I have been a type II diabetic for 5 years. The past two years I have taken glucotrol 5 mg and immediately put on 15 pounds.

My doctor has talked to me and tried me on several meds that work to help your boby sensitize insullin better. Actos, I was on a month, but felt really yucky the whole time, Avandia I could only take two days, I was so sick I don't even remember those two days.

I had tried glucophage at one time, the doctor switched me for a week from glucotrol to glucophage -- I immediately dropped 10 pounds but was ill a lot, had trouble eating because I was so nauseous, so went back on the glucotrol and yep, gained the weight back.

My doctor has said that glucotrol will make me retain fat, and I have read a lot on it and find that to be true. I read somewhere on this site where someone said it took a couple of months to get used to the glucophage.

What I am thinking is on my next visit (in a few weeks) is to try the glucophage xr, but ask if I can introduce it in my system slower and go off the glucotrol like he has talked to me about. I also read to take it with your evening meal, previously I take all meds in the morning -- would this help with nausea?

I know I will need to stay on something until I get my sugars lower and stabilized there and I know lowering the pounds will help in that.

My weight has fluctuated, but I am now at a 1 pound loss, and I am hoping changing the meds will help me all the way around.

Any input would be appreciated.

Hi Debi,

It might have been me you 'heard' saying it took me a couple months to adjust and be comfortable with glucophage. FYI, I take a 500 mg tablet with breakfast, dinner & at bedtime. 1500 mg is the maximum dosage and spreading it out over the day is the most beneficial way, which is true for most drugs, unless they have a time release delivery system.

I've never used the newer meds & know nothing about them. I'll bet that doreen T will be around before the weekend is out and she'll be able to give you great info and point you in the right direction.

Good luck with the Dr.

Unfortunately, nausea, stomach upset and diarrhea are common side effects of metformin/glucophage. It's not an allergic reaction though, and apparently the symptoms are transient, meaning the body adjusts and they resolve on their own over time. The usual recommendation is to start at a low dose and work up, and to take with food. There's no difference between the xr and the immediate release forms regarding the side effects

Apparently 1500mg per day is the MINIMUM effective dose, and may be up t 2550mg depending on response, ie .. blood sugar control and HbA1c (glycosylated hemoglobin, which indicates peak blood sugar levels over a period of 5 - 6 weeks). The glucophage can be used in combination with the glucotrol or other sulfonurea-type hypoglycemic drug until your blood sugars are under control.

Glucophage/metformin really would be the drug of choice, if you could somehow tolerate the side effects at the beginning. Maybe the dr. could prescribe an anti-nausea medication that you could take for the first few weeks, to get you over the "hump".

Glucotrol and other sulfonylureas lower your blood sugar by stimulating the pancreas to pump out more insulin. It's the extra insulin that causes increased fat storage, and also prevents fat from being lost. Plus over time, the cells become more and more resistant to the excessive insulin.

Metformin works by decreasing insulin resistance, so less insulin gets pumped into the blood. Less insulin means fat isn't being stored, and your body can actually lose fat. It also slows the absorption of glucose from the intestine, and it inhibits the liver from producing glucose (glycogen). It will even help to reduce cholesterol and triglyceride levels .. I guess the unpleasant side effects are the trade off. As well, if you have existing kidney and/or liver disease, metformin may cause a toxic buildup of lactic acid in the blood, which can be fatal.

Here is an online version of the patient information/package insert for metformin/glucophage.

Doreen

Thank you for all the information and the link to the glucophage information. It gives me a lot to consider before my appointment but I'll go in feeling much more informed about making a decision.

Debi ... I understand exactly the confusion and don't know if this will help, but I would like to share some of my journey.

You might remember me as the ranting, 'out of control' diabetic who never responded to your most appreciated and heartfelt reply. I was going through one of the most difficult times in all my 20 years of dealing with this disease.

For many years I took all the meds that the doctors threw at me including the ones to activate my pancreas and sensitize my insulin receptors and whatever other story they told me. Add to that buckets of insulin, N R H ... whatever. ADA diet, weight watchers, yada yada yada. Never could keep glucose levels under 200 for more than a few hours.

Then came low-carbing. I actually lost about 10 pounds with this WOE and still had high blood sugars. A month ago I began to try a few days of one or the other combination of meds and saw my glucose levels go from 'not so great' to 'way high.' Out of frustration I just stopped taking all the pills and began covering my meals with humolog. I seem to be doing alot better these days. I can't say that this is a permanent solution for me but think I can manage like this for a while and then add some long acting insulin to the mix. I am certainly finding my glucose levels under 200 more than over and am now aiming for 150. Preprandial readings (except for breakfast) are under 150 and things just seem to be working better for me.

So, for me, the control that the humolog affords is exactly what I need right now. Seems like the meds just compounded my problems. Just some grist for the mill, I guess ... go figure!

--Gaius--

Thanks for your reply -- diabetes can be a puzzle sometimes, what I'm dealing with now is my sugars are responding well, but my weight is not moving at all. The doctor has told me the med I am on does cause you to hold fat and we have seen no change in my weight for several months now.

He has wanted to change me from something not making my pancreas pump more insullin to something making me more sensitive to the insullin my body is producing. He says once I begin to lose weight it will make a difference, and I do know that.

That is one reason I'm going to go in and ask to be changed from the glucotrol to the glucophage for a time. I don't think he would think of me not having any meds at this time and I've read a lot about insullin also making you hold fat -- he said there is a newer insullin that doesn't, but I'm needle phobic too.

I am hoping once I start losing weight I can take less and less meds until hopefully I can be med free -- that has always been my goal.

Thanks for the info -- I read everything I get my hands on just to try and get a better understanding of what my body is doing and why -- it is interesting to hear the different things that work for others and to try and see how those work for me.

I do the best when I stay with simple meals, meats, eggs, lots of veggies. I am having some yellow apples with cheese on occasion and some seeds and nuts on occasion.

This way of eating has really helped me with my diabetes and I've read where others have responded so well as to not be on any meds and that is so encouraging to me.

So onward, I go in next week for bloodwork and then the doctor's visit.