Diabetes Talking

Question:

hello all, I wondered if people who have been using glics for a while could give me some insights… I was prescribed Diamicron a few weeks ago, 30g to be raised to 60g if necessary. So far it’s had no effect on my sugars, and that was my first question : how long it takes. One effect is does have though is as a stimulant. My heart beats faster and harder and I’ve had problems sleeping . This is a little less bad now and I wonder if this side effect (not mentioned in accompanying notice) will wear off. Are there people out there who have been taking this type of medication for some time? Is it a viable longish-term treatment? I read so much bad press on the dangers of over-stimulating the pancreas that I wonder. With thanks for your help, Roger

Response:

Hi Roger, The drug should take affect pretty quickly, certainly within a day or so for me. It encourages the pancreas to produce more insulin so there are worries over ‘burn out’, I meant to discuss using Metformin with my GP last time but other things cropped up, I will possible change over next time I see him though. The fast heart beat  can be a symptom of low blood glucose, take a reading when it next happens. I used to get it overnight and feel hyperactive last thing at night when I was taking 40mg of Gliclazide in the morning and 40mg in the evening. As for me at least the evening dose of the drug was peaking just before I went to bed. about 5-11 hours after taking it. I took the whole 80mg in the morning and it helped. Since then I have managed to reduce to 40mg although that may be temporary. I think the 30mg diamicron you take is a modified released version equivalent to the 80mg I used to take by the way.      Pete F 40mg Gliclazide, Dx’d Mar 2001.

– Hide quoted text — Show quoted text – hello all, I wondered if people who have been using glics for a while could give me some insights… I was prescribed Diamicron a few weeks ago, 30g to be raised to 60g if necessary. So far it’s had no effect on my sugars, and that was my first question : how long it takes. One effect is does have though is as a stimulant. My heart beats faster and harder and I’ve had problems sleeping . This is a little less bad now and I wonder if this side effect (not mentioned in accompanying notice) will wear off. Are there people out there who have been taking this type of medication for some time? Is it a viable longish-term treatment? I read so much bad press on the dangers of over-stimulating the pancreas that I wonder. With thanks for your help, Roger

Response:

- Hide quoted text — Show quoted text – says… Thanks Pete, in fact I have been taking the tabs for about three weeks now with no ascertainable effect at all. Do you reckon that means they’re definitely not going to work? And the rapid heartbeat doesn’t seem to coincide with lows… it’s there much of the time despite my levels not having shifted. Doesn’t sound to me like there’s much future in this strategy. The doc says stick with it for the moment. I think you have to go back and be a little firmer with the doctor, as it’s not him having the problems. Sulphonylurea failure often indicates two potential major problems, namely pancreatic burnout (for whatever reason) and also is a red flag for LADA Type 1 progression. If your pancreas isn’t being stimulated by the drug then there has to be a reason why that process isn’t happening. The main reason sulphs fail is when the beta cells that they are supposed to stimulate are no longer functional. If you only have a limited number of functional betas left then stimulating them won’t have much of an effect as they could be compensating for the lost ones anyway. The closest anaglogy I could think of is a car engine with a couple of broken spark plugs, and only two cylinders running. As they are working to take up the slack of the two missing cylinders, then the potential acceleration isn’t going to be there because they are having to bear the extra load. Go back to the doctor and ask him to take this on board. It’s important, and if the sulphs are not working for you then the reason needs to be established why they aren’t. Ratty

I tend to agree with Ratty, on general principles. There’s no point in taking a drug that isn’t working, and you need to find out why it isn’t working. There’s also this: if the rapid heartbeat and sleep disturbance are a reaction to the Glic, whether it’s listed on the insert or not, you should report it to the quack. If it’s not a reaction to the Glic, it should be investigated to find out what is causing it. Maggie

Response:

