Glyburide-long term

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Question:

Jack, according to ADA book i have, 50% of folks on long term glyburide build a resistance to it. You might also make sure you don’t have an infection. I had to start taking some insulin with my glyburide. Hope this helps. – Hide quoted text — Show quoted text – Does one build up resistance eventually to this type medication or is something else going on. My weight has stayed about the same, I excercise rigorously 3 times a week (2 hour sessions of aerobics and strength training) and I am 57. Any comments would be appreciated. Jack McElhaney

Response:

With exercise, I got 7 years out of glyburide alone. The time frame and description of your problems sound the same. Avoiding insulin just got harder for you. To try and avoid going on insulin, try several other orals first. The two that differ the most and have a good chance are Rezulin and Glucophage. Discuss it with your doctor and make sure there is a understanding that you want to make insulin the last choice. And, even if you go on insulin, you want to continue to try new treatments as they become available. But, if it comes to insulin, don’t tolerate poor control to avoid it. It’s easy to do and get used to. My hardest problem was members of the family and their remarks. Easy to handle by not injecting in front of them. Their experience with needles is the giant things used for injections, they don’t understand. For me, Glucophage bought me nearly a year, Rezulin was not yet out, so I went on insulin. We have since added Rezulin as it does help me, unfortunately not enough to drop the insulin. I’m also back to my 1.25mg Glyburide twice a day that I had for 7 years. It still has about the same effect it aways did, that’s just not good enough by itself now. Attempts to remove the Glyburide require that I take 10-20 units more of supplimentary insulin to compensate. Does one build up resistance eventually to this type medication or is something else going on. My weight has stayed about the same, I excercise rigorously 3 times a week (2 hour sessions of aerobics and strength training) and I am 57.

The thing to realize about Type 2 is that it’s a genetic fault causing the glucose transport across cell walls to be impared. Type 2 is progressive, meaning it gets worse with time, no good explanation, but it could just be aging. All the glyburide is doing is increasing your insulin supply by a small proportion in order to force enough glucose thru the transport. Extra insulin can do this up to a point, so it works for a while. But, the transport problems get harder and you reach a limit of the effect of insulin you can produce. Going on supplimental insulin is just that, supplimenting your natural supply. It does not go away because you went on insulin. I suppose the terms building up resistance could be used. That’s certainly what’s happening at the cell walls. There is far less of a case for tired islet cells, although that’s frequently assumed without evidence. The orientation of the medical community around Diabetes is locked on insulin. Many cannot seem to think of a explanation that does not make the insulin supply the centerpiece. Unless, maybe it’s weight with Type 2’s, another red herring. Of the two choices I gave you, Rezulin is the one that is supposed to directly work on the transport end. Glucophage works primarily by rejecting sugar intake (in the gut) and restricting the liver’s ability to put sugar in the blood stream. When it came out, it was also promoted as helping the transport, but that seems to be pretty minor if it exists at all. The other effects can be useful, but it’s treating a symptom, not the cause. It’s one of the drugs that I lump in the treatment by starvation group in my personal system of viewing the various drugs. Walt

Response:

I don’t believe this is an unusual occurrence for any oral medication. My physician explained that it just depended upon the person, each is different. I lasted three years on oral medications (the last year not being in control) before I had to switch over to insulin. My father was on oral agents for about 10 years and had to be hospitalized for a foot infection and was switched to insulin at that time. My physician tried me on other types of orals to no avail, said that sometimes just a different one would work better. Gin

– Hide quoted text — Show quoted text -I have been on glyburide for amost 10 years. Within the last 6 months I have had to increase it from 2.5 a day to 15mg now and blood sugars are still high. I don’t want to go on Insulin (but nobody does). Does one build up resistance eventually to this type medication or is something else going on. My weight has stayed about the same, I excercise rigorously 3 times a week (2 hour sessions of aerobics and strength training) and I am 57. Any comments would be appreciated. Jack McElhaney

Response:

I have been on glyburide for amost 10 years. Within the last 6 months I have had to increase it from 2.5 a day to 15mg now and blood sugars are still high. I don’t want to go on Insulin (but nobody does). Does one build up resistance eventually to this type medication or is something else going on. My weight has stayed about the same, I excercise rigorously 3 times a week (2 hour sessions of aerobics and strength training) and I am 57. Any comments would be appreciated. Jack McElhaney

Response:

From what I have read, this is not an uncommon occurrence. Glyburide works by stimulating the pancreas to produce more insulin and one of two thintgs can happens: either your pancreas is no longer capable of producing tthe needed insulin or your body becomes more insulin resistant,

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