What Can I Expect from Taking Glimepiride?

[luckharm]

Hi All,

I was diagnosed with Type 2 Diabetes in May of '08 and was put on two 500mg pills of Metformin 2X per day. Gradually my numbers came down (BS from 350 to 120 in the morning, A1C form 10.7 to 6.6) But then a few months ago they started to climb again. Now my A1C is 7.5 and BS is around 180 in the morning. Oh, and I have lost 30 lbs over the last year. I am getting concerned about the high numbers and the weight loss. Since I am only 5'4" and now I weigh 120 lbs, I really do not want to lose any more weight. A year ago I was 150lbs. Ever since I started taking Metformin, I have had diarrhea. Could this be causing the weight loss?

I saw my doctor last week and she halved my dose of Metformin to one 500mg pill 2X per day and started me on Glimepiride.

Does anyone have any experience with these two drugs taken together? Do you think I will stop losing weight? Will my numbers go down again?

I already eat a low carb diet, and I walk 3 miles 3X per week. Is there anything else I can do to lower my numbers? What caused my numbers to climb again? I really want to keep my diabetes under control so I can live a long life. I am 59. I feel fine and do not have any other symptoms right now. When I first got diagnosed, I did have the unquenchable thirst, but that has been gone for a while. Any advice would be appreciated.

Thank You,
:(

[Margiep]

Margie,

Sorry, to hear your numbers are going up. Like they say, this is a progressive disease and is ever changing. I was also on what my PCP indicated as the maximum dose of metformin at 2000 mg per day. I was not being very careful about my eating habits and therefore, my a1c was too high. I tried actos without much change. Endo put me on Glimepiride. She told me to take 1/2 pill in the morning and 1/2 pill at dinner for the first two days. Then go to 1 pill morning and evening. I never got to the full does because my sugar dropped so low. I was on it for about two weeks and after spending two nights without much sleep because I was afraid my sugar would drop too low, I freaked out. Two hours after eating it was 67 and after treating with candy and peanut butter, thirty minutes later I was at 75. Still not feeling real great. I decided that was it. I called my PCP and let her know what was going on and what my plan was. I gradually stopped the Actos and promptly stopped the glimepiride and I started a lower carb diet and really being tuned in to what I was eating. And I have been testing like crazy. That was two and a half months ago. I go in this next week to have blood work done. My meter is telling me I am at 115-125 two hours after eating. Most of the rest of the time, I am between 95 and 115. I am pretty happy with the results and I have lost about 12 pounds. I loved what glimepiride did to lower my sugar, but I felt like I was having to always eat. I could see myself gaining weight because I had to eat so often to correct. Hope this helps.

Hi All,

I was diagnosed with Type 2 Diabetes in May of '08 and was put on two 500mg pills of Metformin 2X per day. Gradually my numbers came down (BS from 350 to 120 in the morning, A1C form 10.7 to 6.6) But then a few months ago they started to climb again. Now my A1C is 7.5 and BS is around 180 in the morning. Oh, and I have lost 30 lbs over the last year. I am getting concerned about the high numbers and the weight loss. Since I am only 5'4" and now I weigh 120 lbs, I really do not want to lose any more weight. A year ago I was 150lbs. Ever since I started taking Metformin, I have had diarrhea. Could this be causing the weight loss?

I saw my doctor last week and she halved my dose of Metformin to one 500mg pill 2X per day and started me on Glimepiride.

Does anyone have any experience with these two drugs taken together? Do you think I will stop losing weight? Will my numbers go down again?

I already eat a low carb diet, and I walk 3 miles 3X per week. Is there anything else I can do to lower my numbers? What caused my numbers to climb again? I really want to keep my diabetes under control so I can live a long life. I am 59. I feel fine and do not have any other symptoms right now. When I first got diagnosed, I did have the unquenchable thirst, but that has been gone for a while. Any advice would be appreciated.

Thank You,
:([/QUOTE]

[matingara]

I already eat a low carb diet,

what do you mean by a "low carb diet"? i.e. how many carbs per day? <30 grams? <300 grams?

:)

-- Joel.

[foxl]

I cannot answer your question, because I was on it less than two weeks. It kept crashing me suddenly, even on half what they had prescribed, and I was told to stop if it did that ...

I would think making those kinds of lows though, it would make you hungry.

[sumi]

Hi Margie,
I don't like to hear your story, but understand that most of up will face a similar fate as our condition worsens. My understanding is that Glimepiride works by stimulating your pancreas to produce more insulin. It does this regardless of whether you have eaten or not. Two problems I think, one that you may go low, and the other is that it might hasten the death of your beta cells which are already working too hard to give you the insulin you need. If I were in your situation, particularly not needing to lose more weight, I would consider insulin. This should give your beta cells some help, and hopefully preserve their function for many more years.

[foxl]

Hi Margie,
I don't like to hear your story, but understand that most of up will face a similar fate as our condition worsens. My understanding is that Glimepiride works by stimulating your pancreas to produce more insulin. It does this regardless of whether you have eaten or not. Two problems I think, one that you may go low, and the other is that it might hasten the death of your beta cells which are already working too hard to give you the insulin you need. If I were in your situation, particularly not needing to lose more weight, I would consider insulin. This should give your beta cells some help, and hopefully preserve their function for many more years.


Yes, it could hasten beta cell death. SOOOO glad I could not tolerate it!

[luckharm]

Hi,

I eat about 120mg of carbs per day per the advice I was given when I took my diabetes training class. After reading the replies to my post, I am now very concerned about starting Glimepiride. I should be getting the pills from my mail prescription pharmacy sometime next week. My doctor said to take 1, 1mg tablet once per day. I guess I will try it and monitor my blood sugar very closely. This morning it was 204 before breakfast and I ate almost no carbs yesterday! I guess I have to do something, since the Metformin is not doing it for me anymore.

Thank you for all the "words of caution". I will report back after I have have been on it for a few days.

Margie

[foxl]

Hi,

I eat about 120mg of carbs per day per the advice I was given when I took my diabetes training class. After reading the replies to my post, I am now very concerned about starting Glimepiride. I should be getting the pills from my mail prescription pharmacy sometime next week. My doctor said to take 1, 1mg tablet once per day. I guess I will try it and monitor my blood sugar very closely. This morning it was 204 before breakfast and I ate almost no carbs yesterday! I guess I have to do something, since the Metformin is not doing it for me anymore.

Thank you for all the "words of caution". I will report back after I have have been on it for a few days.

Margie


Margie, those pills can be split, too! The endo who prescribed to me suggested it in fact. So you might try a slow approach at first.

I do about 60 - 80 g carb per day, with occasional (rare) excursions approaching 100g.

You could try lowering your carb intake and testing to see if you want to even start taking it ... what are your readings after meals, now?

Oh, also thinking back, I took mine in the morning only and my lows hit right before lunch so I was prepared, too. I kept 2 servings of 2 TBS raisins with me, and when I went low I would eat one packet, re-test in 15 min, and if necessary take a second ... and if necessary eat lunch a bit early.

So that is also an approach to trying it cautiously. Mornings.

[luckharm]

Well, I have been on Glimepiride now for about a week and I see absolutely no difference. My fasting blood sugar levels are still about 180 and after meals which include maybe one serving of carbs, they go up to 250 or above. I only tested twice at the 100 range right before dinner after not eating anything in the afternoon and exercising for 30 min. But after dinner they spiked up again. I have now limited my carb intake to about 60 g per day and still there is no effect on my BS. Plus I have now lost another few lbs and weight 118lbs.

I am really starting to get concerned. How long should I wait before calling my doctor? Does it take Glimepiride a few weeks to work? At this rate of weight loss, I will disappear in about a year!

Thank you all for any suggestions.

[sumi]

Hi Margie,
Sorry to hear its not working. No doubt much more experienced people will have some thoughts, but I can't help wondering if your insulin production is just too low to be helped with this.

[foxl]

Glimepiride should definitely work IMMEDIATELY.

I'd be calling the doctor back now.

[luckharm]

Well, I finally called my doctor and she put me on Glimepiride 2X a day now. I have been taking one pill in the morning and one in the afternoon for about a week and my blood sugar readings in the morning are unbudget at between 160 and 200. I have started to keep a food diary to see what I am eating and I find that I eat about 60 to 90 carbs per day and about 1200 to 1400 calories per day.

I really believe that this drug is not doing anything for me at all, but she wants me to stick with it for a month and then we will re-evaluate. I am really concerned as to what these high numbers are doing to my body. I would really like to gain a little weight, but it's such a catch 22 situation. If I eat foods with high calories they usually are also high in carbs, so I wind up eating a lot of cheese, nuts and meat. But I can't seem to gain weight and am stuck at about 119 lbs.

Any other suggestions on how to gain weight without spiking my blood sugar???

I appreciate all your suggestions.
Thank you,

Margie

[foxl]

Margie. Get a C-peptide and if it is low, get on insulin. That'd be my recommendation!

[Possible1]

I'm on Glimepiride and metformin. I started having complications in May. I lost a lot of weight and like you, I want to stop losing and gain some of it back but it doesn't seem to be working. I'm having fatigue and bowel movement complications. I was told these are common side effects of meformin, but my doctor didn't tell me about that. As a matter of fact it wasn't till I told my doctor that I researched it and found out there are side effects that he accepted and said cut the dosage in half. I was told to ask the doctor to put me on another set of medicines and that's what I'm going to do or change doctors.

[jtausch]

Margie. Get a C-peptide and if it is low, get on insulin. That'd be my recommendation!

Or just get on insulin even if you c peptides not low I don't even take metformin just insulin

[RobinP]

I just started Glimepiride last Thursday and I have not had a low yet. In fact, it's not really doing a whole lot to my numbers and I take 3, 2mg pills a day. I think when I go back in 4 weeks, I'm gonna tell him that I want insulin. I'm sick of dealing with these pills.

[mrfino]

I started on glimepiride in November 2008 and stopped in early March 2009. I have been on metformin too since about 2000. Glimepiride began to work immediately and I got better numbers from it, but unfortunately I had no warning about the lows until I had one. I struggled to avoid lows. For the first time in the 14 years since my type 2 diagnosis I had a glimpse of what type 1's must feel every day. I didn't like the tightrope I was walking. And I gained about 15 pounds while on glimepiride.

In March I told my endo that I wanted to try something other than glimepiride. I went off it and started on Byetta. I am SO glad I made that change. My BG numbers are much more on an even keel with the Byetta than on glimepiride. I have lost about 20 pounds. I feel much better.

John

[luckharm]

Well, the saga continues. I had more blood tests this week and my A1C was 8.9 and C-Peptide test was .6. My doctor said that my pancreas is now producing little if any insulin and that I am now Type 1 1/2. She stopped the Metformin and Glimepriride and I started on 10 units of Lantus per day. She said that sometimes there is a "honeymoon" period after diagnosis, when you are able to control the disease with medications and then it stops working. She was surprised that my honeymoon period was only about 1 year, but it happens.

So, I have joined the ranks of insulin takers. I did my first injection today and it actually was not that bad. I am just happy to be finally doing something that will actually help me get this thing under control.

My blood sugar count this morning before injecting was 270. I'll report back in a few weeks to see how things are going.

Thank you for all the good advice.

[jer.lawrence]

That sucks to hear that you were originally mis-diagnosed, but I'm glad they caught it! Best of luck to you with your levels!!

Robin, you also may want to consider having C-Pep tested! I'm hoping that I don't go through the same thing that you guys have gone through, but thank you for sharing your experiences. Hope I can learn from them.

[RobinP]

I did have a C-Peptide test in March. It was 1.0

[NewdestinyX]

Really informative thread.. What's a 'pretty' good C-Peptide number? I mean for a 'controlled' Type 2. At what point do you become a 1.5? How low does that C-peptide have to drop?

After 7 weeks on Metformin 500 ER 2x a day and Actos 30mg once a day for 3 weeks... my numbers stay tightly between 150-180 all day -- after fasting before and after meals.. all in that range.. 30 points. Unless I go crazy carby then I can get up to 200. I'm beginning to 'surmise' what's likely at hand for me after reading so many of your stories and doing mega reading on the topic. I think my pancreas is compromised -- but not dead. The Met and Actos are reducing my resistance and preventing the liver from pouring too much glucose into the blood that's why I'm not spiking anymore. -- but there doesn't seem to be enough insulin to bring the numbers down to controlled range.

Now resistance could also explain numbers not getting down into controlled range except for the results of other testing I do -- with my exercise program. If it was 'all or mostly' about resistance -- then my weight training and anaerobically focused exercise would make only a moderate change in my BG numbers. Well in me it makes a drastic difference - as much as 50-60 point drop after 30 minute work out. That proves that my cell receptors are 'open' to receiving the sugar when my body asks for it. But to bring it into controlled range I'd need to exercise 3-4 times a day at that level which is not possible and even then -- the number STILL doesn't get under 100 ever. That tells me poor insulin production that's not being helped by any of these meds.

Flaws in my conclusion?

[foxl]

Hey dumb question -- is it Glim-EE-pur-Eyed, or

Glim-EH-pur-eyed?

[foxl]

Really informative thread.. What's a 'pretty' good C-Peptide number? I mean for a 'controlled' Type 2. At what point do you become a 1.5? How low does that C-peptide have to drop?

After 7 weeks on Metformin 500 ER 2x a day and Actos 30mg once a day for 3 weeks... my numbers stay tightly between 150-180 all day -- after fasting before and after meals.. all in that range.. 30 points. Unless I go crazy carby then I can get up to 200. I'm beginning to 'surmise' what's likely at hand for me after reading so many of your stories and doing mega reading on the topic. I think my pancreas is compromised -- but not dead. The Met and Actos are reducing my resistance and preventing the liver from pouring too much glucose into the blood that's why I'm not spiking anymore. -- but there doesn't seem to be enough insulin to bring the numbers down to controlled range.

Now resistance could also explain numbers not getting down into controlled range except for the results of other testing I do -- with my exercise program. If it was 'all or mostly' about resistance -- then my weight training and anaerobically focused exercise would make only a moderate change in my BG numbers. Well in me it makes a drastic difference - as much as 50-60 point drop after 30 minute work out. That proves that my cell receptors are 'open' to receiving the sugar when my body asks for it. But to bring it into controlled range I'd need to exercise 3-4 times a day at that level which is not possible and even then -- the number STILL doesn't get under 100 ever. That tells me poor insulin production that's not being helped by any of these meds.

Flaws in my conclusion?

Grant ...

1) you do not become a 1.5 based on C-peptide -- you have to have antibodies. 1.0 is the lower limits of normal fastingC-pep, meaning not a whole lot of insulin produced right now ...

2) Insulin production can come UP, up to 6 months post-crisis, according to one study I found last week. If you rest those beta cells, and do not ask too much of them!

[Lorac]

I take Metformin and didn't know it could cause this problem. I have been having severe diarrhea for a couple months now. I've always had problems, my mother has IBS and I'm sure I do also, but lately it has been really bad. I thought IBS was getting worse now I'm thinking it's the Metformin. I haven't told my doctor because I was embarrassed. I don't go back for 3 months but if I'm still having problems I'm going to tell him.

I was on 500mg 2x a day for a little under a year - he upped my dose to 1000mg 2x a day about 3 months ago. I've also lost 10 pounds since my last visit in April. I was proud when he told me that at my visit earlier this week. Now I'm wondering if the weight loss is from spending most my time in the bathroom and not because of anything I've been doing!