Repaglinide(prandin) for over 75s

Diabetes
1

wi have suffered from Diabetes Type 2 for 30 years and for the most part it has been very well controlled. I took Metformin in combination with Prandin.

Then 3 years ago I got Polymyalgia rheumatica and was prescribed Prednisolone. I am on 8mg and trying very hard to reduce very slowly.

My B/s rose quite a lot on steroids but I did not fully understand why. Now I know.

A young dodtor suggeted I change my Diabetic tablet to see if it would control B/S better. It did not.OTher tablets have been tried to no avail.

The best by far id Prandin,my ''old'' favourite which I should never have changed.The problem is my Doctor says it is not Licensed for over 75s. I am 79.I have scoured the internet to see if it is dangerous for that age group. Nothing came up.Simply to tell your doctor if you are over 75 and taking it.

My quality of life is very poor,spending most of my day in bed and feeling very weak and miserable.

Exactly what is the position with this treatment and 0ver 75s? It is my only hop of normal life. I don't want to upset my GP who tends to go by the book,but I really do wish I could persuade him to prescribe it again for me.

2

I'm sorry to here about that. I had to go on pedisone also and it sent my numbers into the 300's. I got off the steroids eventually.If you can deal with pain a other way I would get off the steroids. Of course consult with the merrier.

My numbers through the roof.i would get off the steroids and seek alternative treatments for pain. Of course consult with your me first.

3

Hi Panamabob,

my mother is 86 and was on several medications with elderly warnings. Unfortunately, most of these warnings seems to be related to meds causing liver and kidney problems.

While my mother wasn't on the medication you're asking about, she was on others, and one in oarticular, zyprexa, with warnings about use for elderly.

i will tell you, whatever the benefit of the medication, if there's a warning, it's because a significant number of people have died. Do you want to gamble that you're one of the people that won't have any negative effects? Not a good risk, since as you say, you are already week and unable to get around much.

i would err on the side of caution, since the ramifications of these drugs ar severe. 

My mother was on zyprexa, previously not at risk for diabetes. She ended up with blood sugar bear 800, diabetic ketoacidosis and dehydration, had seizures, coded and was expected to be on diabetes meds, most likely insulin dependent for the rest of her life.

i proactively intervened with her diet and was extremely strict, used herbs and acupuncture, and got her off the diabetes meds three months after the hospital event.

i have since then removed all of her prescription drugs, and maintained a good diet, Paleo style. Guess what? She's getting much better! At this age healing is slow, but getting her blood sugar stabilized was huge progress at any age.

if you look at many of the diabetes meds, they cause kidney problems... I suspect the kidney problems can exacerbate and accelerate diabetes.

Get it? There isn't an easy fix, quality food is your best option, though this is difficult when you're dependent on others.

The food and care while my mother was in the "best" care facilities is unacceptable. They did not get her meds or diet correct a single time in the month she was in a rehab facility.

I encourage you to find another solution. Of course, I understand you've been dealing with diabetes for decades, but I can only share my experience of the last few months in an effort in inspire you with hope and confidence to find a solution that works for you.

Good luck!

4

Catherine many thanks for sharing your experience. Food for thought here.I have a choice of competing risks.To accept the risk of high BS whilst on Pred or to persuade my GP to allow Prandin and the risks you suggest are present with it.  Help !!

5

That's ridiculous panamabob.  What's age got to do with anything? It sounds more like yet another cost sutting exercise to me.

I hope you find a way round the problem.

6

I'm a type two and currently on 14mgs of prednisone plus a raft of other drugs for RA.   Tablets never worked for me so I went on insulin.   My insulin requirement on prednisone doubled but I still get Hba1cs in the low sixes.   Prednisone also helps keep the BGLs steady, haven't had a hypo since being on prednisone.   The best thing about insulin is you can vary the dose acording to your carb intake.   Going onto insulin does not mean the disease is worsening either, diabetes is diabetes regardless of control methods.   Insulin is and always has been recognised as the best way to control BGLs.   Ask your Doc about bydureon, a once a week injectable.   Your Doctor is there to help you, not the other way around.   If your Doctor has a problem with that then you should change Doctors.

7

Tony,

Tablets did work well for me for 30 years.Now they don't.Insulin is an atractive alternative if one injection per week is all that's required.Did I get that right? One weekly imjection and you're set for the week.Sounds wonderful.Are there any side effects etc?

8

None that I know of.   I inject with Novo Rapid three times per day and once with Protophane at night, that in concert with count counting works well for me.   I don't know why everyone worries so much about injecting insulin, it is recognised as the best method for BGL control and has the least amout of side effects.

9

Bob, is your diet as good as it can be? Do you have anyone who can help you with home prepared, really fresh organic foods from the farmer's market?

This is was a huge piece of the work I did for my mother. I made soups with greens and meat and root vegetables when she first came home. If she gets in a bad way, I go back to this. Put everything in the crockpot and you have soup for 4 days.

My mother is not a big meat eater. However, I notice the meat is a huge factor in stabilizing her BS.

THe other thing you can try is Berberine. This herb is extremely effective at lowering BS. However, be warned, it can be a little rough on the body because it will also kick out any bacteria or yeast.Great all the way around, but if you're weak, it can be rough. So start out with one pill, and increase as you can tolerate and as BS indicates.

I used the Berberine to wean my mother off the oral meds.

 

10

Catherine,

I am very careful with my diet and already eat many items you suggest,

However, Berberine is new to me and I would like to try it,

I live in UK,so I don't know how easy it is to get here.

11

Clive.

Nobody yet can answer my question and that is why is Prandin not available to over 75s. Or is it left to GPs discretion. My own research indicates that no study was done including over 75s so that is the only reason I can discover. It is the only tabley which controls my BS whilst on Prednisolone which makes it very frustrating.

12

I could understand a lower age limit, say not to be prescribed to children under 12, or even a restriction on how long a patient can be prescribed the drug but to set an arbitariy upper age limit of 75 seems absolutely  ludicrous.

I too have Type 2 am treated with Meformin, diet and exercise and 75 years of age so I just hope I don't get to need Prandin,,,,

13

Clive,

Apparently it is only Licensed to age 74. I don't know why. I believe the group used to get the License did not include any over 75s.Seems crazy to me too.

14

Hi Bob, great that you're on top of the diet! I ordered the Berberine from Amazon, along with citrus bergamot. You should be able to find it online easily.  I gave my mom both. I did some research, but not a ton. I was more concerned about trying it, seeing if she could tolerate it, seeing if it actually worked for her. You don't know until you try.

15

Clive, I nearly lost my 86,year old mother due to contraindicated meds.  She was prescribed a medication not recommended for elderly and it caused diabetic ketoacidosis. She was not diabetic, not even considered at risk. Unfortunately her doc ignored the warnings. 

Not or only was her blood sugar nearly 800, she was dehydrated... During her hospital stay she had two seizures and coded.

it was not worth the risk. Just saying. Drug companies have nothing to gain by recommending not to use.

16

Wow - that must have been scary.  Glad your Mum got through OK.

17

Clive, it was scary. She isn't really ok. At 86, it extremely difficult and slow to recover. She now needs 24 hour care. She can't speak enough to advocate  for herself, so a care facility is out. She's with me so she can have the best possible chance for recovery.

18

Saddened to read your Mum still needs 24 hour care but it's good that you are able to provide it for her and I  wish you both well.

19

Thank you.