Starting On Glicazide

[adrianj]

Hi All

I have been a type 2 diabetic for a few years now and my H1BAC level has ben steady at about 60 for the past two years.Unfortunatley since my reading of 60 in January this year my latest result a few days ago was 80. I visited the diabetic nurse and she has decided to put me on two doses of 80mg of glicazide once with breakfast and once with the evening meal. I also currently take 2000mg of metformin a day as well. I was given a blood sugar monitor as well as mine was fairly old at this point. I was asked to return to the nurse on 15th July and take a few readings before meals to give them an indication of how the glicazide was effecting my blood sugar. I was warned about driving with the new medication and of the potential to have a Hypo and what to do if I experience one. Iam normally a worrier and suffer from anxiety so I main question is about how much will an 80mg dose of glicazide lower my blood sugar by on average. Iam only testing before breakfast and before my main meal in the evening and currently my reading are between 8.5-9.0 before a meal. At these levels could Glicazide cause a hypo potentially ,and am I at a level where I actually need the additional drug ?

 

[everydayupsanddowns]

Welcome to the forum @adrianj

Sorry to hear your HbA1c has been rising respite your best efforts. Good that you have been offered an additional medication to try to bring your glucose levels back into line.

The recommended HbA1c for people with T2 diabetes is 48mmol/mol or below, so your most recent reading of 80 does seem to need a little extra help.

Your worries about hypoglycaemia are only natural. It’s common to be started on a relatively conservative dose of a new medication which can then be adjusted.

It would be helpful to keep your BG meter with you at all times, and to always carry hypo treatment (eg a pack of glucose tablets) so that you can take a reading if you begin to feel any of the common warning signs of impending hypoglycaemia.

It’s worth checking your levels before you treat, as it may be that your body has got used to running higher BG levels, and you may get ‘false hypo’ warnings when your levels are, say, 4-6, just because that is lower than normal for you. A smaller nudge at those levels can help reduce the symptoms without pushing your BG levels back up into high readings again. The usual advice is to treat readings below 4.0 with 15g of fast carbs, and recheck after 15 minutes.

 

[rebrascora]

Hi.

Sorry to hear that your levels have started rising significantly. Had you made any dietary changes and if so, what sort of things do you typically eat for breakfast and evening meal. The reason I ask is that those premeal readings will rise if you are eating carbs, so the medication is not working on those pre meal levels but on the higher levels your food will cause an hour or so after eating, so unless you are following a very low carb diet, your levels will likely be well up into double figures after meals and it is those higher, post meal readings that the Gliclazide will hopefully bring down.

If you are already following a very low carb diet (no bread, pasta, rice, potatoes, breakfast cereals as well as no cakes, biscuits and sweets and very little fruit) .... and have been following that for some considerable time, then it may be that the Gliclazide will not be effective anyway, because your insulin production is likely impaired, rather than just insulin resistant. Gliclazide encourages the pancreas to produce extra insulin, but if it is already unable to produce enough, then the Gliclazide is unlikely to be effective.

Just to reassure you, 80mg twice a day is a moderate dose. How much it drops your levels will be dependent on how much insulin your pancreas is able to make and how insulin resistant you are and what you eat. I think the maximum dose is double that. I took the max dose for a few weeks together with a very low carb diet (not recommended) and it had no effect so it was safe to assume my pancreas was no longer able to produce enough insulin and I needed to inject it.

 

[Docb]

i can tell you my experience - I took it at various dose levels (40,80,120 mg/day) whilst getting my blood glucose under control and stopped when things were well settled. Here is a plot of some of my test results



The upward step in Feb 2022 was due to my stopping gliclazide, then at 40 mg/day. The plot shifted upwards by 1 mmol/l or thereabouts giving some idea of the effect of taking it in terms of blood glucose levels. Whilst taking it, even up at 120 mg/day, I never got into hypo territory, nor had any side effects.

You can read some other stuff into the plot but essentially for me, gliclazide did its stuff effectively without any drama.

Hope that helps.

 

[Tdm]

Same here...i was a glicaside and metformin before my diagnosis was confirmed, as gylcoside was very gentle for me.

 

[DaveB]

160mg/Day is a medium dose and it will depend on the state of you pancreas the extent to which it works and whether it takes you too low. Do check your BS regularly to start with. I was started on 160mg/Day and it worked quite well but eventually I was at 320mg/day and it no longer had any effect as my beta cells had largely died. Some say if you are on Gliclazide for too long it can burn out the beta cells but there is no proof for that. Be prepared for the potential need for insulin injections in the future as LADA often goes down that route

 

[adrianj]

Thank you to everyone that has replied and shared their own personal thoughts on Glicazide it has really helped me understand how it works and what I need to do to improve my diet and how to deal with any Hypo's. I have found this so much more helpful than what the diabetic nurse has told me. Really appreciate it.