OK so now im on another tablet.

[Steff]

Thought id carry on from my annual reveiw thread as now im back here is what happened, well firstly feet and sensations are still ok bp is ok, blood test has been booked in for the 16th for my hbA1c, actually some might know when i last had a hbA he did not disclose it will today i found out it had risen from 7.2 to 8.6 😱 therefore further proof if proof be needed the metformin is doing nothing for me well anyways this blood test will take for hbA and a liver test to.Right onto the actual main bits i will be put onto Gliclazide i think its called as she said sometimes if one pill is not working we tend to mix it with another to see if that will make any improvement as for byetta it is still put on the back shelf for now i am seeing my actual DSN on the 22nd and she said that i can have a more comprehensive talk to her about medications, when asked what i thought about byetta i said ive looked into seen tutoials on line and i would be happy to go on it.
I mentioned my hypers she asked what the general reading of a hyper was so got my diary out and showed her the 4 i had had,cant really say she was that bothered but at least she asked my opinion.My knee well she felt around for abit poking and pushing she said it is nothing serious if you just get yourself some deep heat or biofreeze which i told her i already use and she said if it is stil giving me hassle to come back to see her and she will refer me to a psyschiotherapist(?) spelling.

Is anyone here on both metformin and this gliclazine and how are you finding it if you are?


Cheers

 

[Caroline]

I have metformin and gliclizide. Sometimes the metformin needs a little help. I take 3 metformin and 2 gliclizide.

I was originally told to take just gliclizide in the evening, but now take it morning and evening and have no problems.

 

[Vanessa]

Until just before Christmas I was on both metformin (in the slow release version) and gliclazide but found that I was having too many hypoglycaemic episodes and a significant drop in my HbA1c given weight loss, managing carbs and exercise regime. Now back on just glucophage but wondering whether it will need increasing a little in March as getting the revised balance right is somewhat of a challenge

Other than the fact that I started dropping too low too often I had no problems with the gliclazide so hope it works for you. You might find that you put on a couple of lbs with it though as it does lead to a little weight gain for many which is one of the reasons it is not the first choice of drug for most of us. Hopefully your practice team will build you up slowly so you can adapt your diet/snacking approach as needs be

 

[thedame]

Hi Steff 🙂

I haven't been on here for a while but something made me come and have a poke around and then I saw your post about your review, so it seemed like a good place to start!

First of all sorry that the metformin is not doing the job as well as you hoped - the levels you quoted don't seem outrageously high to me and this is something I queried in the Diabetes UK forum but never got a reply So I am going to post a new thread on this forum in a minute.

Just wanted to say that I hope the Glicazide gets things going for you - I was not been offered any other meds due to my excessive weight problem but my optician recommended Glic when I was struggling to get my levels down a few months back and I have heard a lot of positive feedback about the two meds working together.

From my own research into Byetta, I know that it is unlikely to get prescribed if one is not seriously overweight - I guess it is cost versus cheaper alternatives when this isn't an issue and despite the benefits I have had from being on it, injecting twice a day is a pain - not literally-just inconvenient!

I know you have dona lot of research yourself on Byetta so forgive me if you know this, but I gather that Byetta is has to be used with caution with Glicazide as the combination can cause hypos - so if they eventually choose to put you on it, I hope the team can advise you on this point.

Good luck with the meds and you meeting with the DSN🙂

 

[Steff]

Thank you for the insight vanessa and caroline.

And yes thanks dame i was wondering if you where still about as i know your one on here who uses byetta I think i will get better advice from the dsn rather then gp .

 

[Peter C]

Thought id carry on from my annual reveiw thread as now im back here is what happened, well firstly feet and sensations are still ok bp is ok, blood test has been booked in for the 16th for my hbA1c, actually some might know when i last had a hbA he did not disclose it will today i found out it had risen from 7.2 to 8.6 😱 therefore further proof if proof be needed the metformin is doing nothing for me well anyways this blood test will take for hbA and a liver test to.Right onto the actual main bits i will be put onto Gliclazide i think its called as she said sometimes if one pill is not working we tend to mix it with another to see if that will make any improvement as for byetta it is still put on the back shelf for now i am seeing my actual DSN on the 22nd and she said that i can have a more comprehensive talk to her about medications, when asked what i thought about byetta i said ive looked into seen tutoials on line and i would be happy to go on it.
I mentioned my hypers she asked what the general reading of a hyper was so got my diary out and showed her the 4 i had had,cant really say she was that bothered but at least she asked my opinion.My knee well she felt around for abit poking and pushing she said it is nothing serious if you just get yourself some deep at or biofreeze which i told her i already use and she said if it is stil giving me hassle to come back to see her and she will refer me to a psyschiotherapist(?) spelling.

