Glyburide

[scottinnh]

Sorry to post so much...but I need to get a grip....

Here's the thing...before starting low carb 3 weeks ago my Bg was upwards of 250-280. After low carbing I would wake at 200, after breakfast be 170, after lunch 150 and before dinner 120-130, going to bed at around 140-150.

I thought great! I see the effects of low carb and started thinking about my meds. I discovered the timing of my meds had alot to do with the numbers...if I took Avandia(4G) ,Glucophage(1000g) and Gyburide before dinner my after dinner number was much lower.

I then read about glyburide and how it stimulates the pancrease to make more insulin, and that most type2's already produce more than enough insulin, and I became concerned about burning out the beta cells, so I stopped taking it. Also I understand dropping a few or more lbs helps with the insulin sensitivity and too much insulin keeps you fat...

Now my BG stays in the 180-220 range, even taking in low carbs...you can see what I eat by visiting my very public diary at
http://www.fitday.com./WebFit/PublicJournals.html?Owner=SCOTTINNH

So now I am beginning to think I don't make enough insulin...and I am thinking of going back to the glyburide, but this also probable means a needle in my future... :daze:

??????????????

[nopie]

I was going to suggest that you eat fewer carbs or fewer calories, but I checked your fitday journal and can see that you are eating very little. One thing I did notice was that you are eating Atkins muffins and/or Keto cereal for breakfast. Those things list zero or very few carbs but that is sometimes misleading. Try just eating bacon and eggs for breakfast - no muffins, cereal, etc. - for a week or so and see if that helps. Also, are you drinking coffee with caffeine? Caffeine does cause problems for some people - stimulates insulin. If you are drinking caffeine now, you should taper off gradually or you will wind up with the headache from hell.
Are you exercising? Weight lifting is best for long term but I found that a walk about an hour after a meal lowers BG dramatically. Just 15 minutes or so helps and does not cause BG to go up as a long hard walk can do for some people. Are you in New Hampshire? If so, I guess the weather is not conducive to an afterdinner (and breakfast and lunch) stroll. You may have to substitute weight lifting at home. Doesn't have to be too heavy. Just doing something for 15 minutes or so is the object here.
I don't know anything about avandia or glyburide but I do know that it takes several weeks for Glucophage, metformin to start working. How long have you been taking that? Is it maybe time to increase your dosage?

[scottinnh]

Thanks for your input. I decided to go back to taking all my regular meds until everthing stabilizes, then maybe try dropping the glyburide...

I was questioning the Keto/Atkins stuff...but I was taking that before I changed meds with good results...but I will try doing without it...(what will I sop my eggs up with now?...)

But my Coffee! :eek: I drink a thermos full every day...my coworkers joke about how much I drink...I have heard conflicting reports on the net about the effects of coffee...maybe I will start a new thread....

[scottinnh]

I took glyburide before dinner at a BG of 180+. Ate a good dinner and 2 hours later was at...117!

Guess that answers my question about resuming glyburide.. :(

I can only conclude my pancreas does not produce enough insulin by itself..it needs a kick in the pancreas with the glyburide to get it to produce..which probably means beta cells quitting and a needle in my future! :thdown:

[Norma June]

Great readings ... ! I was wondering if perhaps you should go on Metformin instead, which acts on the insulin receptors rather than Glyberide which works on the pancreas.

I've heard that Glyberide is one med that causes weight gain. I'm supposed to be on Glyberide 2 X 5 mg. twice a day, at breakfast & dinner. But ... since I began LC I had to stop taking the Glyberide as it brought my BG down to (3.8 Canadian readings) which is around 72.2 American.

Just goes to show you what carbs can do to the BG huh?

I'm glad you've got it under control, that's a major accomplishment ... secondary to weight loss (which will happen).

Good work!

[freydis]

Glyburide will only make the problem worse. Ask your doctor to increase your dosage of Glucophage and get off the other med. I'm totally serious. I had to do this, too. If you don't want to continue getting worse and worse, if low-carbing is your way of eating for life, and if you want to someday (after significant weight loss) NOT be diabetic anymore, you've got to worry about the islets you have left to you. Glyburide burns them out FASTER.

[kjturner]

The recommended maximum dose of metformin/glucophage is 2500 mg. The maximum *safe* dose is 4000mg. Ask your doc to take you off glyburide and put you on Glucophage XR, maybe increase it to 1500-2000mg. Try that for at least 3 weeks and see how you do. That's what I did. You are probably making plenty of insulin, but you have *severe* insulin resistance, which the Avandia and Glucophage will address. Avandia can also cause weight gain and sometimes the liver doesn't like it. I'd strongly recommend you to stay on the Induction Level for a while and see how it goes. Don't worry if your cholesteral goes up a bit for a while, it'll come down in time. Mine did. I've been doing this for 19 months now and I pretty much have to keep my carbs at 30 or less per day. Oh, I have some really good days where I can bend the rules a little, but I don't do it often. My goal is to become totally medication free. I've been able to drop the Glucotrol altogether and while I had to increase my Glucophage XR to 2000 mg for nearly a year, I'm now down to 1000mg. It takes time to heal the damage--be patient.

[scottinnh]

I am already taking 1000G glucophage twice a day..so thats 2000 daily...I have been taking both glucophage and glyburide for years....I can't imagine what damage I have done.

I will research the glucophage xr and approach my doctor...he will be thrilled I am starting to finally manage my own diabetes, but I have a suspicion he may not be in total agreement with how...I have a regular scheduled appt in March that includes the 3 month blood test and I was waiting to get good results with that test to "beef" :daze: up my claim that this low carb IS working.

The clinic I go to has a patient online where I can email my doctor and I have done so in the past for various things with great success, so if I think the XR looks good Iwill ask him for that earlier.

Right now my concern is to get my BG consistently between 100-150 ( and screw the dawn phenomenom). Once I feel I have it under some control I may screw around with the glyburide..but right now I am focusing on diet..and strength exercise. My company has a free gym with start of the art strength equipment just installed...I went today and it felt great! BG 124 after...good for me!

[freydis]

I took glipizide (damaging to the islets) for about 4 years before getting off of it. Getting off sooner would have helped me, but I only found low-carbing last year. Glucophage takes a little while to work, but it is worth it. The longer you wait to get off the other med, the more you chance never being able to reverse your diabetes.

[kjturner]

scottinnh,
Did you mean to say you take 4MG of Avandia--instead of 4G? You also didn't say how much Glyburide you are taking. Perhaps you could get your doc to switch you to 2500 mg Glucophage XR and if you are tolerating the Avandia ok then up it to 8 mg/day. You'd take the XR just once a day and you *can* take the Avandia once a day or twice a day. I agree about trying to come off the sulfonylurea if you're going to even *think* you may be able to control it with diet and a minimum of medication. I never could understand doctor's prescribing sulfonylureas for Type two diabetics. I mean, our problem is insulin resistance caused by too much insulin so then they prescribe a medication that will INCREASE the amount of inuslin we have!!!