my own analysis of the situation was much as Ratty’s. I’m fairly sure I’m a LADA case. But it’s been 3 1/2 years with no medication and only a slow and not too drastic deterioration… this combined with low carbing and lack of pancreatic  antibodies has led several doctors to specifically say and insist I don’t need insulin. The specialists I’ve seen include people with very good reputations. I reckon there have been at least four of them. Maybe to prove to them and to myself that my pancreatic resources aren’t what they should be and need external help I should up the carbs and take the results to the clinic. This discussion is useful for me in clarifying what I already suspect. ta everyone Roger – Hide quoted text — Show quoted text – Organization: Customer of PlusNet plc (http://www.plus.net) Newsgroups: alt.support.diabetes.uk says… Thanks Pete, in fact I have been taking the tabs for about three weeks now with no ascertainable effect at all. Do you reckon that means they’re definitely not going to work? And the rapid heartbeat doesn’t seem to coincide with lows… it’s there much of the time despite my levels not having shifted. Doesn’t sound to me like there’s much future in this strategy. The doc says stick with it for the moment. I think you have to go back and be a little firmer with the doctor, as it’s not him having the problems. Sulphonylurea failure often indicates two potential major problems, namely pancreatic burnout (for whatever reason) and also is a red flag for LADA Type 1 progression. If your pancreas isn’t being stimulated by the drug then there has to be a reason why that process isn’t happening. The main reason sulphs fail is when the beta cells that they are supposed to stimulate are no longer functional. If you only have a limited number of functional betas left then stimulating them won’t have much of an effect as they could be compensating for the lost ones anyway. The closest anaglogy I could think of is a car engine with a couple of broken spark plugs, and only two cylinders running. As they are working to take up the slack of the two missing cylinders, then the potential acceleration isn’t going to be there because they are having to bear the extra load. Go back to the doctor and ask him to take this on board. It’s important, and if the sulphs are not working for you then the reason needs to be established why they aren’t. Ratty — me here at www.flyingrat.net Agree with Ratty you don’t want to wait on this. Before you give up on the Gliclazide though I am curious what changes you have made to diet over the last three weeks. If you have increased carbohydrates – foods like potato, bread, sugar convert very quickly to blood glucose and could cause the problems you noted. To a lesser extent extra fruit, rice and pasta too would do it. If your diet is more or less the same though you should see the doctor as the tablets simply are not working. Probable you should see the doc anyway for the rapid heartbeat. Pete F

Response:

Roger, Getting the high readings may (unfortunately) be the only way of convincing them! A one-off shouldn’t be to bad. If it does turn out to be LADA or even if not, so that the group doesn’t only see positives – could you re-post here as it would give everyone a bit more information. I’m not an expert but if it is LADA then an over 3 years delay of insulin injection is interesting – it may be of course be a natural variance in how quickly LADA develops &/or a success for low carbing or something else entirely!    Whatever, Good Luck     Pete F

– Hide quoted text — Show quoted text – my own analysis of the situation was much as Ratty’s. I’m fairly sure I’m a LADA case. But it’s been 3 1/2 years with no medication and only a slow and not too drastic deterioration… this combined with low carbing and lack of pancreatic  antibodies has led several doctors to specifically say and insist I don’t need insulin. The specialists I’ve seen include people with very good reputations. I reckon there have been at least four of them. Maybe to prove to them and to myself that my pancreatic resources aren’t what they should be and need external help I should up the carbs and take the results to the clinic. This discussion is useful for me in clarifying what I already suspect. ta everyone Roger Organization: Customer of PlusNet plc (http://www.plus.net) Newsgroups: alt.support.diabetes.uk says… Thanks Pete, in fact I have been taking the tabs for about three weeks now with no ascertainable effect at all. Do you reckon that means they’re definitely not going to work? And the rapid heartbeat doesn’t seem to coincide with lows… it’s there much of the time despite my levels not having shifted. Doesn’t sound to me like there’s much future in this strategy. The doc says stick with it for the moment. I think you have to go back and be a little firmer with the doctor, as it’s not him having the problems. Sulphonylurea failure often indicates two potential major problems, namely pancreatic burnout (for whatever reason) and also is a red flag for LADA Type 1 progression. If your pancreas isn’t being stimulated by the drug then there has to be a reason why that process isn’t happening. The main reason sulphs fail is when the beta cells that they are supposed to stimulate are no longer functional. If you only have a limited number of functional betas left then stimulating them won’t have much of an effect as they could be compensating for the lost ones anyway. The closest anaglogy I could think of is a car engine with a couple of broken spark plugs, and only two cylinders running. As they are working to take up the slack of the two missing cylinders, then the potential acceleration isn’t going to be there because they are having to bear the extra load. Go back to the doctor and ask him to take this on board. It’s important, and if the sulphs are not working for you then the reason needs to be established why they aren’t. Ratty — me here at www.flyingrat.net Agree with Ratty you don’t want to wait on this. Before you give up on the Gliclazide though I am curious what changes you have made to diet over the last three weeks. If you have increased carbohydrates – foods like potato, bread, sugar convert very quickly to blood glucose and could cause the problems you noted. To a lesser extent extra fruit, rice and pasta too would do it. If your diet is more or less the same though you should see the doctor as the tablets simply are not working. Probable you should see the doc anyway for the rapid heartbeat. Pete F

Response:

Organization: Customer of PlusNet plc (http://www.plus.net) Newsgroups: alt.support.diabetes.uk If it does turn out to be LADA or even if not, so that the group doesn’t only see positives – could you re-post here as it would give everyone a bit more information.

