Gliclazide - why not long term?

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christmas

christmas

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Hi all,

Does anyone know why a diabetes team might advise gliclazide not to be taken long term?
I'm sure I've read it elsewhere (or been told) but I can't find any info about it online.
Asking because I've found it suits me wonderfully, it controls my blood sugar well, and I wish I could stay on it but have been advised to stop, and the reason they gave me is 'it's not used long term'!

Thanks in advance
 
christmas said:
Hi all,

Does anyone know why a diabetes team might advise gliclazide not to be taken long term?
I'm sure I've read it elsewhere (or been told) but I can't find any info about it online.
Asking because I've found it suits me wonderfully, it controls my blood sugar well, and I wish I could stay on it but have been advised to stop, and the reason they gave me is 'it's not used long term'!

Thanks in advance
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To be honest, the person to ask that question of is the one who made the statement.

In terms of full disclosure I have never taken any medication to control my blood sugars, so have no personal experience of this drug, however, I know someone who worked for the manufacturer of Gliclazide, who described the drug as kicking the stuffing out of your pancreas, attempting to make it produce more insulin. She reckoned it was more likely to wear out an already ailing organ than fix the underlying issue. In other words, addressing the symptoms, not the cause.

I know Gliclazide has been utilised by many, without any apparent downside, so it is important you hear a range of opinions, but also go back to your HCP for their explanation.
 
Like @AndBreathe I have not taken Glic and my knowledge is only anecdotal.
However, I too have read that it is likely to "wear out" an ailing pancreas. This is why it is not recommended for someone with LADA going through their honeymoon period - it will overwork the few remaining insulin producing cells.
 
Unlike you I found Gliclazide, gave me hypos, and when it was stopped felt much better.
 
Very surprised by this as been on gliclazide for at least three years but have others conditions that won’t allow use of most injections now. Keep us posted on anything you find out.
 
Found this on the web and as I use Gliclazide I thought it may be useful.

Gliclazide is a medication commonly used to treat type 2 diabetes. Here are some important points regarding its long-term use:

  1. Dosage and Strength:
    • Gliclazide comes in standard tablets and slow-release tablets.
    • Standard tablets release gliclazide quickly, so you may need to take them several times a day depending on your dose.
    • Slow-release tablets release gliclazide slowly, usually requiring only one dose in the morning.
    • The maximum daily dose for standard gliclazide is 320mg, while for slow-release gliclazide, it’s 120mg.
    • If you need more than 160mg of standard gliclazide daily, divide it into 2 equal doses.
  2. Duration of Treatment:
  3. Monitoring and Adjustments:
  4. Missed Doses:
Remember that gliclazide is safe for long-term use, but regular monitoring and adherence to your doctor’s instructions are crucial for effective diabetes management. If you have any concerns, consult your healthcare provider.
 
I was put on Gliclazide 3 weeks ago at a lowish dose but now on max dose. My Nurse told me to think of the pancreas like a sponge and this tablet will wring every last drop of insulin out and I couldn't be on it long term. I have a feeling reading other comments that is because she's sent bloods off as she thinks I am falling off the cliff of Type 1.5 and has said it's likely I shall be on insulin only next month rather than because it might cause complications. I'm finding I start the day at around 9, have a piece of toast for breakfast, non carbs for lunch and then bouncing around 16/17 until the following morning. Be interesting to see what she says tomorrow on the follow up call.
 
I think the research is fairly inconclusive regarding the 'burn out' of beta cells. Studies that have been done on T2s generally use patients that don't change their lifestyle so the condition progresses. I believe the rate of people on a Sulfonylurea that progress to insulin is around the same as those on Metformin (UK Prospective diabetes study.) Some research has shown that in mice beta cells stop working but will start again by removal of the medicine.
 
AndyGlos said:
I was put on Gliclazide 3 weeks ago at a lowish dose but now on max dose. My Nurse told me to think of the pancreas like a sponge and this tablet will wring every last drop of insulin out and I couldn't be on it long term. I have a feeling reading other comments that is because she's sent bloods off as she thinks I am falling off the cliff of Type 1.5 and has said it's likely I shall be on insulin only next month rather than because it might cause complications. I'm finding I start the day at around 9, have a piece of toast for breakfast, non carbs for lunch and then bouncing around 16/17 until the following morning. Be interesting to see what she says tomorrow on the follow up call.
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It does sound as if you are struggling to cope despite the gliclazide and other than your toast what other meals are you having.
When do you take your gliclazide?
 
christmas someone has fed you with wrong info with regards to the med not been long term. i used to take that but only had to stop because i was having allergic reactions but besides that it is def not a short term one... i would def challenge them on that issue. also ask for your diabetes type to be tested best bets they never even bothered to check what type of diabetes you have as there are all different ones.
 
AndyGlos said:
I was put on Gliclazide 3 weeks ago at a lowish dose but now on max dose. My Nurse told me to think of the pancreas like a sponge and this tablet will wring every last drop of insulin out and I couldn't be on it long term. I have a feeling reading other comments that is because she's sent bloods off as she thinks I am falling off the cliff of Type 1.5 and has said it's likely I shall be on insulin only next month rather than because it might cause complications. I'm finding I start the day at around 9, have a piece of toast for breakfast, non carbs for lunch and then bouncing around 16/17 until the following morning. Be interesting to see what she says tomorrow on the follow up call.
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Just to be clear. Type 2 does not become type 1.5 or type 1 by virtue of the treatment changing to insulin. Type 2 is a different condition with different causes even if the medication is sometimes the same.

Someone who becomes type 1.5 (lada) or type 1 has either been misdiagnosed originally or are still type 2 but now treated with insulin.
 
