Glburide and panic

[scottinnh]

I have been doing this WOE for 6 weeks. I have been maintaing my BG around 150 daily average..about 100 points lower than before. My fasting BG was always the highest..around 170.
Monday I woke to a fast BG of 200..and the lowest I could get during the day was 170. Panicked I took some glyburide this morning. (I had stopped taking gylburide after the first week when my numbers were improving, and was able to maintain those numbers off glyburide...until now)

2 hours later and after breakfast my BG was 212! It has never gone up after breakfast...and I ate my usual. I went for my morning workout, and right after my bg was 148...2 hours later before lunch it was 86...and after lunch 78..a record low for me.
It has stayed low all day so far.

I don't know what to think about this. I am not sick, and my diet has not changed. I average 1500 cal a day, 65% cal from fat, and average 20 net carbs a day. I have lost 15 lbs, going from 270 to 255 lbs.

My priority has to be the numbers. No good to me losing weight and getting complications anyways from high BG. If I have to chose burning out my pancreas and taking insulin, over poorer control but weight loss...well Iguess I go with the numbers.....

If I continue to get a week or so of good normal range readings I will try to wean off the glyburide, but if control slips..I guess I will need to prepare myself that my pancreas is really failing after 10 years of neglect.....and face the needle!

[Lisa N]

It's not time to panic just yet. The fact that your blood sugars responded to the Glyburide is actually a good sign. It means that your pancreas is still capable of producing enough insulin to do the job with the right stimulation.
You've only been low carbing for a short while. It takes time for insulin resistance to heal; sometimes months of eating properly.
Would your doctor consider Glucophage XR instead of Glyburide? It can help reduce that insulin resistance without forcing your pancreas to keep producing more insulin and contributing to the insulin resistance or slowing down the healing process.
Glyburide and Insulin are not your only choices here. Have a long talk with your doctor and see what the two of you can come up with together with the goal in mind of helping you lose weight, heal your insulin resistance and eventually get you off medications if it's possible to do so.

[scottinnh]

Thanks for your reply. I am already taking glucophage and advandia. Just today I asked my doctor to call in a prescription for glucophage XR. I'll see if that works better then regular glucophage.

[Lisa N]

Scott...how much Glucophage are you taking? Your dosage might need to be increased a bit until you can get things to settle down. I lucked out and never needed to go above 1000 mg. and wasn't on that level for more than a couple of months before I started having to cut it by half due to getting hypo episodes, but I've read recently that 1,500 mg. is considered the minimum therapeutic dosage. It may also be that you're trying to cut back the meds too quickly, but the sooner you can get off the Glyburide, the better.
You can also be getting sick (and your body reacting with higher blood glucose levels) before you start to feel any symptoms...just something to consider.
Something else to consider with the higher morning readings is making sure that you don't eat too close to bedtime (Bernstein recommends no eating for at least 4 hours prior to bedtime for non-insulin dependent diabetics) and how many carbs you are having with your breakfast (possible dawn phenomenon). Many diabetics just can't handle many carbs first thing in the morning or sometimes not until nearly lunchtime. Are you having 6 grams of carb or less for breakfast? For the first several weeks, I needed to keep my carbs at breakfast to less than 3 to keep my blood sugars from rising too much in the morning; now I can handle 6 or sometimes a bit more.

[kjturner]

Actually, I'm picking up more on the fact that the exercise triggered insulin uptake. Because you had taken the extra glyburide you had much more insulin available for your muscles to take in, resulting in lower BG later in the day. My suggestion? If BG readings are high--go take a hike! :D

I had to do the same thing when I first started this. I had discovered that if my readings were starting to go in the wrong direction I found a brisk 30 minute walk would drop them about 30 points and keep them lower the rest of the day.
Let your muscles help you overcome the insulin receptor problem. It'll improve in time. Some folks improve right away, others take longer (I'm one of the 'longer' ones, but improving all the time) Plus we all have 'good' days and 'bad' days. Don't let a bad day or two upset you. DON'T PANIC! It'll iron itself out in time.