WENT TO ENDOCRINOLOGIST TODAY.
"well, i went to dr. today. had his associate dr. a lady. she said i
shouldn’t
have had those severe lows with byetta and is taking me off of it. we
think it
may have something to do with me taking a beta-blocker which masks the
symptoms
of low blood sugar. she is putting me on januvia 50 once a day and still
the
glipizide twice a day. we both agreed my diet needs to be better so she is
sending me to a nutritionist for help with food choices. i will let you
all
know how i make out. god bless you all……………….baz"
My thought is that the glipizide in combination with the byetta is the
source of lows. It prompts the release of insulin regardless of glucose
levels. In most people byetta causes a release only when glucose reaches a
certain level.
Adding the two together caused too much insulin to be produced with the
after meal glucose rise. My first approach would have been to reduce or
toss the glipizide instead of not using byetta.
In this case the 50 mg januvia will be almost the same as the 100 mg pill.
In a person without kidney problems both doses cause an insulin release at
a similar level when a certain glucose level is reached. The 50 mg dose
lasts at full effect for 12 hours while the full dose for 24 hours. You
will still want to look for lows when the glipizide effect is added to the
januvia effect after meals.
As for food choices, except at the most general level only you can
determine which foods to eat to reach your glucose level goals. A periodic
visit to a doc or nutrition person is unable to do this. You must do this
by testing after meals to see which foods and in what amounts cause what
post meal glucose levels. It is only this kind of day to day knowledge for
you to correct what you eat that will control glucose levels.
In the end the hard fact of a diabetics life is that they are in control of
their treatment and not the doc or other advice sources. Going to a doc
every 3 months or so to learn that poor food choices of some kind in some
unknown amounts did not work as reflected in the a1c number is worthless
for the day to day and meal to meal decisions that only post meal testing
can provide you and only you.
A dietperson can do no better unless the general information they can
provide is confirmed for you as a specific example by post meal testing
that you and only you can do.
There are rules of thumb for post meal levels as goals and ways to achieve
them. If you are interested we can discuss them in your case for you to
try until you learn what carb laden foods in what amounts you can consume
and still balance it with the insulin you are producing.
I hope I have not offended, in my opinion too often docs and others are not
willing to tell diabetics the hard facts of life but do then no favor in
the end.
March 31st, 2007 at 2:00 am
dan, thanks for all the info, however, i did continue with the byetta and
stopped glipizide and still had the lows. dr. said maybe this isn’t the right
drug for me and started the januvia with the glipizide. today is my first day on
it. i did pretty good. my eating habits were very poor and i ate whatever i
wanted regardless of bs. now i an very aware and test often. i know a little
about what makes my bs rise and what doesn’t. it is hard for me to break the
eating habit as i am a foodaholic and eat almost continuously from supper on. i
am trying to limit my intake as best i can. that is why i liked the byetta, it
made me full and not want to eat as much………………..baz
My thought is that the glipizide in combination with the byetta is the
source of lows. It prompts the release of insulin regardless of glucose
levels. In most people byetta causes a release only when glucose reaches a
certain level.
Adding the two together caused too much insulin to be produced with the
after meal glucose rise. My first approach would have been to reduce or
toss the glipizide instead of not using byetta.
In this case the 50 mg januvia will be almost the same as the 100 mg pill.
In a person without kidney problems both doses cause an insulin release at
a similar level when a certain glucose level is reached. The 50 mg dose
lasts at full effect for 12 hours while the full dose for 24 hours. You
will still want to look for lows when the glipizide effect is added to the
januvia effect after meals.
As for food choices, except at the most general level only you can
determine which foods to eat to reach your glucose level goals. A periodic
visit to a doc or nutrition person is unable to do this. You must do this
by testing after meals to see which foods and in what amounts cause what
post meal glucose levels. It is only this kind of day to day knowledge for
you to correct what you eat that will control glucose levels.
In the end the hard fact of a diabetics life is that they are in control of
their treatment and not the doc or other advice sources. Going to a doc
every 3 months or so to learn that poor food choices of some kind in some
unknown amounts did not work as reflected in the a1c number is worthless
for the day to day and meal to meal decisions that only post meal testing
can provide you and only you.
A dietperson can do no better unless the general information they can
provide is confirmed for you as a specific example by post meal testing
that you and only you can do.
There are rules of thumb for post meal levels as goals and ways to achieve
them. If you are interested we can discuss them in your case for you to
try until you learn what carb laden foods in what amounts you can consume
and still balance it with the insulin you are producing.
I hope I have not offended, in my opinion too often docs and others are not
willing to tell diabetics the hard facts of life but do then no favor in
the end.
XB
IC|XC
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