Hi - I’m a new member to TuDiabetes and am interested in input about using glipizide long term. It is from your discussions that I have begun to suspect it might not be a good idea. I was diagnosed about 2 years ago first as type 2 and then by an endo as type 1 or at least as testing positive for type 1. My dr only seems to recognize type 1 or 2. I still produce insulin. I was able to control with diet (I use the zone diet) alone for awhile, but am now on 2.5 mg of glipizide twice a day. Combined with the zone diet I feel MUCH better and my numbers are better, but I am concerned about long term use and the preservation of the cells in the pancreas. It is a very low dose, but I wonder about long term? If I still produce my own insulin and I try taking insulin can I stop or is it one way only? I also wonder how insulin resistance plays into the equation. Any thoughts out there? Thanks and thank you for such a great forum. I have learned so much from you! Sarah
If you were diagnosed with autoimmune Type 1.5, glipizide is probably not such a great solution for you. Dr. Bernstein has strong feelings that it damages the beta cells and he has been practicing endocrinology for many years with a practice full of Type 1s.
OTOH, the some recent research suggests that contrary to some hopes, injecting insulin doesn’t prevent the autoimmune attack from continuing.
I am not sure what to believe here. If it were me, I’d inject insulin, because with Type 1.5 you will end up doing it any way, and if there is some slight chance as Bernstein insists there is that injecting will prevent further deterioration, it’s worth doing.
I have another form of Type 1.5 (not autoimmune in nature) where long term research suggests that stimulating the beta cell is a good option, because C-peptide is produced. But I am so insulin sensitive that I can’t tolerate Glipizide. I do occasionally use Prandin at meal times–it’s weaker. But I don’t like it’s long term complication profile which includes more heart disease.
Maybe you need a younger endocrinologist. Some of the ones trained decades ago can be REALLY out of touch. Been there, paid them a lot of money for bad advice.
My primary care doctor had me on Glipizide but my endo took me off. Why beat up your pancreas on a daily basis!! Think of you Pancreas as a lemon once you have squeezed all the juice out you can squeeze harder but in the end you will still get nothing. This of course is my opinion but you would be better off using a small dose of insulin and NO Glipizide. You should be able to have great control (because you are honeymooning) and hopefully you pancreas holds out a bit longer because you aren’t putting so much strain on it.
Thanks, Jenny. I have been considering a second opinion. I think my current dr would be open to anything I want to try, but he really does seem to feel that it’s fine to just use up the beta cells. I think I’d rather be used to insulin first and make the transition gently on my own timetable not because all of a sudden I can’t get my numbers down. I am just a bit nervous to go to insulin having never used it. From what I read people on this site seem to consider it a relief and that the inconvenience is worth it. Thanks for the info - Sarah
Hi David - I think you are right - I hate to think of completely draining all function out of a part of my body - it seems unwise. I’d love to have even more control. I still go over 200 after meals occasionally. I have to be very strict about how many carbs and what kind. Thanks! Sarah
I agree with David.
not long after I started glipizide they realized I was type 1.5 or type 1, I was first misdiagnosed as type 2, but once I started that, that was it , I needed insulin, now I am on pump and love it, good luck
Sarah, I tried glipizide for 3 months. It made me VERY Hungary and if I missed a meal I went low, not to mention how bad it made me feel. When I took myself off my BS didn’t go below 300 for almost two weeks…I’m convinced it would have caused more damage to my beta cellls is i’d stayed on it long enough. Now i take metforming and insulin. My control is excelllent and I feel wonderful.
Type 1, 1.5 or 2 if metformin and/or diet exercise dont do the job then insulin is the way to go. Diet and exercise is very important because it is a weight gain drug.
Hmmm - that is interesting! Do you remember how much glipizide you were taking by any chance? I can’t miss meals - that’s for sure!! I don’t go more than 5 hours without eating and if I don’t eat before bed I always have to get up. Do you know if it is impossible to try insulin and go back off it, if your body still produces some insulin? I am wondering if insulin is a one way street. I am going to have to talk to my dr. The consensus from this discussion and others I have followed is to not let the pancreas just go kaput, but to go on insulin before that happens. Sorry about all the questions, but what does metformin do - why do you combine that with insulin? Thanks so much!
