Turned down gliclazide - correct decision?

[MrsMonty]

Hi all,

I am recently diagnosed T2D, with starting HbA1c of 119 and lots of weight to lose. Initially started on 500mg Metformin to be titrated up to 4x500mg over 4 weeks. Don't start full dose until tomorrow. A follow up blood test last week (3 weeks after initial one) showed HbA1c down to 101, plus I have lost over a stone in weight.
A telephone appt with DSN yesterday and she wanted to start me on gliclazide, which I declined for the moment. She was completely OK with this, but I just would like some feedback on whether I have done the right thing in hindsight.
I feel that my HbA1c is already coming down on a combination of diet & part-dose Metformin. I am being really careful with what & how much I eat & I'm tracking everything with an app. I'm focusing on lower carbs, plus keeping my calories low as well as staying within the app guidelines on everything else. I also feel that as HbA1c is a measure of the last 3 months, every day of this new regime knocks a day of poorer eating off the back end, so my HbA1c should continue to come down. We agreed a review at 3 months and then see where we go from there.
Should I have gone with the gliclazide option (& risk of weight gain, hypos etc) or is my decision sensible?

 

[Leadinglights]

Hi all,

I am recently diagnosed T2D, with starting HbA1c of 119 and lots of weight to lose. Initially started on 500mg Metformin to be titrated up to 4x500mg over 4 weeks. Don't start full dose until tomorrow. A follow up blood test last week (3 weeks after initial one) showed HbA1c down to 101, plus I have lost over a stone in weight.
A telephone appt with DSN yesterday and she wanted to start me on gliclazide, which I declined for the moment. She was completely OK with this, but I just would like some feedback on whether I have done the right thing in hindsight.
I feel that my HbA1c is already coming down on a combination of diet & part-dose Metformin. I am being really careful with what & how much I eat & I'm tracking everything with an app. I'm focusing on lower carbs, plus keeping my calories low as well as staying within the app guidelines on everything else. I also feel that as HbA1c is a measure of the last 3 months, every day of this new regime knocks a day of poorer eating off the back end, so my HbA1c should continue to come down. We agreed a review at 3 months and then see where we go from there.
Should I have gone with the gliclazide option (& risk of weight gain, hypos etc) or is my decision sensible?

My personal opinion is you have made a wise decision and a review in 3 months to see if your strategy is being successful. If you take the gliclazide then you need to eat enough carbs otherwise you risk low blood glucose and as you are following low carb it seems pointless to have to eat more carbs to counteract the medication.
Obviously you can reconsider when you see what the HbA1C is after a full 3 months on your regime.

 

[harbottle]

I'd see what happens after 3 months.

Then re-evaluate. If it's still high, gliclazide might be worth adding to try to get it down to safer levels.

 

[Martin.A]

I started off on Metformin and after 3 months my HbA1c had dropped from 114 to 56 doing exactly what you're doing, so I also think you're probably right to say no at this early stage.

 

[harbottle]

In hindsight I wish I'd not started Metformin, and just tried diet initially.

 

[Newbie777]

Having been a long term Diabetic where every year a small increase in my medicine was prescribed due to high BG. I would advise any new Diabetic to see if Metfirmin only will help them and if it does then good, weight loss is key, so is a bit if exercise and not forgetting carb control.

Also there rae mnay many articles of Diabetes regression in early stages so it can be reversed for many people.

Finally, think you are doing a fantastic job, keep up the good work.

 

[Lucyr]

I feel that my HbA1c is already coming down on a combination of diet & part-dose Metformin. I am being really careful with what & how much I eat & I'm tracking everything with an app. I'm focusing on lower carbs, plus keeping my calories low as well as staying within the app guidelines on everything else.

Is this sustainable for you and are you fingerpricking to check that your levels are in the right place?

I’d start fingerpricking if not already, and add the gliclazide if either your levels need a bit of help, or if your initial full steam ahead changes have been more drastic than you can stick to long term and a bit of gliclazide would mean you can eat a few more carbs and stick to it longer term.

If fingerprick levels are good and what you’re doing is sustainable then I’d give it till the next check to see where things are.

I know your hba1c has come down and it hasn’t been 3 months yet, but hba1c is weighted towards the latest data so I’d agree with the nurses suspicion that your current levels are perhaps still too high.

 

[Lucyr]

Should I have gone with the gliclazide option (& risk of weight gain, hypos etc) or is my decision sensible?

To address these points. Gliclazide doesn’t cause weight gain. It causes your body to use the carbs you eat so if you eat too much you could gain weight.

