Stopping gliclazide.

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Another update. It is coming up for six weeks since I stopped the gliclazide and the data are firming up.

First off is the raw data.

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You can see what happened after I stopped the gliclazide on 31 Dec - my readings headed upwards and now seem to be settling in a higher band. The with glic average was 5.56 with a standard deviation of 0.89 and the without glic average was 7.09 with a standard deviation of 1.35. These reflect the visual impression from the graph that not only has the basic level increased but the range has increased also.

This is also reflected in the variation of blood glucose through the day.

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The average blood glucose is consistently higher without glic and the peaks are broader.

I have done my best to keep all other factor equal. My weight is the same, I have not changed my eating habits and my exercise levels are about the same. So, for this particular individual it is quite clear to me that taking gliclazide has a marked and consistent effect on blood glucose. My interpretation is consistent with the general observation that gliclazide influences insulin production in the pancreas. Its presence encourages it to react more quickly to elevated blood glucose, reducing the post meal rise, and the time it takes for the blood glucose to fall back to the pre eating level.

I intend to keep going until my next HbA1c which I predict will be in the range 45-48.

A couple of general thoughts.

Those new to testing should take note of the variation in blood glucose through the day. What I get is absolutely normal and should be bourn in mind when looking at your results.

I suspect I would have to reduce my carb intake by quite a lot to regain the effect of the gliclazide. I don't want the hassle of doing this so if my HbA1c creeps over 48 (which it may well do) then I would quite happily start taking it again. Sometimes taking the pills might be the best way forward and there is no real point in trying to fight it.

A rhetorical question... was my diabetes in "remission" before I stopped the gliclazide and would it be back in "remission" if I went to a keto type diet and got my levels back to those achieved by taking gliclazide. I'll put on me tin hat and retire to my bunker.
 
Docb said:
A rhetorical question... was my diabetes in "remission" before I stopped the gliclazide and would it be back in "remission" if I went to a keto type diet and got my levels back to those achieved by taking gliclazide. I'll put on me tin hat and retire to my bunker.
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I think the answers are pretty clear in terms of the definition of "remission" which seems to now be agreed internationally.

For the first part: NO, because you need to be off diabetes meds.
For the second part: YES, if you're not on any other diabetes meds & you maintain a non-diabetic HbA1c for ummmm 6 months or whatever the period is.
 
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Should know better than to ask rhetorical questions. Any thoughts on the numbers?
 
Docb said:
Should know better than to ask rhetorical questions. Any thoughts on the numbers?
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Well, to me the numbers look like you stopped taking a BG-lowering med and then your BG went up 🙂

Anyway, spinning up my mental diabetatron, I'd guess your guess of low 40's for yr next HbA1c is probably about right & if it's a bit more than that, doesn't really matter.
 
Fair enough Eddy, although my short term (30day) average has now crept over 7.3 which if it stays there would put me in the upper 40's for HbA1c.

Its just that if I saw that sort of report from any other chemical plant with some sort of automated control system, I'd be thinking that maybe somebody or something has reset the lower control level on the feedback system. Makes me wonder if the effect of gliclazide could be more to do with the point at which the pancreas is turned on by the blood glucose level rather than encouraging the pancreas to produce more insulin when it has been turned on.
 
Docb said:
Its just that if I saw that sort of report from any other chemical plant with some sort of automated control system, I'd be thinking that maybe somebody or something has reset the lower control level on the feedback system. Makes me wonder if the effect of gliclazide could be more to do with the point at which the pancreas is turned on by the blood glucose level rather than encouraging the pancreas to produce more insulin when it has been turned on.
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Interesting. But just eyeballing yr chart, the timing of peaks & troughs seem to be the same for glic vs no-glic, with differences just in amplitudes? If that's correct, wouldn't it be more consistent with a difference in insulin amount rather than a threshold on-switch effect?
 
Yep, and thats the reason I was wondering about it rather proposing it as a dominant thing. Trouble is that there is no upper control limit. What happens once the insulin is injected into the system is that blood glucose is controlled by the way it is taken out and into the other body systems which could well be influenced by factors other than insulin level.

Maybe what I am trying to illustrate is that what is going on is a lot more complicated than simply saying gliclazide works by making the pancreas produce more insulin.
 
I was on a similar drug when I was diagnosed.
The one I was on extended the release of insulin once it started being released, by suppressing the hormone that turned it off.
Gliclazide seems to increase the duration of insulin release, but in both the first response, so effectively increasing basal insulin, then increasing bolus when you eat.
 
The three months are up and tomorrow I visit the vampires for a determination of my current HbA1c. My current average of finger bodge results taken over the last three months is 7.34mmol/l. Comparison with earlier data relating finger bodge averages with HbA1c measurements predicts this will result in an HbA1c of around 46. Will be interesting to see what it is!
 
Absolutely fascinating @Docb
 
Guess what.... just got HbA1c result and it was...........46!

Either I am dead lucky or a data processing genius. You can make your mind up which.
 
Docb said:
Either I am dead lucky or a data processing genius. You can make your mind up which.
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Total genius in my book! :D 😎
Congrats on your result. Did your nurse/GP have any input as regards the benefit of returning to Glic or are they happy for you to continue without? I imagine the latter since you are below the diabetes threshold and your levels seem to have stabilized at that post Glic level rather than continuing an upward trend.
 
Not spoken to anybody yet @rebrascora. Result has not yet appeared on Patient Access but I smooth talked it out of the receptionist! I'm in two minds about restarting gliclazide. If I do then it will give me a little more leeway on carb intake when it comes to keeping below 48.

I have redone the graph showing the relationship between HbA1c and finger prick test results. I have circled the new point.
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We get a lot of people asking about the relationship between finger prick results and HbA1c and this graph shows what you get for one individual in an experiment where a decent amount of effort was made to keep things under some semblance of control. Most importantly the average finger print result comes from a lot of tests in the three months before the HbA1c with tests being taken at all times of the day.
 
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