Canadian Health and Care Mall: TABLETS

I take Clucobay tablets but always feel very full and bloated afterwards. Would it be better not to take them?

Acarbose (Glucobay) may lead to side effects when you first start taking it. These side effects are related to its action in the body (see the previous question). Because Glucobay slows down the breakdown of carbohydrates, complex sugars may then reach the lower part of the gut where they can cause a bloating sensation giving rise to wind (flatulence) and occasional bouts of diarrhoea. There are two ways of reducing this problem.

• Start with a very small dose of one 50 mg tablet of Glucobay a day, taken with the first mouthful of your largest meal. Increase the dose slowly, in consultation with your doctor, until the optimum dose is reached. This may be up to 100 mg three times a day.
• Try and exclude sucrose from your diet. Sucrose is the ordinary sugar that we add knowingly to sweeten food. It is also added to many foodstuffs by the manufacturers.

My doctor has recently started me on Prandin, which I understand is a new type of tablet for diabetes. How does it differ from metformin, which I also take?

Prandin is the trade name for repaglinide, which, like nateglinide (Starlix), is a prandial glucose regulator. This means that it controls the high glucose levels that can occur when food is consumed. It is a blood glucose-lowering tablet that stimulates the quick release of insulin from your pancreas at mealtimes, and should be taken just before a meal. If a meal is missed, the repaglinide should not be taken (unlike metformin). These tablets are usually used in combination with metformin. They should not however be used together with any of the sulphonylureas because they have a similar action.

I take a lot of tablets and have been told that I will probably have to change to insulin soon. What is the maximum dose of tablets I can take before insulin is required?

Many people continue to use the maximum dose of tablets for years with rather poor control of their diabetes (HbA1c over 7.5%). Although these people often feel fairly well in themselves, they are usually much better off when they change to insulin – they have more energy and can usually manage on a less strict diet. In addition, running high blood sugar levels for years carries an increased risk of heart disease and other diabetic complications, such as eye problems.

What should I do if I am ill while on tablets? Should I take more or perhaps fewer tablets?

During the illness, you may not feel like eating, but you must not stop your tablets as any illness usually causes the blood glucose to rise. If your blood glucose readings are above 15 mmol/L, you should seek medical advice.