Glyburide?

I’m pretty sure this has been discussed before, but not with my body.


I've been on Metformin (850mg BID) for the past 1.75 years (since shortly after DX). This summer, the weight started coming back on, BG levels (which had been in the high 80's to low 90's fasting) won't go below 117 or so, often 10-15 higher than that.

My PA put me on Actos, but that seems to be making things worse. Not only did I start gaining a lot of weight again, but I found myself dozing off after just a few hours of being awake, sleeping a LOT (like most) of the day. No depression, just always tired.

Almost any carbos make me tired shortly after eating (which used to be the case but had passed.)

So now we're talking about adding Glyburide. I've already DC'd the Actos (some improvement in the narcoleptic tendencies, but everything else is still "off".)

Thoughts?

THANKS!

JT

I personally prefer insulin to glyburide I think it gives better control of BG . Glyburide and insulin are make fatter drugs so that is a definite downside.

I think it is possible to do 850 mg of met 3 times a day. It may help.

Try cutting down on carbs some more if possible.

To not rush things it is best to keep your BG in the normal range now. High blood sugars will kill your pancreas.

The only problem with gliburide is that it is a sulfonylurea, and it works by forcing the beta cells to produce more insulin. There is some thinking that this, in turn, causes the beta cells to burn out faster, which in turn hastens the time when one will need insulin.

If you can increase the metformin, I’d do that first and see how it works. You can always add the gliburide if the increased metformin doesn’t achieve the goal. But I’m with Anthony…I’d rather be on insulin if it would mean less of it and it would save pancreas production.

Ruth

There is a bit more than anecdotal evidence that early intervention with insulin is good and stops further damage to the pancreas. Not sure if this is true for sulphonyl ureas like glyburide. Unfortunately the Doctors have a monopoly so they decide for right or wrong.

My diabetes did also develop fully after surgery. I think it is the massive amount of stress that pushes us over the top.

It actually is a good sign that you responded to metformin. Metformin never changed my meter numbers and in particular never brought my fasting down. You actually could increase you metformin to 2.5g/day. As others have noted Glyburide is thought by some to lead to beta-cell “burnout,” I’ll not use it. Sulfonylureas, as a drug class, have also been historically implicated in heart problems.

Don’t expect Glyburide to help with insulin resistance, it doesn’t, it only stimulates your pancreas to push out insulin. If the Glyburide doesn’t get your fasting down, it may actually make your weight problem even worse. I would personally opt for trying an even higher dose of metformin.

First of all I would think about changing doctors. Actos has the same side effects as Avandia. Both can be lethal. As for Glyburide is second generation and Glimepride is 3 rd generation. There was a lower incidence of hypoglycemia with glimepiride than glyburide. You could up Metformin to 2500mg. a day first.

Have you thought about Exercise? It will lower Glucose levels, also cholesterol levels and Blood Pressure. I Nordic walk 1 1/2 hours a day. Hba1c is 5.2. Google Nordic Walking. I use plain ol’ sticks.



Take care



Sonny