This person had stopped ACTOS, because of concerns about risk, started glipizide and then noticed an increase in blood glucose levels. There was no mention of glucophage( metformin ) being used .
I had not yet received a reply to my questions about medication history , especially regarding glucophage.
My suggestions for further discussions with her physician
Unless there is a contraindication ,Glucophage (metformin) is generally accepted as the drug of first choice for patients with type 2 diabetes.
My suggestion is that this person talk with his / her physician about the possible use of metformin with glipizide. This combination may be effective in correcting blood sugars but the glipizide does increase hypoglycemia risk. The risk is the highest in late afternoon and the early morning hours , 2 to 3 AM.
Glucophage combinations with almost no risk of hypoglycemia
There are other combinations with metformin that may be more effective without the risk of hypoglycemia.
Metformin plus a DPP-4 inhibitor ( Januvia , Onglyza or Tradjenta )
Metformin plus a GLP agonist such as Byetta, victroza or once weekly Bydureon
I have attached previous post that may improve your understanding of glucophage, DPP-4 inhibitors, GLP-1 agonist , sulfonylureas and lizard spit.
I have attached previous post that may improve your understanding of glucophage, DPP-4 inhibitors, GLP-1 agonist , sulfonylureas and lizard spit.
Sulfonylureas are still controversial
Have fun Be smart and study your medication options before your next doctor visit
Merry Christmas
David Calder,MD
No comments:
Post a Comment
Your comments and questions are appreciated. David Calder,MD