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ok Hubby was put on Glyburide - Metformin almost 2 weeks ago. The Dr wrote the Rx for 2/500 tabs in the morning and 2/500 tabs in the evening BUT said to start out taking one/one (guessing to not hypo?) Well his sugars have came down but still running 140-150 most of the time. Do you think we should up it to 2and2 like the Rx says or should we give it more time. To me it sounds like a lose/lose situation. Glyburide is bad for the pancreas but if he don't take it his liver dumps and has High readings in the AM. Your 2 cents is much appreciated :)

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I can't speak to dosing on that med as I take just metformin. When diagnosed, my numbers were quite high so they also gave me a sulfonylurea (glipizide) to take along with the metformin. Soon, I got off the glipizide, but the high dosage of metformin gave me brutal gastric side effects. Perhaps that's why his doc wants him to titrate the med. If he's having no side effects, I'd suggest calling his doc to see if it's okay to increase dosage (maybe adding one more vs 2 more?)

In the long run, I'd talk to his doc about taking just the extended-release metformin w/out the glyburide. The XR version is gentler on the gastric system and I'm not sure why all docs don't prescribe it vs the regular.
 

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I am just on the Metformin alone but I take the maximum dose 2550 mg. It takes that amount to control my liver dumps. Metformin builds up in your system slowly over a month or so. Your husband may find at the smaller doses of metformin it is not enough to lower bgs substantially. The glyburide part should work immediately since it signals pancreas to overproduce insulin. That is where the problem tends to be. In some people it may burn out beta cell function quicker because of the high insulin production. The higher insulin levels may also make him more insulin resistant, so it is like a Catch 22.
 
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