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Have Diabetes, Put On Metformin, Glyburide And Acarbose. Sugar Reading Is Still Very High. Advise?
Hi, thanks for using healthcare magic
Most adults , unless diagnosed as a child , are type 2 diabetics.
In type 2 diabetes the person is resistant to their own insulin.
Insulin is secreted from the pancreas. In diabetes more than a normal amount of insulin is needed to reduce blood sugar because the body is fighting it.
AS a result the pancreas has to work hard releasing increasing amounts of insulin.
Over the years, the exact time frame depending on how hard the pancreas had to work, the pancreas starts to burn out.
This means it starts releasing less and less insulin.This is the reason that most diabetics may end up on insulin for control of blood sugars.
It is not that your body is not tolerating the medications, the medications may just have less insulin to work with.
Metformin, one of the medications that you are using, helps reduce insulin resistance and therefore helps the pancreas to work a little longer.
Your doctor may consider different options: (1) maximise the dose of your medications if you can tolerate it, for example the maximum dose of metformin is 3000mg a day
(2)Add another medication such as a GLP agonist. This would include medication such as exenatide and liraglitude. These work differently from the medications you are on to reduce blood sugars.
Another type of medication are the DPP - example januvia
(3) Start insulin. After 22 yrs, there may be some burnout and insulin may be needed now or soon depending on if you can achieve control other wise. Our bodies were born with insulin and if it is burning out you may need it. It would provide good control
(4) each of the above should be associated with a healthy eating program and exercise. Your doctor may know a nutritionist who may be able to give you advice.
I hope this helps, feel free to ask any other questions
Most adults , unless diagnosed as a child , are type 2 diabetics.
In type 2 diabetes the person is resistant to their own insulin.
Insulin is secreted from the pancreas. In diabetes more than a normal amount of insulin is needed to reduce blood sugar because the body is fighting it.
AS a result the pancreas has to work hard releasing increasing amounts of insulin.
Over the years, the exact time frame depending on how hard the pancreas had to work, the pancreas starts to burn out.
This means it starts releasing less and less insulin.This is the reason that most diabetics may end up on insulin for control of blood sugars.
It is not that your body is not tolerating the medications, the medications may just have less insulin to work with.
Metformin, one of the medications that you are using, helps reduce insulin resistance and therefore helps the pancreas to work a little longer.
Your doctor may consider different options: (1) maximise the dose of your medications if you can tolerate it, for example the maximum dose of metformin is 3000mg a day
(2)Add another medication such as a GLP agonist. This would include medication such as exenatide and liraglitude. These work differently from the medications you are on to reduce blood sugars.
Another type of medication are the DPP - example januvia
(3) Start insulin. After 22 yrs, there may be some burnout and insulin may be needed now or soon depending on if you can achieve control other wise. Our bodies were born with insulin and if it is burning out you may need it. It would provide good control
(4) each of the above should be associated with a healthy eating program and exercise. Your doctor may know a nutritionist who may be able to give you advice.
I hope this helps, feel free to ask any other questions
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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