Is anyone here on both metformin and this gliclazine and how are you finding it if you are?
Cheers

Hi Steph,

The move on to gliclazide is predictable if a little precipitate in your case (?). You have only been on 1000 mg of metformin when the max dose is 2500. In general you wouldn't be put onto a sulfonylurea like gliclazide until you had maxed out on met and failed with it.
As you can see from the treatment path below you are just setting out on a long road. The position at present ( NICE guidelines) is that T2s have to have failed on the maximum of the three routine drugs ( metformin, a sulf ( gliclazide) and a TZD ( e.g. Rosiglitazone)) before byetta can be tried. Which would mean that, unless you are morbidly obese, byetta is probably three or four years off into the future for you. At the moment byetta is still very new and concerns about pancreasitis witn it have been raised. Anyone going onto byetta now is effectively a guinea pig for the rest of us.

The usual treatment algorhythm for T2 diabetes is ...
...D&E ( very few T2s can sucessfully control it with just this)
...D&E plus metformin
...D&e plus metformin plus a sulf e.g Gliclazide ( and don't listen to urban myths about them wearing out your pancreas)
...D&E plus metformin plus a sulf plus a TZD ( the sulf might be dropped)
...D&E plus metformin plus byetta
...D&E plus metformin plus an introductory insulin regime ( e.g. single dose of lantus at bedtime or a mix twice a day ( e.g Humalog Mix 25)
...D&E plus metformin plus a true physiological insulin regime ( basal/bolus)

If your A1cs are rising there are other matters to consider ...
1. Getting back to basics with Diet and Exercise. Like for example reading Maggie Davey's Open letter for the Newly Diagnosed and Jennifer's Smart Advice in our LInks section.
2. You are relatively young for Type 2 Diabetes and if you have T1 in the family you might consider whether the hypers are an indication that you are actually LADA in the honeymoon phase. Just a thought.

 

[Steff]

Hi Steph,

The move on to gliclazide is predictable if a little precipitate in your case (?). You have only been on 1000 mg of metformin when the max dose is 2500. In general you wouldn't be put onto a sulfonylurea like gliclazide until you had maxed out on met and failed with it.
As you can see from the treatment path below you are just setting out on a long road. The position at present ( NICE guidelines) is that T2s have to have failed on the maximum of the three routine drugs ( metformin, a sulf ( gliclazide) and a TZD ( e.g. Rosiglitazone)) before byetta can be tried. Which would mean that, unless you are morbidly obese, byetta is probably three or four years off into the future for you. At the moment byetta is still very new and concerns about pancreasitis witn it have been raised. Anyone going onto byetta now is effectively a guinea pig for the rest of us.

The usual treatment algorhythm for T2 diabetes is ...
...D&E ( very few T2s can sucessfully control it with just this)
...D&E plus metformin
...D&e plus metformin plus a sulf e.g Gliclazide ( and don't listen to urban myths about them wearing out your pancreas)
...D&E plus metformin plus a sulf plus a TZD ( the sulf might be dropped)
...D&E plus metformin plus byetta
...D&E plus metformin plus an introductory insulin regime ( e.g. single dose of lantus at bedtime or a mix twice a day ( e.g Humalog Mix 25)
...D&E plus metformin plus a true physiological insulin regime ( basal/bolus)

If your A1cs are rising there are other matters to consider ...
1. Getting back to basics with Diet and Exercise. Like for example reading Maggie Davey's Open letter for the Newly Diagnosed and Jennifer's Smart Advice in our LInks section.
2. You are relatively young for Type 2 Diabetes and if you have T1 in the family you might consider whether the hypers are an indication that you are actually LADA in the honeymoon phase. Just a thought.

I dont have any immediate relatives type 1 i have 1 uncle thats type 1 and me a type 2 but thats it,thank you for that comprehensive reply peter it is really helpful and certainly raises questions in my mind.

 

[Peter C]

I dont have any immediate relatives type 1 i have 1 uncle thats type 1 and me a type 2 but thats it,thank you for that comprehensive reply peter it is really helpful and certainly raises questions in my mind.

Forgot to mention it Steph, gliclazide being an insulin secretogue ( forces your pancreas to produce insulin), can lead to hypos and therefore NICE guidelines GUARANTEE test strip prescriptions to Glic users.

