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Old 03-15-2014, 11:37   #21
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Welcome. Def get off the komb meds. Just drop them. And def get tested for type. Good luck!!

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Old 03-15-2014, 11:55   #22
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I do not plan to take the Kombiglyze XR this morning based on your advice and that of the others. I'll talk to my doctor about it this upcoming week. I'll just stick with the insulin until then.

I currently have Metformin, which the endocrinologist stopped when he put me on Kombiglyze XR. Any reason for him to do that? I understand that Kombiglyze XR contains Metformin, but what is the benefit of Kombiglyze XR alone?

Either way, I feel great this morning. I went to bed at 145 and actually woke up at 112. Generally when I sleep, I skyrocket. I suppose the insulin I take at 7PM is starting to do the trick.

Last night was the first night I slept a FULL 8-hours without waking up once!

Quote:
Originally Posted by mbuster View Post
I can't tell you what to do, but what I would do would be to get the GAD and c-peptide tests done to find out if I were not type 2. I would drop the Kombiglyze like a hot rock in either case (I was on Janumet, same type of mechanism).

If type 2 get the endo to put me just on the metformin that is the "not bad" component in the Kombiglyze. You could try the regular, and if you get digestive upsets for more than a week, request the extended release (ER or XR) version.

I said you may have to give up more than you thought on foods to keep the BG under control. I failed to mention that there would be a lot more foods to take their place, that you probably didn't eat before and some very near the real thing substitutes. I don't feel like I gave up anything, it was just a change.

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Old 03-15-2014, 13:33   #23
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Quote:
Originally Posted by knarfny View Post
Either way, I feel great this morning. I went to bed at 145 and actually woke up at 112. Generally when I sleep, I skyrocket. I suppose the insulin I take at 7PM is starting to do the trick.

Last night was the first night I slept a FULL 8-hours without waking up once!
Nothing like some initial success.

The rise in BG in the morning is caused by the liver dumping glucose into the bloodstream as part of the waking-up process. It's called dawn phenomenon (DP) and you'll find many threads about this. I believe you are correct in that the evening insulin is helping to cover the added glucose in the morning and keeping your BG level down.

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Old 03-15-2014, 19:56   #24
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In my opinion, metformin is the best and safest medication for insulin resistance, bar none. As for why doctors insist on prescribing other drugs instead of metformin, it may be because there are drug representatives visiting them day in and day out, touting all the newer drugs and their 'miraculous' benefits, and nobody is making any money on metformin. It's been around for years, the patent has long since expired, and it's one of the drugs on the $4 formulary. If I were you, I would get off Kombiglyze as soon as humanly possible, and I would insist on metformin if the doctor balks.




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Old 03-16-2014, 12:04   #25
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I stopped the Kombiglyze XR yesterday and only took my insulin last night but my numbers were high all day; without carbohydrates or sugar. I basically lived off whey protein shakes for the day because I was afraid to eat. Less than a gram of carbohydrates. I added fish oil to them to boost the fat.

I have Metformin from my first doctor but didn't want to start taking that again until I spoke with the endocrinologist tomorrow to make sure it was alright.

I'm assuming I can just put myself back on my Metformin this morning without approval from the endocrinologist since the Kombiglyze XR also contained 500MG of Metformin? The Metformin I have is 500MG.

Also, I do remember someone stating that Metformin is free for those without insurance, so you're likely right on track. I guess a lot of this is about money, which is a shame. Kind of messing with people's lives here but I guess that's another topic entirely.

Even with the insulin last night, I went to bed at 132, which was 3-hours after I ate dinner and woke up at 243. I also woke up 7 times to use the bathroom.

You don't have to answer the above regarding the Metformin, I know it's kind of sketchy to ask people for medical advice. Prior to the Kombiglyze XR and insulin, I was taking Metformin 500MG once daily.

I'm just kind of stuck until tomorrow. My endocrinologist has not been around for a week.

I should have read up on him a bit first, he doesn't have a good rating on "healthgrades.com" [Dr. Hassan Hito, MD], but I don't even know if that is accurate information.

Quote:
Originally Posted by Shanny View Post
In my opinion, metformin is the best and safest medication for insulin resistance, bar none. As for why doctors insist on prescribing other drugs instead of metformin, it may be because there are drug representatives visiting them day in and day out, touting all the newer drugs and their 'miraculous' benefits, and nobody is making any money on metformin. It's been around for years, the patent has long since expired, and it's one of the drugs on the $4 formulary. If I were you, I would get off Kombiglyze as soon as humanly possible, and I would insist on metformin if the doctor balks.

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Old 03-16-2014, 13:35   #26
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Just a note on eating lower carbs - don't just eat protein (i.e. protein shakes). Eat more fats. Fats have no impact on blood sugar. Protein in excess of what you actually need - does eventually raise blood sugar, a few hours later or overnight or the next morning (because excess protein is converted to glycogen and stored in the liver, which then converts that to glucose and puts it in the bloodstream).

I sure hope the endo is good and can help you with your insulin regime.

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Old 03-17-2014, 16:37   #27
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Metformin does not cause you to drop too LOW, which is what makes it so safe. As it was descibed to me, it tells your liver to stop producing so much glucose, and kicks the insulin in the pants to process the glucose you have better. Your Kombiglyze XR contains an ingredient that can cause your blood sugar to DROP to unsafe levels.

So if you are changing your eating habits, the Met should be fine (but that is your call to take or to discuss with your endo), as it works well in conjunction with a low-carb diet.

As for eating. Stock up on bacon and eggs. I would not consume more than 1 protien-boosting product (bar, shake, powder pancake) a day, and I usually only do it 3 times a week. But I'm about 30g carbs (no grains), 60g protein, and a bunch of fat. I count the carbs and eyeball the protein and if I'm not satisfied, eat some fat.

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TCh 196 : 146 : 208 : 211
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Old 03-17-2014, 16:44   #28
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Agreeing with Veejay.
You'll need to add fats and keep your protein levels to roughly 1-2 g per KG of lean body mass.
Good luck!
Your endo may need to up your insulin.
And don't despair.
It may take a while to get your insulin figured out.
Just do the best you can for now.

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