Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
162 Doctors are Online

Diabetes type 2. Asked to take basal insulin. Accurate medication? Other medications help equally?

User rating for this question
Very Good
Answered by

Diabetologist
Practicing since : 2000
Answered : 103 Questions
Question
I am 37 years old with type 2 diabetes. My height is 6ft 2in and weight is 185 lbs. Blood pressure and cholesterol tests are normal.
     
I was diagnosed with diabetes 12 years ago. For the first 11 years, I took Glucotrol, Glyburide and Metformin at different times. The medications always made my blood sugar go too low in the mornings (below 75). So I stopped taking all medications for 10 months.

I recently visited a new doctor and had an A1c blood test. My A1c level came back as 8.3 (205). My A1c has always been slightly high, but in the 5.x range.

The new doctor wants me to take injectable Basal insulin daily for 30-days to reduce my A1c level quickly and remove the "toxic" level of sugar in my body. Then he recommended switching to oral medication. The doctor stated that Metformin or other oral medication would take 12 months to do the same job (while my body is damaged from the toxic sugar levels).

Question: Is the advice to take Basal insulin accurate? Is this typical treatment option for someone in my position? Will it really take 12 months for oral medication to do the same job? Are there other oral medications available that will work like Basal insulin?

My belief is that since I was not taking any medication at all, of course my A1c is high. If I resume the medication that keep it under control for 11 years, then my A1c should return to normal after only a few months. Thoughts?

Posted Sun, 15 Apr 2012 in Diabetes
 
 
Answered by Dr. Amit Rajput 5 hours later
Hello XXXXXXX

Thank you for posting your query on Healthcare magic.

Glucotrol and glyburide were the pills which may have caused hypoglycemia in you when you were on the medications. Currently, you seem to have 'glucotoxicity', a condition due to raised sugars in which pancreas stops producing it's own insulin.

Coming to your queries:

•     Is the advice to take Basal insulin accurate?


o     Yes.

•     Is this typical treatment option for someone in my position?

o     Ideally yes. Insulin taken for a month will lower the sugars fast. This will help in providing rest to the pancreas which in turn will start producing it's own insulin again. This will act as a primer for oral medicines to act fast and better.

•     Will it really take 12 months for oral medication to do the same job?

o     No. One to three months should suffice in ideal conditions. However, insulin for a month still sounds like a good solution as insulin will act fast and further damage to the pancreas will be prevented.

•     Are there other oral medications available that will work like Basal insulin?

o     There are other group of oral medications which can bring the sugars back to normal. You can discuss them with your doctor. But time required for their action is around 1 to 3 months during which the damage to the pancreas continues. Insulin is a better option, though not the only option as on today.

•     My belief is that since I was not taking any medication at all, of course my A1c is high. If I resume the medication that keep it under control for 11 years, then my A1c should return to normal after only a few months. Thoughts?

o     Yes. This should work as long as there is not too much damage to your pancreas. You must also discuss with your physician about prescription of the medications which would not cause hypoglycemia.

o     Further, if you experience hypoglycemia, stopping the medicines is not a good solution. The raised sugars would continue to damage to the pancreas and various organs in the body including the kidneys and the heart and the probability of various complications due to diabetes in the future increases many fold. Consult your doctor for fine tuning the dosages in case you experience hypoglycemia in the future.

Hope I have answered your queries. I will be available to answer your follow up queries, if any.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Diabetes type 2. Asked to take basal insulin. Accurate medication? Other medications help equally? 15 hours later
Due to the wonderful state of our healthcare insurance rules, I cannot see another doctor until 1/15/2012. At that time I will adopt the recommended treatment program.

Until then - is there anything I can do? I have Metformin ER 500MG 24HR Tablets and take one daily. Will it help to increase the dosage to 1000MG? (or other value)?
 
 
Answered by Dr. Amit Rajput 6 hours later
Hello XXXXXXX

Thanks for reverting.

For the time being, you can again start with Glucotrol and Metformin. You can avoid Glyburide. In case, you still experience hypoglycemia, you can stop Glucotrol. If not, you continue with both tablets till you XXXXXXX your physician.

Avoid taking a single drug like metformin which alone would not suffice.

Hope my answer is adequate and helpful to you. Please accept my answer if you do not have further queries.

Wish you Good Health.

Regards.
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Drug/Medication
Treatment/Therapy

The user accepted the expert's answer

Ask a Diabetologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor