Gliclazide

[Nicoll]

Good Morning, I would like some advice please. Every time I go to my doctors surgery for my review, I see a different person, as they don’t seem to keep their staff. One doctor put me on Gliclazide and it worked well. Another doctor too me off of Gliclazide as he thought it wasn’t a nice drug. He put me on Metformin and I ended up in A&E, I also lost a lot of weight, I was down to 7 stone. I had lots of tests and my weight loss was put down to Metformin. I was thenput back on to Gliclazide And was fine. Last week I had another diabetic check and the diabetic nurse wanted me to stop taking Gliclazide and try something else. She pointed out that it was not a very nice drug and was likely to cause hypos in older people (I am72). HBA1C 72. She also said that it would end up burning out my pancreas. I feel so frustrated!

 

[Nicoll]

Oooops! Made a typo - my HBA1C is 52 (6.9), not 72!

 

[Nayshiftin]

Good Morning, I would like some advice please. Every time I go to my doctors surgery for my review, I see a different person, as they don’t seem to keep their staff. One doctor put me on Gliclazide and it worked well. Another doctor too me off of Gliclazide as he thought it wasn’t a nice drug. He put me on Metformin and I ended up in A&E, I also lost a lot of weight, I was down to 7 stone. I had lots of tests and my weight loss was put down to Metformin. I was thenput back on to Gliclazide And was fine. Last week I had another diabetic check and the diabetic nurse wanted me to stop taking Gliclazide and try something else. She pointed out that it was not a very nice drug and was likely to cause hypos in older people (I am72). HBA1C 72. She also said that it would end up burning out my pancreas. I feel so frustrated!

I hear your frustration , can you not explain to them that the Glicazide was changed before . If you have reacted so badly to metformin then you need to tell them and hopefully they will listen and change. Really I cannot say anything about medication because we are all unique and it’s really up to your health professionals to help you there. Your blood sugar must be high to go on medication . It might be worth asking for more help on coping . The phone helpline is here to help you more. I’m sorry I’m no help. There are many medications other than Glicazide but they will work for you in many different ways from metformin so it might be worth trying. As I say we rely on the Gp to prescribe and if they are not good I’d tell them. It might be they have not read your notes.

 

[Nicoll]

Thank you for your reply. I do, of course, tell them of my problems, but they all have their own opinions and sadly they are all different. Gliclazide works really well for me, but their comments on how bad it is really trouble me.

 

[grovesy]

Gliclazide can cause hypos, and works by stimulating the pancreas to produce more Insulin.Have you had any other investigations to weight loss?

 

[Nicoll]

Gliclazide can cause hypos, and works by stimulating the pancreas to produce more Insulin.Have you had any other investigations to weight loss?

Yes, lots of investigations for cancer etc. but all proved negative and my weight loss was put down to Metformin. I’m fine now and have put on 6lbs - looking a lot less skeletal thank goodness. Apparently, I am told that most of the diabetic drugs are weight reducers.

 

[Felinia]

Hi
If your HbA1c is 52 you are only just in the diabetic range so I question why you are being given medication at all. At that level many people are given the option to reduce their HbA1c with a suitable eating pattern and exercise. If I understand correctly you are less than 8 stone, so are clearly not overweight. You may just need to reduce carbs and increase fats/protein to maintain weight but reduce blood glucose. But if you have to take a medication, my main medication is Canagliflozin, one of the "flozin" medications. You need to drink plenty - 3 to 4 litres a day, and you pee a lot. It is bringing my levels down. I was told not to reduce my carbs too much. So it's very much trial and error - what works for you and what you are comfortable with.

 

[Barrowman]

Thank you for your reply. I do, of course, tell them of my problems, but they all have their own opinions and sadly they are all different. Gliclazide works really well for me, but their comments on how bad it is really trouble me.

In the three months since being diagnosed with type 2 I have had three different tablets starting off with Metformin and now on Gliclazide which works well for me.
Having had Pancreatitis three times with obvious damage to my Pancreas anything that will induce more insulin production has got to be good for me, feeling better on gliclazide is a bonus.

 

[Nicoll]

Hi
If your HbA1c is 52 you are only just in the diabetic range so I question why you are being given medication at all. At that level many people are given the option to reduce their HbA1c with a suitable eating pattern and exercise. If I understand correctly you are less than 8 stone, so are clearly not overweight. You may just need to reduce carbs and increase fats/protein to maintain weight but reduce blood glucose. But if you have to take a medication, my main medication is Canagliflozin, one of the "flozin" medications. You need to drink plenty - 3 to 4 litres a day, and you pee a lot. It is bringing my levels down. I was told not to reduce my carbs too much. So it's very much trial and error - what works for you and what you are comfortable with.

Thank you for your reply, but I think I have misled you a little. My HBA1C is 52 (6.9) when using Gliclazide. It would be a lot higher, I suspect if not using medication.

 

[Nicoll]

In the three months since being diagnosed with type 2 I have had three different tablets starting off with Metformin and now on Gliclazide which works well for me.
Having had Pancreatitis three times with obvious damage to my Pancreas anything that will induce more insulin production has got to be good for me, feeling better on gliclazide is a bonus.

Interesting - thank you

 

[grovesy]

Yes, lots of investigations for cancer etc. but all proved negative and my weight loss was put down to Metformin. I’m fine now and have put on 6lbs - looking a lot less skeletal thank goodness. Apparently, I am told that most of the diabetic drugs are weight reducers.

That is goodyou havehad investigations. Not all diabetic drugs reduce weight, though Metformin is supposed to help with weight loss.

