Questions on T2 oral medication

[jen_slc]

I haven't spent much time in the T2 world, but a close friend of mine was just diagnosed as T2 and we're both confused. We both think there's a possibility she might be T1.5.

Her FBG was in the 200s and urine tests showed elevated ketones and glucose. A1c is 8.4. The PA at the urgent care center told her she was T2 without any further tests. She's a healthy ~30-yr old woman who eats right, exercises regularly and at a healthy weight.

Her GP doesn't seem too up-to-date on the latest T2 management; gave her a meter, told her to test 3x/week for the next 3 weeks until her follow-up appt (3x/week... is he crazy or is that just me?). He's also started her on 5mg glyburide, one pill a day, and so far her BG levels are still in the 200-300s.

I don't know anything about T2 oral medications, so this is where I need some help. Are the oral meds taken once a day, or at varying times according to your need? How long do they last in your system? Do they take a while to start working? How soon can my friend expect to see improvement in her BG levels?

Given that her BGs are still awfully high since her diagnosis on Friday, she feels absolutely terrible, is guzzling down water, feels like she shouldn't eat anything because her BGs are so high, she is tempted to up her dose of glyburide to 10mg. And if she does, should she take it all in one go in the morning, in the evening, or should she take 1 pill in the AM and 1 in the PM?

What are people's thoughts on this? Do you think it is safe to do so? I have no clue. If she were on insulin, I could help. Any thoughts/suggestions?

[Harold]

Initially glyburide is taken once a day and it should start working the first day. 3X a week and I suppose he just wants FBG. Yes, he sounds crazy, but he will have to prove it to himself. She should ask him for a c-petide test and go in fasting so he can take it then. This would show if she has normal or low levels of insulin.

[Keezheekoni]

Seems like typical US doctors to me. Most of them treat T2s like people who aren't going to take care of themselves anyway, so why bother?

The glyburide should be taken in the morning. She should have also been given metformin though, unless she has a preexisting liver problem. Glyburide starts working almost immediately in people already on metformin, I don't know about those who aren't on it though...

Doubling the glyburide *might* be okay, if she's not on metformin. She'd take one before breakfast and one before dinner. It's a sulfa med, so if she's at all sensitive, make sure she has someone watching her.

I wouldn't expect it to work right away though, so maybe wait a week before doubling the dose.

Obviously I'm not a T2, so I don't know for sure...my dh is, so I'm going by what his doc told him at the beginning of his dx. Of course, he was immediately put on metformin and told to change his diet and start exercising, which from what I hear lately is quite abnormal...grrrr!

Definitely have your friend come here. I know quite a few of the T2s will have some excellent advice for her!

[Phonelady61]

Hi maybe you should tell your friend to go to see an endo . I know i had to to finally feel better . he told me if I feel like **** then I know what I need . you see my endo is also an insulin dependant diabetic and he knows what each of us goes through I got really lucky , anyway have her make an apt with the endo cause he should be able to help her .I wish her luck.

[davef]

jen_slc,

I'm a Type 2 but not on glyburide (I'm using metformin) so can't help there. However I think the doctor's suggestion of testing just 3 times a week is pure madness, but not at all uncommon. It appears that some doctors think us T2's are either not really diabetic or as Rikki say, they think we won't look after ourselves.

I'd strongly recommend:

- Test, test, test: FBG in the morning, then before each meal and 2 hours after first bite so your friend can find out what foods are working for her.

- Try cutting back on the carbs, I avoid things like pasta, rice, white bread and potatoes

- Try get some exercise in, it really does help us T2's to get numbers down

If your friend is confirmed as a T2, then I highly recommend "The First Year: Type 2 Diabetes by Gretchen Becker" I found it to be a very good book, informative and easy to read.

[princesslinda]

From what I understand, the glyburide should start working quickly. I have a co-worker who takes it 3 times a day, along with metformin and Byetta, so I know it can be more than a one a day pill, though it may be started at once daily and adjusted as needed. I'm surprised they didn't start her on metformin, as this is usually the first med many of us tried.
I know from experience with the metformin that it can take up to 3 weeks for it to reach optimal levels, but I noticed some change in just a few days. I was started on metformin 500 mg twice daily and stayed on that dose with good results until I stopped it when I started Byetta.

As for testing 3 times a week...RIDICULOUS!!!! I was told to just worry about fasting blood sugars, it was only after coming to the forum that I learned the importance of 2 hr post meal testing. She should test several times a day, esp. at first.

Is there an endo she can see in the area? Sounds like her GP isn't being much help at all.

[jen_slc]

Thanks all! She is a member of the forum now (k_dub) and I'll direct her to these comments.

[Scratch]

I haven't spent much time in the T2 world, but a close friend of mine was just diagnosed as T2 and we're both confused. We both think there's a possibility she might be T1.5.

This sounds 1.5 to me.