my glicazide dose to half now but I’m concerned as to the effect it might have on my levels. I’ve been working extremely hard to control my levels by carb counting etc and have reduced my points by 50 in 6 months. I don’t want them to rise again. I had a low g I roll today and tested 2 hours after and my sugars were high at 13!! I did have slightly higher carbs over Xmas (140 or so). Will this be a contributing factor?
Thanks

 

[rebrascora]

Sorry to hear you had such a nasty incident. Do you remember feeling unwell at all before you passed out. What were you doing when it happened and how long was it after you had taken your Gliclazide?
Have you tested the low GI roll you had? ie testing just before eating and then 2 hours afterwards to see how your body responds. Low GI does not mean that the roll is low carb or suitable for your body or diabetics in general, because we all have different gut biomes and metabolisms and what might be low GI for some people, may not be slow release for others. A classic example of this is porridge. Some of us here find that porridge sends our BG levels into orbit almost as quickly as glucose, whilst others find it lives up to it's low GI reputation and releases slowly over several hours. Personally I find all normal carb breads spike my levels and going up to 13 after a bread roll (even a low GI one) would be what I would expect. I gave up on bread nearly 5 years ago as it just wasn't worth the BG upheaval.

 

[Jojoann]

Thank you for the reply. The only thing I can do is get back on to my usual carb count of under 100g per day and no low gi roll! When I had my episode I’d had a very low carb day, been at a gig dancing and had a glass of wine. I felt very giddy and hot prior to the episode. Just made it to a seat and spent the night in hospital! It was frightening! I’d had no carbs since breakfast either. I’m just concerned my levels will rise with a half dose of glicazide!

 

[rebrascora]

If you had taken Gliclazide with very few carbs and then added exercise (dancing) and alcohol into the mix, then it isn't surprising you had a nasty hypo, and yes, it certainly does sound like a bad hypo.
It is important to understand how the medication works and insulin whether it be injected or home produced is a very powerful substance. Gliclazide works by stimulating your body to produce more insulin to cope with the glucose released by the food you eat. If you didn't eat many carbs then that insulin has very little to act on. If you are dancing then your muscles will suck glucose out of your blood for energy, so even less glucose for the insulin you have stimulated. If you add in some alcohol, that stops your liver from releasing glucose, so effectively removes your safety net, as your liver will usually kick in and release more glucose when your levels get low from exercise and Gliclazide effect.

If you are going to stop the Gliclazide then you will need to be more careful with your diet and learn which foods you can get away with and which you can't, by testing just before and 2 hours after meals to see how your body responded to them. If your levels rose by more than 2-3 mmols after the meal, then there were too many carbs in that meal for your body to process and next time you have that meal, you need to reduce one of the higher carb elements (maybe have a wrap instead of a roll and see if that works better) or scrap bread as I have. All carbohydrates are not created equal, when it comes to your body and your diabetes, so sticking to 130g carbs a day may not be enough to manage your levels without Gliclazide unless you do some strategic testing.

 

[Inka]

Thank you for the reply. The only thing I can do is get back on to my usual carb count of under 100g per day and no low gi roll! When I had my episode I’d had a very low carb day, been at a gig dancing and had a glass of wine. I felt very giddy and hot prior to the episode. Just made it to a seat and spent the night in hospital! It was frightening! I’d had no carbs since breakfast either. I’m just concerned my levels will rise with a half dose of glicazide!

Try to eat the same amount of carbs per meal every day @Jojoann As @rebrascora says, you need carbs with the Gliclazide. Very few carbs, extra exercise and alcohol causes your hypo. Yes, they are scary and horrible and I hope you’re ok now. If you keep your carbs consistent each day meal by meal, you’ll greatly reduce your risk of another such hypo. The only exception to this would be if you took extra exercise or had alcohol. Then you might want to increase your carbs and/or cut or omit the Gliclazide.