While it is true that some people who are newly diagnosed with type 2 diabetes do not need to take medicine, there are many that do. So, it is important to understand a few things including the following: 1.) while your healthcare professional started you on a particular medicine, with changes to your meal planning and increasing physical activity, you MAY be able to reduce or eliminate those medicine. Now, this is not a guarantee and it all depends on how high your blood sugars are and what other health conditions you have; 2.) make sure you know the exact name and dose of the medicines you are prescribed; and 3.) know exactly WHAT these medicines are doing for your diabetes.
Diabetes medicines work in different ways in the body and some may have side effects. Armed with this information, you will have a better chance of working with your healthcare team to improve your diabetes control.
These two medicines are the most commonly prescribed first-line drugs given to newly diagnosed patients that are required to take medication. However, it is important to note that they work in different ways and affect your blood sugar differently. Some people are only started on one of them, but there are some people that may be on both. To understand what they do, you first need to know what is happening in type 2 diabetes. Very simplistically, the pancreas is not making enough insulin OR is making too much and the insulin is not doing it’s job correctly. In addition, the liver, our storage unit for sugar, tends to start kicking out TOO much sugar, especially overnight. Both glyburide/glipizide and metformin work on these specific issues. Glyburide/glipizide helps the pancreas make more insulin, to help increase the amount that can be used so the insulin can bring the sugar to the brain, muscles, and nerves. Metformin tells the liver to stop kicking out too much glucose, so the blood sugars do not rise as high–especially in the morning.
Each of these medicines do have some side effects, though. Because glyburide/glipizide is increasing the amount of insulin the pancreas makes, it can increase hypoglycemia (low blood sugar), especially if someone is more active or if they skip meals. While metformin does not cause low blood sugar, it can cause stomach upset and diarrhea, especially if it is not taken with food.
So, how do you reduce these side effects? Make sure you talk with your healthcare team about any problems you are having when you start taking these medicines. If taking glyburide/glipizide, be sure to test your blood sugar during the day to see how it is affecting your numbers. But, also, talk to your team about how to adjust the medicine if you are going to be more active. This could be any normal activity such as gardening or cutting the grass or walking at the mall.
When people start metformin, they tend to start on the lowest dose to make sure that it will be tolerated. So, a starting dose is one pill (500 mg), typically right before the dinner meal because of how the liver tends to kick out more sugar overnight. If stomach upset occurs by taking it before the meal, some people “sandwich” their dose by starting to eat, then taking the pill in the middle of the meal. This seems to reduce stomach upset because the food “sandwiches” the pill and keeps it from being on an empty stomach. If someone tolerates the first dose, then they are typically asked to increase the doses.
While there are many other diabetes medicines available, these are usually started first. By knowing more about your medicines, it will help you work with your healthcare team to be more successful in your overall diabetes control!
