Quote from Hoozdo
Well, I just got home from work and glucose is my predictable 98 on my usual food with no glyburide. Your post is extremely helpful to me. I am on glyburide because my transplant center told me (7 years ago) that it is the only hyperglycemic that is easy on the liver.
I am thinking now that I probably need an endocrinologist appt. Your drug suggestions are certainly things I can suggest.
PS - dose of glyburide is 10 mg BID. I can't take any within 24 hours of working or I will go hypo. It is easier to deal with insulin than what I am doing now....which is basically starving to control my glucose at work!
The new drug, Januvia, has no contraindications or dose adjustments based on liver function. Dose is 100 mg daily taken without regard to meals. Also can be used it pts with renal failure (reduced dose). Action of Januvia is glucose dependent, so will not produce hypoglycemia. This might be a good drug for you.
Your glyburide dose is max allowable dose. Dose can be as low as 1.25 mg up to max of 20 mg/day. Rx info from PDR states can be given once daily for doses up to 10 mg/day. Higher doses can be divided and taken with breakfast & dinner. My question is if you have had low BG, why are you on max dose? Why couldn't you take 2.5mg, eat breakfast, and go to work Does have note to give at lower dose with decreased renal or hepatic function (similar statement is in PDR info for Actos).
Insulin is actually more flexible than oral antihyperglycemics. Dose can be adjusted in very small increments depending on ac BG and amt of carbs in meal. Best would be Humalog, Novolog, or Apidra before meals and Lantus at bedtime. But there are more choices (of po meds) available to you other than glyburide. Check BG 2 hrs after start of meal to assess response to meal.
Have you always been so thin? Was any wt loss related to very high BG at some time in the past (onset of DM, for example)? Is it hard for you to bring food from home (fruit, cheese & crackers or pita bread, 1/2 sandwich or yogurt? You certainly owe yourself a more healthful, less restrictive diet!