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What Causes Uncontrolled Glucose Levels Despite Taking Metformin?
Question: I am 62 years and have been diabetic for about 15 years now. Used to be on glucovance 5/500 for several years till my doctor changed it to Amaryl 2mg plus metformin 1000mg in the morning and 1000mg Metformin in the evening. After a while my blood sugar is not well controlled especially in the morning and after lunch. My mornings now are in the range 7.9-8.6 while my after lunch(2hours) ranges 9-11. Should I change to Galvus Met? Thank you. I am 1.79 m and weighs 85 kilos.
Brief Answer:
Yes,galvus-met will help you to manage your diabetes.
Detailed Answer:
Hi dear user.
I have gone through your question and understand your concern.
Glucovance is used to treat type 2 diabetes and contains a combination of glyburide and metformin.
Amaryl is an oral sulfonylurea that contains the active ingredient glimepiride.
Your BMI is 26.5 , you are slightly overweight so you should take a hypocaloric diet.
For people with diabetes,recommended blood sugar level targets are as follows:
Before meals: 4 to 7 mmol/L
After meals: under 8.5mmol/L
You have high glood glucose in the morning and after lunch so i suggest not to change but to take triple therapy:(if you dont have kidney diseases)
Galvus-Met(50/850) and amaryl in the morning,
Galvus-Met(50/850) after lunch
Metformine 850 mg after evening
My advice is to be careful with your lunc meal,you must reduce your carb intake
(I think you will be able to take under control your diabetes ,anyway let me know if there are any problem with your blood glucose values after this changes.)
Hope I have answered your question. If you have any further questions I will be happy to help.
Thank you for using HCM.
Wish you good health.
Yes,galvus-met will help you to manage your diabetes.
Detailed Answer:
Hi dear user.
I have gone through your question and understand your concern.
Glucovance is used to treat type 2 diabetes and contains a combination of glyburide and metformin.
Amaryl is an oral sulfonylurea that contains the active ingredient glimepiride.
Your BMI is 26.5 , you are slightly overweight so you should take a hypocaloric diet.
For people with diabetes,recommended blood sugar level targets are as follows:
Before meals: 4 to 7 mmol/L
After meals: under 8.5mmol/L
You have high glood glucose in the morning and after lunch so i suggest not to change but to take triple therapy:(if you dont have kidney diseases)
Galvus-Met(50/850) and amaryl in the morning,
Galvus-Met(50/850) after lunch
Metformine 850 mg after evening
My advice is to be careful with your lunc meal,you must reduce your carb intake
(I think you will be able to take under control your diabetes ,anyway let me know if there are any problem with your blood glucose values after this changes.)
Hope I have answered your question. If you have any further questions I will be happy to help.
Thank you for using HCM.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Prasad
I think I am also experiencing the somogyi effect because often when my bedtime is below 7, after waking up the next morning it will read higher not lower than 7. It only drops when my bedtime is very high. How can I manage this phenomenon?
Brief Answer:
You should eat more in the evening to manage this phenomenon.
Detailed Answer:
Dear user
The Somogyi effect, also known as the “rebound” effect is the tendency of the body to react to extremely low blood sugar (hypoglycemia) by overcompensating, resulting in high blood sugar.
When blood glucose levels drop too low, the body sometimes reacts by releasing counterregulatory hormones such as glucagon and epinephrine. These hormones spur the liver to convert its stores of glycogen into glucose, raising blood glucose levels. This can cause a period of high blood sugar following an episode of hypoglycemia.
The Somogyi effect is most likely to occur following an episode of untreated nighttime hypoglycemia, resulting in high blood sugar levels in the morning.
My advice is to check their blood glucose levels in the middle of the night (for example, around 3 AM.(to prove if you have the somogyi effect)
If your blood sugar level is falling or low at that time, you should increase your food intake in the evening to manage this phenomenon.
(The pacients who take insulin,they should lower their insulin dose in the evening to manage the somogyi effect.)
The only way to prevent the Somogyi effect is to avoid developing hypoglycemia in the first place.
Hope this information is helpful for you.
Take care.
You should eat more in the evening to manage this phenomenon.
Detailed Answer:
Dear user
The Somogyi effect, also known as the “rebound” effect is the tendency of the body to react to extremely low blood sugar (hypoglycemia) by overcompensating, resulting in high blood sugar.
When blood glucose levels drop too low, the body sometimes reacts by releasing counterregulatory hormones such as glucagon and epinephrine. These hormones spur the liver to convert its stores of glycogen into glucose, raising blood glucose levels. This can cause a period of high blood sugar following an episode of hypoglycemia.
The Somogyi effect is most likely to occur following an episode of untreated nighttime hypoglycemia, resulting in high blood sugar levels in the morning.
My advice is to check their blood glucose levels in the middle of the night (for example, around 3 AM.(to prove if you have the somogyi effect)
If your blood sugar level is falling or low at that time, you should increase your food intake in the evening to manage this phenomenon.
(The pacients who take insulin,they should lower their insulin dose in the evening to manage the somogyi effect.)
The only way to prevent the Somogyi effect is to avoid developing hypoglycemia in the first place.
Hope this information is helpful for you.
Take care.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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