frustrated

[sofaraway]

I'm really frustrated at the moment. My pancreas really isn't behaving itself.

ok brief history, diagnosed in 2000 MODY3. started on gliclazide in 2003. was maintained on 40mg until earier this year when i went up to 120mg which didn't have any effect. ended up being admitted in april for a week as was running higher than 28mmol/l (thats as high as my meter reads), and had an HbA1c of 9.5%. they had no idea why I'd suddenly lost any sensitivity to the drug.

So changed over to glibenclamide 5mg/ day. I was taking either 2.5mg at breakfast and then 2.5mg at lunch or 5mg at breakfast (depending on my schedule). Almost all blood sugars were in range, with the occasional hypo and was looking forward to get my new HbA1c done to see the improvement.

all was good until past few days and now I've been running 12-14 mmol/l fasting and then my bedtime reading have been 17-20mmol/l. I don't know why this is. nothing has changed, I don't feel unwell and don't think it's down to infection.

Do you think that i could have now lost sensitivty to this drug? it's like the change gave my pancreas a kick and now that effect has worn off.

Thinking I might just increase to 7.5mg tomorrow and see if that has any effect. i know I can go up to 15mg/day of this. just finding it really frustrating. any other suggestions of what i can do?

[Lorna]

Not sure how it works for type 2- so I may be talking nonsence, but it may be that it is the fasting that is making you rise, as you body stops producing insulin when you do not eat causing your sugar level to rise. Do you have ketones? Remember that's a bit of a guess though, sorry I can't be more helpful.

[Harold]

Both of those druge are in the sulfonylureas class. Which works by making the pancrease work harder to produce more insulin. You may need to add another drug that inhibites the release of glucose by the liver. Some believe the sulfonylureas will cause the beta cells to wear out from the overwork.

[sofaraway]

Went to the GP today, as blood sugar was over 28mmol (my meter only reads to that) and she spoke to the diabetes docs. Have now x3 my dose of glibenclamide to 15mg tomorrow morning. Have some urine ketone sticks and have to report to the hospital if develop ketones.

I asked what if this didn't work, and she said we'd just hope it did. I'm less against insulin than I was, and am resigned to the fact it's probably not too far int he future.