You’d have been given a meter and test strips alongside the gliclazide and if it caused hypos you’d just have reduced or stopped the gliclazide. Hypos arent expected to be a permanent long term thing on gliclazide.

 

[Newbie777]

Hi Lucy,

Now you tell me!

when I was on Metfirmin only I used to lose weight, but started on Glicizide and put it on. Glad I know the truth now . Lol.

 

[victorhamesse]

You did the right thing. I only took G for 4 months but that was enough have an effect. Now I'm back on it for a few months (6 years later), I'll probably stop again. Unless it's an urgent need to reduce sugars (mine was) I would go Metformin first and see.

 

[JITR]

In hindsight I wish I'd not started Metformin, and just tried diet initially.

After the shock of diagnosis, I tried a low very calorie diet for 7 days without taking Metformin or other medication. It brought my glucose level down to normal so I carried on.

 

[mark1985]

I was on glizacide for first few weeks and now on metformin 2x 500mg a day 2 weeks till on full does. im now tracking my meals and exercise on a app and hope that the weight starts to come off soon.

 

[Anna DUK]

Also there rae mnay many articles of Diabetes regression in early stages so it can be reversed for many people.

@Newbie777, we tend to use the term, 'remission', rather than reversal because this means the symptoms of diabetes have gone away, rather than the condition has been 'cured'. Remission means people still have their annual diabetes checks. People can also go into remission, but they can also come out of remission. See here for more information:

What is type 2 diabetes remission?

Jump to: What is remission?

www.diabetes.org.uk

 

[Burylancs]

@Newbie777, we tend to use the term, 'remission', rather than reversal because this means the symptoms of diabetes have gone away, rather than the condition has been 'cured'. Remission means people still have their annual diabetes checks. People can also go into remission, but they can also come out of remission. See here for more information:

What is type 2 diabetes remission?

Jump to: What is remission?

www.diabetes.org.uk

There's actually no mention of symptoms going away in the standard definitions of this so-called 'remission'. Are you making this up as you go along ? .

 

[Anna DUK]

There's actually no mention of symptoms going away in the standard definitions of this so-called 'remission'. Are you making this up as you go along ? .

No, being in remission from type 2 diabetes means people don't have the symptoms of diabetes, like high bloods sugars for example.

 

[Burylancs]

No, being in remission from type 2 diabetes means people don't have the symptoms of diabetes, like high bloods sugars for example.

You're kidding right ? Are you claiming that a t2 'in remission' who ate a Mars Bar wouldn't see their bg rise ? Are you claiming that a person with a hba1c under 48 and not taking medication cannot have background retinopathy or peripheral neuropathy in the toes or diabetic dyslipidemia ? Can you provide citations of scientific research supporting your claims ?

 

[Anna DUK]

Of course a mars bar would raise sugar levels, just in the same way it would for people with no history of diabetes, but being in remission means the organs are working more effectively to manage the rise in blood sugars. And besides, when it comes to remission we are talking about the long term blood sugar levels, from a HbA1c. It's okay if you don't agree with this @Burylancs but there's no need to come across argumentative. This is a space for all to learn and share knowledge and experiences. If you don't agree with remission that's okay, please just be respectful to those who do agree with the concept or those living in remission of type 2 diabetes and their lived experiences.

 

[Newbie777]

@Newbie777, we tend to use the term, 'remission', rather than reversal because this means the symptoms of diabetes have gone away, rather than the condition has been 'cured'. Remission means people still have their annual diabetes checks. People can also go into remission, but they can also come out of remission. See here for more information:

What is type 2 diabetes remission?

Jump to: What is remission?

www.diabetes.org.uk

@Anna DUK Thank you, yes sorry not regression I meant remission, heard about 2 years ago when they trialled people on 700 calories via drinks and shakes and about 80% went into remission.

 

[Newbie777]

There's actually no mention of symptoms going away in the standard definitions of this so-called 'remission'. Are you making this up as you go along ? .

Please don't be cruel, everyone on here is trying to help and @Anna DUK especially so. I sometimes get it wrong but the intention is to help.

There is no cure for Diabetes, even the op on the pancreas is not successful. It is also to do with your DNA and Genes, so even if you are super slim and your parents had it, chances are you could also get it.
Eating a Mars bar raises everyone sugar, but being in Remission does you not mean are in the clear as your body will react similar to anyone else with Diabetes as opposed to some one who does not have Diabetes and there BG will absorb the sugar properly.