AndyGlos said:
I was put on Gliclazide 3 weeks ago at a lowish dose but now on max dose. My Nurse told me to think of the pancreas like a sponge and this tablet will wring every last drop of insulin out and I couldn't be on it long term.
Click to expand...
That nurse clearly has no idea clue how beta cells work.
 
Leadinglights said:
It does sound as if you are struggling to cope despite the gliclazide and other than your toast what other meals are you having.
When do you take your gliclazide?
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It is a struggle. My late partner was type 2 for 20 years so food wise I was pretty clued up but seem to have lost direction. I take the gliclazide morning and evening. And a 500 Metformin in the evening. reading was 7 at 8am today then 1 piece of seeded brown toast and 11.30 am up to 12.5. Lunch is usually meat salad, eggs and bacon and avoid carbs (except my guilty secret of a small pear) and evening meat, green veg and maybe 2 small boiled spuds. Can't work out where I am going wrong.
 
AndyGlos said:
It is a struggle. My late partner was type 2 for 20 years so food wise I was pretty clued up but seem to have lost direction. I take the gliclazide morning and evening. And a 500 Metformin in the evening. reading was 7 at 8am today then 1 piece of seeded brown toast and 11.30 am up to 12.5. Lunch is usually meat salad, eggs and bacon and avoid carbs (except my guilty secret of a small pear) and evening meat, green veg and maybe 2 small boiled spuds. Can't work out where I am going wrong.
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They say to take the gliclazide 30 min before eating so it has chance to get your pancreas working to produce some insulin to cope with the carbs in your meal.
It clearly is not working too well if 1 slice of toast is increasing blood glucose by so much as you would only really want to be seeing no more than 3mmol/l increase after 2 hours.
Have you tried having some protein with your toast or give the toast a miss and have something like full fat Greek yoghurt and some berries and seeds or nuts.
It would be worth doing some before eating and after 2 hours testing with a carb estimate both to see what you are tolerating but to provide evidence that your medication regime is not working too well.
 
Leadinglights said:
They say to take the gliclazide 30 min before eating so it has chance to get your pancreas working to produce some insulin to cope with the carbs in your meal.
It clearly is not working too well if 1 slice of toast is increasing blood glucose by so much as you would only really want to be seeing no more than 3mmol/l increase after 2 hours.
Have you tried having some protein with your toast or give the toast a miss and have something like full fat Greek yoghurt and some berries and seeds or nuts.
It would be worth doing some before eating and after 2 hours testing with a carb estimate both to see what you are tolerating but to provide evidence that your medication regime is not working too well.
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These boards are certainly not like the car groups I belong to! There you can wait days for replies lol.
I take the tabs 20 to 30 minutes before eating and with water. Dose at the moment is 160mg in the morning and 80mg in the evening. I've got a routine with my Carers so then go for a wash etc so by the time that's all done I know I am good to eat.
I shall try that advice even though I don't like yoghurt. I'm always willing to try anything. Apart from the toast and the small spuds I am pretty much avoiding carbs. It's a struggle to stay awake all day when the sugars keep going up.
 
AndyGlos said:
These boards are certainly not like the car groups I belong to! There you can wait days for replies lol.
I take the tabs 20 to 30 minutes before eating and with water. Dose at the moment is 160mg in the morning and 80mg in the evening. I've got a routine with my Carers so then go for a wash etc so by the time that's all done I know I am good to eat.
I shall try that advice even though I don't like yoghurt. I'm always willing to try anything. Apart from the toast and the small spuds I am pretty much avoiding carbs. It's a struggle to stay awake all day when the sugars keep going up.
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You are on a reasonably high dose of gliclazide so you do need to eat some carbs otherwise there is a risk of low blood glucose but there is never a defined amount that people should eat just that people shouldn't go too low.
Many people think they don't like yoghurt but that is often because they have only had low fat which is very thin and acidic, a different kettle of fish to a nice creamy full fat Greek yoghurt.
Do you have a blood glucose monitor so you can test the effect of what you are eating, if not the you should have one prescribed as you are on gliclazide so ask.
 
Leadinglights said:
You are on a reasonably high dose of gliclazide so you do need to eat some carbs otherwise there is a risk of low blood glucose but there is never a defined amount that people should eat just that people shouldn't go too low.
Many people think they don't like yoghurt but that is often because they have only had low fat which is very thin and acidic, a different kettle of fish to a nice creamy full fat Greek yoghurt.
Do you have a blood glucose monitor so you can test the effect of what you are eating, if not the you should have one prescribed as you are on gliclazide so ask.
Click to expand...
I am eating some carbs and it's a balancing act to stop sugars going up too far. I have a glucose monitor which I was given when things really started going haywire. Pre lunch today was 17, Post lunch 11 and that was after scrambled eggs and bacon. I suspect the full fat yoghurt with nuts or berries will be easier for me to eat first thing.
Something else you've educated me on is the low blood sugar. I wasn't told that was possible on the tablets. I'm still waiting for todays promised telephone call from the Nurse.
 
mikeydt1 said:
christmas someone has fed you with wrong info with regards to the med not been long term. i used to take that but only had to stop because i was having allergic reactions but besides that it is def not a short term one... i would def challenge them on that issue. also ask for your diabetes type to be tested best bets they never even bothered to check what type of diabetes you have as there are all different ones.
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I actually switched GP a few years ago due to moving house and they double checked my type when I got signed up with them. Looks and behaves like type 2!
 
Thanks for your responses everyone, I will be asking my diabetes nurse why they are suggesting I go off it/why they advise not to use it long term in my check-in appointment for my new meds next week.
 
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