 

[Felinia]

Thank you for your reply, but I think I have misled you a little. My HBA1C is 52 (6.9) when using Gliclazide. It would be a lot higher, I suspect if not using medication.

Do you have your full HbA1c history since first diagnosis. You will see what I mean from my signature below. The HbA1c measures the average blood glucose over a 3 month period. So you are saying you were taking gliclazide for the whole 3 months before the test? So what was it before, when you came off Metformin and went back on Gliclazide? It might provide evidence of how your body works with different medication, and assist your nurse. Sadly when I go for my reviews, they never seem to have looked at my past history and initially suggest something I can't take (Metformin, statins to name but 2!).

 

[DaveB]

Anyone suffering unexpected weight loss with diabetes should consider the possibility of being Late Onset T1 and not T2; my GPs missed that. Ask for the two tests. Legend has it that Gliclazide does burn-out the pancreas but I've never seen any evidence. I was on full dose 320mg for several years until it stopped working i.e. my pancreas was producing very little insulin so couldn't be stimulated any more. I'll never know whether than was burn-out or beta cell death thru other causes. Gliclazide is not normally the best match for a T2 due to most T2s having excess insulin but it sounds like you need to have the two tests for T1 carried out to check. Have enough Fats and Proteins to counteract some of the weight loss. Although Metformin does help a bit with weight loss the effect would normally be minimal?

 

[Nicoll]

Do you have your full HbA1c history since first diagnosis. You will see what I mean from my signature below. The HbA1c measures the average blood glucose over a 3 month period. So you are saying you were taking gliclazide for the whole 3 months before the test? So what was it before, when you came off Metformin and went back on Gliclazide? It might provide evidence of how your body works with different medication, and assist your nurse. Sadly when I go for my reviews, they never seem to have looked at my past history and initially suggest something I can't take (Metformin, statins to name but 2!).

Yes, that’s exactly what happens to me! No not reading! I do list all my readings, so perhaps I should take them with me next time! Thank you

 

[Nicoll]

Anyone suffering unexpected weight loss with diabetes should consider the possibility of being Late Onset T1 and not T2; my GPs missed that. Ask for the two tests. Legend has it that Gliclazide does burn-out the pancreas but I've never seen any evidence. I was on full dose 320mg for several years until it stopped working i.e. my pancreas was producing very little insulin so couldn't be stimulated any more. I'll never know whether than was burn-out or beta cell death thru other causes. Gliclazide is not normally the best match for a T2 due to most T2s having excess insulin but it sounds like you need to have the two tests for T1 carried out to check. Have enough Fats and Proteins to counteract some of the weight loss. Although Metformin does help a bit with weight loss the effect would normally be minimal?

Thank you

 

[pat7762]

i'm on gliclazide been on it for a number of years,i was on metformin but had terrible bouts of thrush with it,i'm 76,should i be worried about taking gliclazide as i'm not getting the low blood sugar readings i use to get

 

[harbottle]

Gliclazide is not normally the best match for a T2 due to most T2s having excess insulin but it sounds like you need to have the two tests for T1 carried out to check. Have enough Fats and Proteins to counteract some of the weight loss. Although Metformin does help a bit with weight loss the effect would normally be minimal?

Some research indicates that Gliclazide may protect Beta cells from dysfunction/apoptosis.

Gliclazide may have an antiapoptotic effect related to its antioxidant properties in human normal and cancer cells

Experimental and clinical studies suggest that gliclazide may protect pancreatic β-cells from apoptosis induced by an oxidative stress. However, the precise mechanism(s) of this action are not fully understood and requires further clarification. ...

www.ncbi.nlm.nih.gov

Gliclazide

T2 diabetes is a combination of reduced insulin levels AND insulin resistance, with varying degrees of both - i.e. it's possible to have low insulin resistance and a very low levels of insulin, and it's also possible to have slightly reduced insulin level and high resistance.

This paper shows how the insulin level decreases when T2 is present following a rise during the early stages (Pre-Diabetes) to handle the excess sugar, hence why it's good to catch it early, as once it hits the peak the pancreas' Beta cells stop working. It also mentions that beta cell mass increases in the early stages to handle the rise in sugar.

Decreased insulin secretion in type 2 diabetes: a problem of cellular mass or function?

Type 2 diabetes is characterized by diminished or inappropriate secretion of insulin, which could be a defect of either islet cell function or beta-cell ma

diabetesjournals.org

Type 2 diabetes is characterized by diminished or inappropriate secretion of insulin, which could be a defect of either islet cell function or beta-cell mass. Quantitation of islet cell populations in postmortem pancreas demonstrates little change of beta-cell mass in type 2 diabetes.

The Newcastle chap has shown that in some people weight loss and diet can restore levels of both first and second line response back to normal levels (In the early stages).

https://eprints.ncl.ac.uk/file_store/production/257170/1F0F5E6C-3794-4455-81B5-3781E2E0A532.pdf

The beta cell dysfunction has, to date, proved less amenable to therapy. Data from the highly impactful United Kingdom Prospective Diabetes Study suggested that at the time of diagnosis, beta-cell function, albeit estimated by surrogate indices, had already declined to around 50% of normal.

Interestingly, there's very little evidence (Or none) that Beta cells do undergo apoptosis, but they do become dysfunctional, possibly be a process called de-differentiation:

Based on such evidence it has hitherto been widely accepted that ongoing death or apoptosis of beta cells plays a major role in the onset and progression of human type 2 diabetes even though direct evidence is lacking.

 

[pat7762]

thank you