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Switching from Metformin to Glimepiride

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#1
sweetdisease

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I have been on Metformin for 2.5 years now and have lost about 40 lbs. BS hasn't changed much. Started at 320 and now is 260 (Fasting). I visited a new doc yesterday and he asked me to swtich from Metformin to Glimepiride. I asked him if it will stop my weight loss and what he told me was that my 40lb loss was because of my diabetes and not metformin. My question is will this switch cause my weight loss to stop ?

#2
Uff Da

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My doctor had me on Metformin for 1.5 years, even though as far as I could tell it did no good. Oh, I got my BG down so I was having A1c's in the 7s instead of the 11.5 at diagnosis. But I got it down by eating less, in particular, fewer carbohydrates. And I took glimepiride, too. As far as I could see, it was the glimepiride that helped my BS.

From what I've read and my own experience, metformin acts as a mild appetite suppressant. That's how people on it seem to lose weight - they simply eat less. (I saw that as undesirable, as I was trying to gain weight.)

Glimepiride isn't going to make you stop losing weight directly. What makes you lose - or not lose - is what you choose to put in your mouth. Without the metformin if your appetite is just slightly better, you might choose to eat more. But that would be your decision, and not really have anything to do with glimepiride.

I'm shocked that you've been treated as a diabetic for 2.5 years and are still having blood sugars that high. What kind of diet are you eating?

Dx diabetic Oct 2011, Dx type 1.5 March 2013
A1c: 10/2011 - 11.5, 3/2013 - 7.6, 7/2013 - 6.4, 10/2013 - 5.8, 2/2014 - 5.8, 5/2014 - 5.6
, 9/2014 - 5.9
Lantus 5 units, Humalog 18-27 units daily, vitamin D3, BP meds
Diet: Moderate carb diet, 120-170 carbs, 1800-1900 calories daily
Currently within my preferred weight range of 125-130


#3
sweetdisease

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Thanks Uff Da. My diet is really bad and I have been neglecting my health but not anymore !!

#4
Uff Da

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Do you check your blood sugar every morning? If so, why not enter your reading in the thread for morning readings on this site each day. That kind of regular reminder can be a motivator, too.

Edited by notme, 17 August 2013 - 10:36 PM.
Soliciting to other sites

Dx diabetic Oct 2011, Dx type 1.5 March 2013
A1c: 10/2011 - 11.5, 3/2013 - 7.6, 7/2013 - 6.4, 10/2013 - 5.8, 2/2014 - 5.8, 5/2014 - 5.6
, 9/2014 - 5.9
Lantus 5 units, Humalog 18-27 units daily, vitamin D3, BP meds
Diet: Moderate carb diet, 120-170 carbs, 1800-1900 calories daily
Currently within my preferred weight range of 125-130


#5
sweetdisease

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will do. Thank you very much

#6
sweetstar

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Hi, Sweet, and welcome.
Just a little warning on the glimiperide. I wasn't watching my BG as dilligently as I should and was on met, glim and januvia.
Once I took control I have come off glim and januvia. As my BG came down, the glim started causing lows. I was in the 60's
a lot. So, be careful and test often.
What dose of Metformin were you one? Met works best when you eat low carb.
Most Recent A1C 1/14 5.6
7/13 5.7
2/13 5.8
9/12 5.8
5/12 5.4
12/11 5.7
7/11 5.7
3/11 5.6
8/10 5.9
11/10 6.2
Diabetes Med
Metformin 1000mg twice a day.

Diagnosed October 1998

I learn something new everyday!!

#7
NoraWI

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I suggest both of you Google *glimepiride* (Amaryl). Glimepiride is a sulf and presses the pancreas to produce more insulin. Metformin dulls the appetite and keeps the liver from dumping. These are two very different actions. Then decide for yourselves which is more appropriate to your situations.
NoraWI
T1 since 2002, MDI since 2004
Pumping NovoLog with an Animas Ping since May 2010

#8
jwags

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What sometimes causes weight loss is uncontrolled diabetes and very high bgs. Could you tell us what your bgs are running? I take the max of metformin every day, 2550 mg and I am at a normal weight, 114 for my height. Be careful of the glimperide it can cause bg lows and weight gain.

metformin 2550 mg
Moderate carb diet 40-75 carbs a day
3 T of Coconut Oil daily

Vit D, CoQ10, Melatonin, Multi vitamin, zinc, B 12
Chia Seeds , Flaxseeds, fish oil, biotin, occuvite and zinc

Exercise- Tennis - 2 hours/week, Power Walking- 2-4 miles most days, Hiking in the summer on trails and in the mountains

diagnosed Feb 2007
Age 64

#9
Uff Da

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I suggest both of you Google *glimepiride* (Amaryl). Glimepiride is a sulf and presses the pancreas to produce more insulin. Metformin dulls the appetite and keeps the liver from dumping. These are two very different actions. Then decide for yourselves which is more appropriate to your situations.


Neither is appropriate for my situation. I'm a type 1.5 and thankfully now on insulin. My PCP treated me as a type 2 and had me on oral meds for 1.5 years before she finally referred me to an endo who did the proper tests. The met didn't do squat for me. I'd asked her to let me try dropping it a month or so after I started, because I couldn't see that it was doing any good, but she wouldn't let me. The glimepiride did some good, but I still had to basically starve myself (and lost 17 pounds I couldn't afford to lose) while on it.

The endo got me off the glimepiride immediately. The thinking seems to be that it will just burn out the beta cells faster, and as a type 1.5 mine were pretty well shot anyway. He told me I could stay on the metformin, but I dropped it on my own. I don't have much of a dawn phenomenon and if it helps at all, it is only enough to decrease my insulin use about 1 or 2 units a day. Since I was already having to inject a small amount of insulin anyway, why not just a bit more and not have to take the four pills a day of metformin, which was making it difficult to eat enough to get my weight back to normal?

Dx diabetic Oct 2011, Dx type 1.5 March 2013
A1c: 10/2011 - 11.5, 3/2013 - 7.6, 7/2013 - 6.4, 10/2013 - 5.8, 2/2014 - 5.8, 5/2014 - 5.6
, 9/2014 - 5.9
Lantus 5 units, Humalog 18-27 units daily, vitamin D3, BP meds
Diet: Moderate carb diet, 120-170 carbs, 1800-1900 calories daily
Currently within my preferred weight range of 125-130


#10
Uff Da

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A major question: Do you see your weight loss as desireable or not? When I answered your question initially, I thought you were trying to lose weight and were afraid that the switch to glimepiride would be undesirable because weight loss might stop. If that's not the case and the 40 pounds weight loss is undesirable to you and you are now underweight, my question to you then is this:

Has your doctor given you the appropriate c-peptide and antibody tests to make sure that you are not a type 1 or 1.5 instead of a type 2?

Dx diabetic Oct 2011, Dx type 1.5 March 2013
A1c: 10/2011 - 11.5, 3/2013 - 7.6, 7/2013 - 6.4, 10/2013 - 5.8, 2/2014 - 5.8, 5/2014 - 5.6
, 9/2014 - 5.9
Lantus 5 units, Humalog 18-27 units daily, vitamin D3, BP meds
Diet: Moderate carb diet, 120-170 carbs, 1800-1900 calories daily
Currently within my preferred weight range of 125-130


#11
TX_Clint

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I have been on Metformin for 2.5 years now and have lost about 40 lbs. BS hasn't changed much. Started at 320 and now is 260 (Fasting). I visited a new doc yesterday and he asked me to swtich from Metformin to Glimepiride. I asked him if it will stop my weight loss and what he told me was that my 40lb loss was because of my diabetes and not metformin. My question is will this switch cause my weight loss to stop ?


If you want to control your bg (it does appear to be out of control), your best solution is using a basal insulin like Lantus. It will likely help you stop weight loss and possibly gain weight. Most of us must eat very low carb and watch the insulin levels because we are trying to loose weight and the insulin can make it difficult. I would never stop metformin unless it was causing me severe GI issues.

Best of luck.

<p>DX - 08/1997 - A1c 10.4

Metformin 500x4

Invokana 300

Levothroxine 137

2012 A1c 10.4/6.2/5.7

2013 A1c 5.9/5.5/5.3/5.4

2014 A1c 5.5/5.4/5.8


#12
Uff Da

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I would never stop metformin unless it was causing me severe GI issues.


I'd go along with that if the person is really a type 2. A prescription for metformin is, however, off-label for a type 1, as many type 1's don't have much of an issue with the liver. (If I recall correctly, about half do.) What we don't know at this point is whether or not the OP has been designated as a type 2 on the basis of tests or if that is merely an assumption because she is an adult.

From what I've read it is estimated that 10-20% of diabetics being treated as type 2 may actually be type 1.5. Individuals especially likely to be misdiagnosed are those who are normal or low weight upon diagnosis. But is the OP of normal or low weight and wanting to stop a trend of weight loss - or is she overweight and concerned that continued weight loss might be more difficult with the new medication?

Dx diabetic Oct 2011, Dx type 1.5 March 2013
A1c: 10/2011 - 11.5, 3/2013 - 7.6, 7/2013 - 6.4, 10/2013 - 5.8, 2/2014 - 5.8, 5/2014 - 5.6
, 9/2014 - 5.9
Lantus 5 units, Humalog 18-27 units daily, vitamin D3, BP meds
Diet: Moderate carb diet, 120-170 carbs, 1800-1900 calories daily
Currently within my preferred weight range of 125-130


#13
TX_Clint

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I'd go along with that if the person is really a type 2. A prescription for metformin is, however, off-label for a type 1, as many type 1's don't have much of an issue with the liver. (If I recall correctly, about half do.) What we don't know at this point is whether or not the OP has been designated as a type 2 on the basis of tests or if that is merely an assumption because she is an adult.

From what I've read it is estimated that 10-20% of diabetics being treated as type 2 may actually be type 1.5. Individuals especially likely to be misdiagnosed are those who are normal or low weight upon diagnosis. But is the OP of normal or low weight and wanting to stop a trend of weight loss - or is she overweight and concerned that continued weight loss might be more difficult with the new medication?


I would expect he (Sweetdisease) is a type 2 as Glimipiride won't do much for a type 1 and he wouldn't have been on metformin to begin with if he is a type 1. However, that's assuming that his doctor isn't useless for treating diabetes. In which case he certainly could be a 1.5 or 1.

<p>DX - 08/1997 - A1c 10.4

Metformin 500x4

Invokana 300

Levothroxine 137

2012 A1c 10.4/6.2/5.7

2013 A1c 5.9/5.5/5.3/5.4

2014 A1c 5.5/5.4/5.8


#14
Uff Da

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I would expect he (Sweetdisease) is a type 2 as Glimipiride won't do much for a type 1 and he wouldn't have been on metformin to begin with if he is a type 1. However, that's assuming that his doctor isn't useless for treating diabetes. In which case he certainly could be a 1.5 or 1.


Hopefully we'll find out. Don't forget, though, that my doctor had me on Glimepiride and Metformin for 1.5 years before finally referring me to an endo. The glimepiride did help some, just not enough for the amount of beta cell function I'd already lost. And from what I read of others in the type 1.5 boards here and elsewhere, mis-diagnosis and extended treatment as a type 2 with little success is extremely common. The doctors just blame the problems on non-compliance.

Dx diabetic Oct 2011, Dx type 1.5 March 2013
A1c: 10/2011 - 11.5, 3/2013 - 7.6, 7/2013 - 6.4, 10/2013 - 5.8, 2/2014 - 5.8, 5/2014 - 5.6
, 9/2014 - 5.9
Lantus 5 units, Humalog 18-27 units daily, vitamin D3, BP meds
Diet: Moderate carb diet, 120-170 carbs, 1800-1900 calories daily
Currently within my preferred weight range of 125-130


#15
TX_Clint

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I'm with you Uff Da. We all must learn that it is ok to fire a Doctor and tell them why. I know it's not easy to stand face to face and tell someone they are failing you and you're going to change Doctors because of thier inability to see to your needs. I try not to tell them directly that they are incompetent but kinda slide into it from the backside. I have had to do this before and it doesn't seem to phase them.

<p>DX - 08/1997 - A1c 10.4

Metformin 500x4

Invokana 300

Levothroxine 137

2012 A1c 10.4/6.2/5.7

2013 A1c 5.9/5.5/5.3/5.4

2014 A1c 5.5/5.4/5.8


#16
Todd G.

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Actually a lot of type 1's take met because it can dramatically reduce insulin resistance. If you only take a small dose of insulin, the difference may not matter, but if you're on a major dose of insulin, then the met can help you use less insulin and maintain better numbers.

#17
jims_forum

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Actually a lot of type 1's take met because it can dramatically reduce insulin resistance. If you only take a small dose of insulin, the difference may not matter, but if you're on a major dose of insulin, then the met can help you use less insulin and maintain better numbers.


Metformin works on liver to arrest excess glucose release at source and thus less insulin needed. Glyburide/glimperide forces pancreas to booot out more insulin.

I do not see this as either one or the other. Metformin does not do same job so that if your insulin output is low and liver kicking out excess glucose; one can use both in type 2 and some folks do.

The other joke is that is your liver works and signals correctly; metformin may be of little assistance and insulin may be what is needed - oral pills or liquid insulin.

The problem is that the human body is an organ complex of each organ doing different roles and contributing to diabetes in many ways not a sole orthagonal disease.
James (Jim) W. Snell
30+ years as type 2 diabetic
40 years as Digital Microprocessor System designer
Stroke in 2007 and retired.
Metformin, Humalog Lispro, 1200 calorie Diet and 1.5 to 2 miles walking exercise A1C = 6.4
http://db2jimcaresta.com

#18
Todd G.

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Metformin works on liver to arrest excess glucose release at source and thus less insulin needed. Glyburide/glimperide forces pancreas to booot out more insulin.

I do not see this as either one or the other. Metformin does not do same job so that if your insulin output is low and liver kicking out excess glucose; one can use both in type 2 and some folks do.

The other joke is that is your liver works and signals correctly; metformin may be of little assistance and insulin may be what is needed - oral pills or liquid insulin.

The problem is that the human body is an organ complex of each organ doing different roles and contributing to diabetes in many ways not a sole orthagonal disease.


I'm not sure why you quoted me. Your statement and mine seem to address different things. I was pointing out to the poster that said met was counter indicated in type 1's that this was not actually so. There are many type 1's on this forum that use met, and wouldn't have it any other way.

#19
jims_forum

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Todd G.

My apologies. Yes type 1 are using and I believe for the reason you state and reducing excess liver glucose release. No argument. My comment had to do with topic of switching from Metformin to Glimperide and me comment was simply to calrify that nor negatively commenting on your excellent comments.
Best wishes.
James (Jim) W. Snell
30+ years as type 2 diabetic
40 years as Digital Microprocessor System designer
Stroke in 2007 and retired.
Metformin, Humalog Lispro, 1200 calorie Diet and 1.5 to 2 miles walking exercise A1C = 6.4
http://db2jimcaresta.com





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