 

[Steff]

Forgot to mention it Steph, gliclazide being an insulin secretogue ( forces your pancreas to produce insulin), can lead to hypos and therefore NICE guidelines GUARANTEE test strip prescriptions to Glic users.

Thanks i get mine on prescription.

 

[squidge63]

I started off on diet and exercise, then onto Metformin, couldnt cope with 2000mg of that so was put on 1000mg and gliclizide, only lasted a year on that regime before going onto novomix 30 insulin 2 inj a day and a year later ended up on Insulatard at night and novorapid 3x a day, and am now on Levemir 2x a day and novorapid 3x a day...

physiotherapist is the word you were looking for Steff.

 

[Steff]

I started off on diet and exercise, then onto Metformin, couldnt cope with 2000mg of that so was put on 1000mg and gliclizide, only lasted a year on that regime before going onto novomix 30 insulin 2 inj a day and a year later ended up on Insulatard at night and novorapid 3x a day, and am now on Levemir 2x a day and novorapid 3x a day...

physiotherapist is the word you were looking for Steff.

Thanks Squidge x

 

[twinnie]

hi there steff i was on glizade for 9 years and had no bother with it
started menformin 7 years later and again no bother with ether or them i really hope this works for you and you stop haveing the hypers

 

[Steff]

hi there steff i was on glizade for 9 years and had no bother with it
started menformin 7 years later and again no bother with ether or them i really hope this works for you and you stop haveing the hypers

Thanks Vickie. I told her i hate having the hypers i can almost cope with the odd high number but the hypers just hate them gr x

 

[wallycorker]

.........I told her i hate having the hypers i can almost cope with the odd high number but the hypers just hate them.......

Hi Steff,

Hypers are going too high and hypos are going too low - i.e. under 4 as I understand things.

You keep referring to having "hypers" do you mean that you are having hypers or do you mean hypos?

Best wishes - John

 

[Steff]

Hi Steff,

Hypers are going too high and hypos are going too low - i.e. under 4 as I understand things.

You keep referring to having "hypers" do you mean that you are having hypers or do you mean hypos?

Best wishes - John

I have never had a hypo , always hypers

 

[squidge63]

If a hyper is anything over 7, being as 4 - 7 is the norm that we need to be.. I am always hyper then... sadly i can now get up to blood sugars of 28 and don't feel ill, sometimes a little sleepy but not always... whereas when I first became diabetic I would get sleepy and get a headache at 12..

Woke up today with reading of 15.7 yet tomorrow I could wake up and have a reading of 7 or even 6.

 

[Steff]

If a hyper is anything over 7, being as 4 - 7 is the norm that we need to be.. I am always hyper then... sadly i can now get up to blood sugars of 28 and don't feel ill, sometimes a little sleepy but not always... whereas when I first became diabetic I would get sleepy and get a headache at 12..

Woke up today with reading of 15.7 yet tomorrow I could wake up and have a reading of 7 or even 6.

the ONLY thing at the moment that tells my brain im hypering is my slurred speech during a hyper i have no other symptom itd only maybe an our or so after my hurt really hurts.

 

[rossi_mac]

lets hope this added pill to the cocktail will help smooth the way Steff🙂

 

[vince13]

Steff, I am on slow release Metformin 1500mg at night and 80mg gliclazide morning and night. However my levels are starting to go higher and I am hoping to increase both to the maximum levels allowed as promised by my Consultant before taking the step of going onto insulin.

When first diagnosed I was on the ordinary Metformin (one with each meal) and they messed my stomach up so badly I went on the slow release which stopped those problems immediately. I was also started on a higher dose of gliclazide in the mornings (2x80mg) and I began to go very low mid-morning hence the dose of 80mg twice a day now. This has worked for me up to now with no ill effects.

I see my Surgery Nurse, who is very understanding, next Tuesday and will know more then. I've also had this blasted virus which has completely beggered up my levels so I don't really know where I am but will get my six-monthly HAB1C then too which I know will be higher again (probably mid 7s to mid 8s the way I was before the blood test last week).

I hope the new medications work for you with no ill effects but do watch out for lows mid morning wqith the gliclazide as I understand they are known to do that to you. Good luck.....

 

[thedame]

Hi Steff and others

I am getting a lot of useful info reading this thread - Peter's excellent summary of a typical T2 "journey" would make a good introduction to any T2 newly diagnosed - I just wish they would standardize this info across all the health care teams😉