still stuck on appropriate medication.

[mollylogan]

Hi, I just need some advise/info/your experience please?
I am on metformin 1000mg x2 a day and 1 Januvia (the maximum and only dose I believe) The Januvia hasnt reduced my HbA1c a lot but it certainly has more than kept it stable.
I was on Glizlazide together with the Metformin upon diagnosis for about a year until I stopped as it was giving me crashing sugar levels and making my extremely hungry.

My GP surgery are very reluctant to prescribe anything else and so put me on Gliclazide MR 30mg tablets telling me that the slow release version may suit me. I was told to take 1 tablet a day for 7 days and then 2 from then onwards. Once I started taking the two tablets I felt very similar, although not as bad maybe? as i did on the standard Gliclazide. So I'm not taking those anymore.

The nurse at my surgery who works with Diabetics told me that we are now 'scraping the bottom of the box in terms of medication and that insulin is the next step".
I asked her to give me something that didnt make me so hungry and she said that maybe drinking a glass of water when I was going for the food would be preferable. I was slightly shocked by this piece of wonder advise and told her that if it was that easy there wouldnt be any overweight people in the world...
She mumbled something about Pioglitazone? and said she'd discuss this with the diabetic nurse specialist.
My recent HbA1c was 72 and I am about 21lb overweight. So not hugely so - although I will be if I continued on the Gliclazide.
I did mention Victoza and Byetta but she wasnt very keen on those at all and said that I didn't fullfill the criteria. weight? BMI? again, keep me on Gliclazide and I'll soon be eligable!
Im thinking maybe that this could be about money.....
I still care full time for my very poorly daughter so i need ease. When I mentioned that I was taking 7 tablets a day and that I actually found in hard to remember to take mine as administering my daughters was all consuming she helpfully informed me that "some of my diabetics take 16 tablets a day"
I'm a little upset by this attitude and wonder if I'm taking things a little personally;-)
Can anyone advice me on any other meds I can do my homework on and mention tomorrow when she hopefully calls?
Many thanks!

 

[AlisonM]

There are other alternatives: Sitagliptin, Victoza and Byetta are just three of them. The last two are injections and the first does a similar job to Gliclazide. Perhaps it's time to discuss the options with your doctor.

 

[AlisonM]

Oops, I forgot to say hello and welcome to the forum.

 

[Northerner]

Sounds like a money-saving reason to me to dismiss Victoza or Byetta I would persist with this suggestion - is there someone else you can see apart from this nurse? You could point out that if you end up on insulin this will be at least as, or more expensive than Victoza/Byetta, so what would be the harm in letting you trial one of them for a few months? It might also help with your weight loss, whereas insulin might be more of a difficult proposition in that respect.

Some of our members have had great success with Victoza/Byetta and it's not THAT expensive - around ?60 a month I believe.

 

[DeusXM]

What are you doing in terms of your diet and exercise routine? Medication is essentially there to offset the strain put on your body by food, so depending on what you are eating at the moment, a change in diet could reduce the overall burden (while exercise will increase your insulin sensitivity).

21lb is not hugely overweight so I'm wondering whether your issue may not be insulin sensitivity by a lack of insulin production. In which case, I'm not seeing why going onto insulin would be a problem. I may be wrong but I thought Gliclazide works by overstimulating your beta cells, thus accelerating burnout of your natural insulin production which means it wouldn't be an ideal long-term treatment. Can anyone confirm/deny?

 

[mollylogan]

The Sitagliptin (Januvia) hasn't helped enormously Alison. I really want to give the other two a go- seperately of course! but need to know the criteria. Do NICE stipulate the criteria?
Deusxm, I'm learning slowly! Im training for the London 10k atm and am struggling to run 2k. My food depends on where in this world my daughter is being treated. (she has relapsed Neuroblastoma) This week I've spent 5 days at The Royal Marsden where I bring my own food and am more in control but my daughter is also treated in Philly and now Boston. This is a nightmare for me🙂 Food everywhere and no real place to plan what I need to eat. As I type I can hear these excuses;-)
Obviously a huge reduction in carbs has helped (thank you to the person who recommended Burgens Soya and Linseed bread a few months back) but I feel the thing for me is the excersise. When I run I fell 'normal' again.

 

[DeusXM]

As I type I can hear these excuses;-)

They're not excuses - they're just reality and you've nothing to feel bad about. Treating diabetes means minimising the impact it has on your life. You're doing what you need to get by, so it's essential your medication helps you to do this.

Exercise sounds like it makes a massive difference to you, so hopefully you'll be able to get running soon. Another step to consider is maybe cutting down your carb intake where possible. You've made some very smart dietary choices to date on the face of it but it may be you need to make tighter ones - instead of eating Burgen bread, you might want to look at avoiding bread entirely. If your daily carb intake is say, 50g, maybe trimming it to 25g could make a huge difference.

 

[AlisonM]

Sorry about that, I didn't recognise the name. That leaves the injections. Byetta, twice daily before meals or it's sister, Bydureon, a once weekly jab. And Victoza, daily jab not associated with a meal. Well worth dicussing with the doctor/nurse.

 

[trophywench]

Try your GP (the organ grinder not the monkey!) and if no joy and not satisfied, request a 2nd opinion ie referral to hospital diabetes clinic.

 

[Copepod]

Welcome to the forum mollylogan.

Just an idea to help you organise your own and your daughter's medications / tablets - a set of dosette boxes each. Dosette boxes have sections for each day of the week and up to four times a day. Obviously doesn't help dea lwith injections.

 

[SimplesL]

The nurse wanted to put my hubby on Gliclizide, but due to my concerns over his weight he is actually obese, she agreed to try him on Sitagliptin but this hasn't brought his levels down enough so she again mentioned gliclizde.

However she looked closer at her notes as I'd been the 1 to mention my concerns over him taking gliclizide & cost involved when his weight went even higher (he will not exercise; despite his father & mine having T2 complications). Perhaps she didn't want me to gatecrash another of his appointments. Anyway she is getting his HBA1c checked again in a couple of months & if no improvment she told hubby there is an injectable version they may try rather than gliclizide as it is more effective. I expect she means byatta etc as no mention of insulin as yet.

I'd try & see your GP & if still no joy ask for a referral to a specialist.

 

[mollylogan]

Thank you for the welcome everybody. I have been an occasional poster in the past but I keep disappearing...
The nurse at GP surgery has referred me to a diabetic nurse specialist. I didn't even have to ask. There is still this push for insulin though because of my age (not young! but young for this type of diabetes).
DeusXM, like many people I love bread and i dont appear to have the imagination to replace it with something. Ill start another thread in the food section.

 

[mollylogan]

SimplesL, sorry I missed your post. I am a little mift that I spent months on a drug, wondering why I always felt I wanted to eat the furniture before I realised that it was in fact the Gliclazide doing it. I think I'm a little annoyed at myself for not doing a bit of research on any side effects. I know that not everyone feels hungry when on either this meds or the MR version but I wish they had told me that this could have been a possibility. It's almost as if I was set up to fail.
I'm still on Sitagliptin and it has helped marginally however, I really need something else. I think you would know within a couple of weeks whether you had this side effect and I would certainly ask for the MR version just in case. I also had massive dips in my BM with this medication too. It didn't agree with me at all...