Metformin helps make a type 2 diabetic less resistant to insulin absorption. If you are a type 1.5 working towards type 1, Metformin will not help you as your bodies cells are not resistant to using insulin. I was originally on Metformin because they thought I was type 2 and it did nothing because I was type 1.5 working towards a 1. My primary care doctor just had no clue!!!
I’ve wondered if I have some resistance. Sometimes I feel like I have to eat more carbs or more fast acting carbs to feel normal after a meal. It results in higher BG readings, but I can’t stand that feeling - it’s not hunger or cravings more a kind of restlessness. It doesn’t happen all the time, just when I eat very conservatively - say I try to get all of my carbs from brocoli and otehr slow acting foods. I have to add some fruit or something else that hits fast. My original GP dianosed me as 2 and then I went to an endo myself and switched to the endo for GP as well. The original GP had me fill out a survey right way about how good his diabetes care was - of course I had no idea at the time. I think I’d fill out the survey quite differently now…
Same here, with and without metformin 3X 500 mg per day my BG average and standard deviation were exactly the same. The same thing happened with avandia no effect whatsoever. Here ( Calgary, Canada) you are assumed to be type 2 if you have any tummy grease or are older than a child. Adult onset diabetes no existant.
Dear sarah.
You cannot match the action of the glypizide to the food you eat no matter what you do. so this drug will make you feel hungry and give you poor blood sugar control at the same time. You should probably be on a slow acting insulin for your basal needs and a fast acting one for meals. Getting good control is not easy but as least you have a chance with insulin.
Hi Sarah–If you have Type 1 diabetes, it is best to be on exogenous insulin for multiple reasons. If you have some not-dead-yet beta cells, as you do, exogenous insulin prolongs their life, improves control, and lessens your chances of complications (an offshoot study of the DCCT showed this). Good luck to you!
Melitta
Dear Sara.
If you have been reclassified as type 1 why are you on that s==t? Yes you have good reason to be worried. Without outside insulin you pancreas will die turning the disease from fun into your worst nightmare. It is not for sure that going on insulin will insure that your pancreas lives on but that has a much better chance than glipizide, the more so if you can keep you BG in the normal range at all times.
Glipizide is a sulfonylurea that does nothing for insulin resistance. Metformin helps some people with that.
That’s the feeling I am getting. That in the long run this is not a good approach. My endo said something about how maybe I’ll be the one that fools them? I don’t know what that means unless he thinks I am actually a type 2. I test postive for the GAD antibodies though. Either way - I don’t understand why my endo thinks it is acceptable to just wear out the pancreas. That is his thoery - let it wear out and when I see numbers in the upper 200’s for a couple of days it’s time to go onto insulin. My control is good on the glipizide I think mainly because of the diet I follow. I keep a strict ratio of fat/protein/carb every time I eat. Basically 1 gram of fat to 2 grams of protein to 3 grams of good carbs (mainly veggies or whole grains). But I can’t do it on diet alone - I am either too sensitive or not quite disciplined enough so I need those extra boosts of insulin that the glipizide is giving me. I do feel better on the glipizide, but I think that is because I needed that insulin that it is squeezing out of my pancreas. I am thinking about asking the endo to run the full blood work panel again to see if there is any change in how much insluin I am producing. That test was at 6 last year. Not sure what the normal range is. Thanks for writing - I was thinking of getting a second opinion and I think I have it now. Everone on this forum has told me in no uncertain terms - glipizide is not for type 1!! Or for that matter type 1.5…Thank you.
Sarah, if you test positive for GAD antibodies you have Type 1 diabetes. You absolutely do not have Type 2. As I mentioned in a previous post, one of the DCCT studies looked at study participants who had been diagnosed with Type 1 diabetes as adults. All of them had some remnant insulin production, and the incidence of complications was greatly reduced in those study participants who were in the tight control group (MDI or insulin pump therapy). Glipizide is not an appropriate treatment for an antibody positive Type 1 diabetic, it is only indicated for Type 2 diabetics, and IMO your doctor should not be experimenting with you and your life.
I just made the call and have an appt to talk about this with my doctor. The stars must be aligned just right because he is booked until April, but I was able to squeeze in tomorrow. Thanks for your reply - I appreciate it!
Let the pancreas die, same idiotic approach as that of the CMA ten years ago. Once your pancreas kicks out completely it is not a fun disease but your worst nightmare. Glipizide is not even good for type 2. I am not sure there is such a thing as a good carb for diabetics. the good carb is the one you dont eat.
Good like with your appointment.