Diabetes patient summary

KIRSTIE GALBRAITH: Now, you’ve heard about the science of gliclazide. Let’s check back with our patient Shirley. Shirley’s been trying to keep her blood glucose under control for some time by focusing on eating better and exercising more. She’s already been treated for her diabetes with one medicine called metformin, but unfortunately, her blood glucose has remained high. She finally decided, with her doctor, that it was time to start additional treatment. Shirley’s doctor started her on gliclazide, 30 milligrammes daily. David told you the story behind the development of gliclazide, an interesting tale which started many years ago. Dan has explained how gliclazide works to increase insulin in the bloodstream and, therefore, lowers blood glucose.

And you now know from Ian that the effect of gliclazide can last for 24 hours due to the combination of its reasonably long half-life and a modified release formulation, so it only has to be taken once a day. The pharmacist will need to explain to Shirley that gliclazide can have some side effects. The most concerning side effect is blood sugar becoming too low. This is called hypoglycemia. If Shirley’s blood sugar gets too low, she could become very unwell quite quickly. She could experience loss of coordination, slurred speech, confusion, and eventually, even loss of consciousness. The first signs of low blood glucose are weakness, trembling, shaking, sweating, and lightheadedness.

Shirley really needs to know to immediately eat some sugar to raise her blood glucose level. This could be in the form of some jelly beans, sugar or honey, or some soft drink. There also glucose tablets and gel available. Even after consuming sugar, the blood glucose can fall again, so Shirley also needs to eat a meal or at least have some biscuits, fruit, or milk, to ensure her blood glucose stays high enough. Shirley’s doctor will want to keep a close eye on her as she starts the gliclazide tablets and will do a number of blood tests to determine how well controlled her blood glucose is.

The doctor will also check that Shirley’s diabetes is not causing other problems, such as kidney disease. Shirley needs to make sure she tells all of her health care professionals that she has diabetes and is taking gliclazide so they can monitor her appropriately.