Will do. I’ll be in contact with the doc soon. I reckon she’ll suggest that I first of all increase the dosage of the glic. I’m only on 30mg at the moment. My intuition tells me it’ll make no difference, but who knows? Thanks to all, Roger – Hide quoted text — Show quoted text –

Response:

Latent Autoimmune Diabetes in Adults = LADA — Join us in the Diabetic-Talk Chatroom on UnderNet /server irc.undernet.org — /join #Diabetic-Talk More info: http://www.diabetic-talk.org/ – Hide quoted text — Show quoted text – If it does turn out to be LADA or even if not, so that the group doesn’t only see positives – could you re-post here as it would give everyone a bit more information. What does LADA mean ?

Response:

If it does turn out to be LADA or even if not, so that the group doesn’t only see positives – could you re-post here as it would give everyone a bit more information.

What does LADA mean ?

Response:

– Hide quoted text — Show quoted text – says… Thanks Pete, in fact I have been taking the tabs for about three weeks now with no ascertainable effect at all. Do you reckon that means they’re definitely not going to work? And the rapid heartbeat doesn’t seem to coincide with lows… it’s there much of the time despite my levels not having shifted. Doesn’t sound to me like there’s much future in this strategy. The doc says stick with it for the moment. I think you have to go back and be a little firmer with the doctor, as it’s not him having the problems. Sulphonylurea failure often indicates two potential major problems, namely pancreatic burnout (for whatever reason) and also is a red flag for LADA Type 1 progression. If your pancreas isn’t being stimulated by the drug then there has to be a reason why that process isn’t happening. The main reason sulphs fail is when the beta cells that they are supposed to stimulate are no longer functional. If you only have a limited number of functional betas left then stimulating them won’t have much of an effect as they could be compensating for the lost ones anyway. The closest anaglogy I could think of is a car engine with a couple of broken spark plugs, and only two cylinders running. As they are working to take up the slack of the two missing cylinders, then the potential acceleration isn’t going to be there because they are having to bear the extra load. Go back to the doctor and ask him to take this on board. It’s important, and if the sulphs are not working for you then the reason needs to be established why they aren’t. Ratty — me here at www.flyingrat.net

Agree with Ratty you don’t want to wait on this. Before you give up on the Gliclazide though I am curious what changes you have made to diet over the last three weeks. If you have increased carbohydrates – foods like potato, bread, sugar convert very quickly to blood glucose and could cause the problems you noted. To a lesser extent extra fruit, rice and pasta too would do it. If your diet is more or less the same though you should see the doctor as the tablets simply are not working. Probable you should see the doc anyway for the rapid heartbeat.      Pete F

Response:

Thanks Pete, in fact I have been taking the tabs for about three weeks now with no ascertainable effect at all. Do you reckon that means they’re definitely not going to work? And the rapid heartbeat doesn’t seem to coincide with lows… it’s there much of the time despite my levels not having shifted. Doesn’t sound to me like there’s much future in this strategy. The doc says stick with it for the moment. cheers, Roger – Hide quoted text — Show quoted text – Organization: Customer of PlusNet plc (http://www.plus.net) Newsgroups: alt.support.diabetes.uk Hi Roger, The drug should take affect pretty quickly, certainly within a day or so for me. It encourages the pancreas to produce more insulin so there are worries over ‘burn out’, I meant to discuss using Metformin with my GP last time but other things cropped up, I will possible change over next time I see him though. The fast heart beat  can be a symptom of low blood glucose, take a reading when it next happens. I used to get it overnight and feel hyperactive last thing at night when I was taking 40mg of Gliclazide in the morning and 40mg in the evening. As for me at least the evening dose of the drug was peaking just before I went to bed. about 5-11 hours after taking it. I took the whole 80mg in the morning and it helped. Since then I have managed to reduce to 40mg although that may be temporary. I think the 30mg diamicron you take is a modified released version equivalent to the 80mg I used to take by the way. Pete F 40mg Gliclazide, Dx’d Mar 2001. hello all, I wondered if people who have been using glics for a while could give me some insights… I was prescribed Diamicron a few weeks ago, 30g to be raised to 60g if necessary. So far it’s had no effect on my sugars, and that was my first question : how long it takes. One effect is does have though is as a stimulant. My heart beats faster and harder and I’ve had problems sleeping . This is a little less bad now and I wonder if this side effect (not mentioned in accompanying notice) will wear off. Are there people out there who have been taking this type of medication for some time? Is it a viable longish-term treatment? I read so much bad press on the dangers of over-stimulating the pancreas that I wonder. With thanks for your help, Roger

Response: