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Kerstin

Glipizide vs insulin

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:confused: I was diagnosed in 10/07 and have been on glipizide and metformin ever since. After reading about the possible heart and pancreas cell damage done by glipizide, and after spending more than a year trying to guess the right amount to eat at the right time to keep from going hypo (and several very scary lows)..I am wondering if insulin might not be easier to use??:confused: :confused:

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Some doctors now advocate early use of insulin for exactly the reason you state - to prolong the activity of the islets. However, you will be still faced with the same problem - learning how to adjust your food intake to match your insulin dose. For years I kept a food log along with my insulin log and registered all I ate with it's carbs and calories. I now know pretty much how many carbs I'm eating at a meal and can keep my intake pretty consistent.

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Some doctors now advocate early use of insulin for exactly the reason you state - to prolong the activity of the islets. However, you will be still faced with the same problem - learning how to adjust your food intake to match your insulin dose. For years I kept a food log along with my insulin log and registered all I ate with it's carbs and calories. I now know pretty much how many carbs I'm eating at a meal and can keep my intake pretty consistent.

 

If you are on basal/bolus (MDI) then you can adjust your basal to match your food, instead of the other way around.

 

I had lows in the 40's on glipizide, only twice last year in the 50's on insulin. Insulin is much more controllable.

 

-Lloyd

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Thank you for the information! I think I will ask my doctor about this as I am already micromanaging my food intake and the time I take my meds to avoid the glipizide lows.

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I am a new diabetic since this month and I take the same meds as you do. That's some scary info to see, I wonder why my doc did not tell me of possible side effects.

 

I don't know what these side effects are from but since I started on diabetes meds my muscles twitch from time to time.

 

I take Metformin, Glipizide, B12, Simvastatin, Metoprolol and Low Dose Bayer Asprin. I don't know which one is making me twitch like that but it feels really strange.

 

After what you posted I think I will give the doc a call and have a little discussion. Thanks for the info.

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My doc didn't warn me about the side effects of either. I found out the hard way ...well, and I guess I was dumb not to read the warnings on the bottle..but still..I mean..the doctor SHOULD have warned both you and me!!

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It's probably the Metoprolol...I was on that stuff it made me do all sorts of crazy things. I stop taking it. You must have high blood pressure?

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This is my personal experience so it may or may not apply to you. But I think we have similar situation. I have been on the pump+CGMS for 15 months now. It has been an interesting journey as I only did basel injection for a short period before it. In other words, I went pretty much from oral medications to insulin only. What prompted me for the change is mainly a desire to get better control. Also oral meds does not match my work and daily life schedule very well. It is too restrictive.

 

So this is what I can share as my personal experience: (about 18 months of work)

 

1. My A1C dropped from 8.XX to 5.92

2. My triglyceride dropped from 300+ to 133.

3. Dump Metformin / Glimipride / Actos to control my diabetes.

4. Dump Hydrochlorothiazide to reduce the swelling caused by Actos.

5. Dump Tizanidine as I do not have muscle spasm related to meds or deficiency.

6. Dump Crestor as my lipid # is back to normal with better BG control.

7. Dump Lovaza (fish oil) as my triglyceride is back to normal with better BG control.

8. Dump B12 oral, B12 shots & B Complex as I do not have deficiency caused by taking Metformin.

9. No more Metformin moments. No more sudden bathroom trips. Life is good.

 

What I have left to deal with is 81mg Aspirin and 10mg Lipitor to protect my heart. Then all the up-keep as a pumper and all the supplies I must carry daily. However, I will not go back in a million years.

 

Side note: Gilmipride is similar to your Glipizide. I had taken Gabapentin before for back problem. Similar dose.

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I'm bumping this old-ish thread up, because despite eating a very low carb diet 90% of the time, and being consistent with exercise, and losing over 40 lbs since dx to get in normal weight range, my numbers have been creeping up in the last 6-8 months and I suspect that very soon I will be adding something to my current Metformin-only regime.

 

I got a new doctor who is more willing to listen and problem solve. In mid-August I'm scheduled for an appointment, and for getting GAD and c-pep done. (Based on what I've been experiencing, I suspect I don't have much pancreatic action left.) I think he's thinking glip is the next step, but I also think he'd be willing to listen and do what I wanted if I want insulin instead.

 

If this helps offer your opinion: What happens is one higher-carb day or meal (not even high-carb, but, like over 40 or 50 or so) sends me up to 180-270 and then it takes a LONG TIME for it to come back down even if I go down to minimum carbs possible while still ingesting food. So while as recently as a month ago I could have numbers as low as 70s and a morning fasting of 100 (low for me - I have some kind of dp), say I go out and have 1/3 of a dining companion's flourless chocolate cake three weeks ago, my numbers are still up there. Sometimes the only thing that gets it back down is long exercise sessions and fasting, just trying to use up the bg b/c my pancreas isn't getting rid of it. But I can't live like that.

 

If my c-pep is low (and we'll see about the antibodies), it seems to me that it's clear that I will have to take insulin one day and we might as well start now, rather than mess around with the glip and tax whatever beta cells I may have left. (Actually that seems clear to me even without the c-pep test, just based on what my meter tells me about what's going on.) Also, it seems like insulin is something I could use as a tool in my bag - using it to bring down these high episodes, but maybe not need to use it when I'm eating consistently low-carb if I start my meal from a good number.

 

I've gotten to the point where I'm not longer afraid of insulin or see needing it as some sort of failure. And I've also gotten to the point where I know I'm doing the best I can, and I can't be perfect all the time, and I know there will be the nights of the flourless chocolate cake, or the 1 serving of sweet potatoes or something, every couple-few weeks, and I want to have more freedom about those things and not spend the next 3 weeks trying to get my numbers back to somewhat normal.

 

Any thoughts on all of this?

 

[FYI: I'm nearly 41, dx'ed at 38 with A1C of 10.4. Which makes me think I had the D for quite some time before I started to feel symptomatic. (I still don't feel symptoms even if my bg is in mid-200s. I feel great.) I got it down between 5.7 and 6.5 for the next couple of years, but last one was 7.8. I eat low-carb, with emphasis on quality of food - more primal/paleo style but I'm not militant about it.]

 

Thank you!

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In my opinion it's not the doctor's place to go through all the 'side effect' possibilities with a new prescription. That's up to the pharmacy...the people who are selling you the drug. Almost every pharmacy I've ever been in has a little corner set aside for such consultations. If not...all it takes is to ask them before you toss the prescription in your pocket and walk away. Nowadays, with all this computerized equipment, I'm sure all they'd have to do is input the drug and it'll print you out a copy of all the side effects. Then there's your own computer and that helpful little site called...Google! One is only as informed as they want to be.

 

As an edit: my post isn't directed at anyone specifically.

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:confused: I was diagnosed in 10/07 and have been on glipizide and metformin ever since. After reading about the possible heart and pancreas cell damage done by glipizide, and after spending more than a year trying to guess the right amount to eat at the right time to keep from going hypo (and several very scary lows)..I am wondering if insulin might not be easier to use??:confused: :confused:

 

That would be my choice....never would have taken the glipizide..metformin is a good drug.....

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I was on Glipizide for about 10 years and it pretty much depleted my pancreas and did some funky things to my heart rate. I also had a lot of lows on it, but then when my pancreas quit working so did the Glipizide, then I had wicked highs. I am now on insulin (humalog blous and lantus basil) and 500mg metformin. My numbers are perfect now and I have so much better control over my bgs. I wish I would have started it right out of the diabetes gate 10 years ago.

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I am only taking Metformin and so far my numbers are responding pretty well to the low carb eating, daily exercise and Metformin. I have already decided that if and when my sugars deteriorate in spite of tight dietary control and still exercising (in other words, for reasons other than what I am eating or not exercising) I will go right to insulin. Someone once posted that taking insulin is perfectly natural----instead of my pancreas sending it out, I am injecting it in. It is a natural hormone and may help preserve whatever beta cells that are functioning so that I can have a small amount of insulin production. I know some on here take Glipizide and have good results, but for some reason I am very uneasy at the thought of taking it. Plus, the only sure fire way to have those good numbers is with insulin---provided you are diligent with what you eat and good at figuring out how much to inject. JMHO.

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Had a follow up endo appt this Monday and she is still not 100% convinced I am T1 or T2. My antibodies indicate I am producing insulin, I'm fit, in shape, etc., and diagnosed at 38. I was taking 10u Lantus at night and a sliding scale of Humalog. My numbers weren't great but about 1/2 of what I was upon diagnoses 2 months ago. I typically run 110-170 with an occasional 200. As of Monday we discussed stopping the insulin and trying Glipizide. I've only ever needed 2u of Humalog once and about 1/2 the time I am under 150 and do not need to take the Humalog, if I need it it's 1 unit.

 

So I have an appt to see a different doc and discuss everything. Although the needles are a PITA I somehow feel more comfortable with the Lantus and Humalog than I do with the Glipizide.

 

Any thoughts?

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Any thoughts?

 

I say get your basal adjusted with the Lantus (10 units, in my opinion, is a place to start) and then work on your Humalog injections according to what you find best with your IC (insulin to carbohydrate ratio). This is as close as I've seen to mimicking what your body actually does. I'm not a big proponent of BG control through oral medications. I'm sure others would disagree with me about the oral medications...but it's probably because they take them.

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Thanks for these responses so far! I definitely feel more inclined to insulin. There don't seem to be many cons v the glip other than dealing with needles.

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Thanks for these responses so far! I definitely feel more inclined to insulin. There don't seem to be many cons v the glip other than dealing with needles.

 

Needle phobia...we all had it. I, for one, would have rather had a beat down than inject myself. I didn't take to the syringe; too much ceremony there with adding air to the vial, sucking out the insulin, trying to get rid of the air in the syringe, reading the dang numbers on the syringe...so my PA suggested the insulin pen. God save the dude that invented the pen! No, really. I now use the sanofi-aventis Solostar pen with a 5mm 31G needle...and cross my heart, take my eyes...it's dial up a dose, slip myself the needle (zero pain), depress the plunger and I'm off and running. Don't get me wrong...some nurse comes at me with a syringe she's gonna need a couple male nurses to hold me still, BIG male nurses with attitude, too. The pen? Piece o' cake!

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I agree, I hate needles and getting blood drawn but the pen is a thing of beauty.

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Oral meds are a guess as in, "I am taking this much of this oral med, so can I eat this many carbs?" Insulin is a much more exact drug since it gives immediate results. You take the insulin based on what you are about to eat, and your BG levels don't vary too much. If you should under calculate your insulin needs for a given meal, you take a BG reading, see that it's too high, then take a second shot of insulin and your numbers come right down.

 

As for the needles, they are so thin that you don't feel them. Of course, even the larger needles that they use to draw blood don't bother me....not since I was a kid getting my second polio vaccine and my older brother told me to just relax my arm and close my eyes tightly so it wouldn't hurt. I did that and he was right, it didn't hurt....even though the needle end came off in my arm and they had to quickly grab another syringe, screw it on the tip end that was stuck in my arm, and pull it out.:eek:

 

I do wonder though....my daughter almost passes out whenever she has a needle stuck in her. She isn't afraid of needles, but whenever she has blood drawn or she gets an injection, when they pull the needle out, her body reacts by causing her to get very lightheaded and almost passing out. They don't know why this happens, so whenever my daughter is going to have a needle stuck in her, she has a soda or some fruit juice in her hand so that she can sip on it as it's happening. This prevents her from passing out.

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