[KatherinePW]

After the diagnosis I decided on diet & exercise as means of controlling my bgs. For as long as I could. After 4 years of oscilatting bet 5.2-6.2, I know I have good & bad days. And tons of temptations. So I asked my dr for meds for those occasions when I can't refuse (or deny myself) some food I really should not have.

Glucophage did nothing, even at high doses , now I am reading in another tread here that it needs to build up in the system?).

Prandin- experimenting with it now, not much success. Lows after 3-4 hours ( I thought it was supposed to be short acting). Then hyper in the morning( why??).

So u can see I don't know what I am doing.... Is there such a thing as ovcassional postprandial control meds?

 

[tgreen]

i dont think you will find what your looking for in oral meds. insulin is the only thing i can think of that would do this.

 

[jwags]

You are right metformin doesn't work right away and it works in the liver not the pancreas. It takes several weeks to a month to accumlate in your system to work. Prandin and Starlix work for a specified amount of time regardless of what you eat. So they can produce lows. Fast acting insulin might work but that also could produce lows if you count your carbs wrong. I think we all want to engage in a meal we know we shouldn't but if we do we pay the price. I find the better way is just to eat a very small portion of the meal so I feel I am not depriving myself. Lots of time before I go out to eat I will eat something high fiber at home to keep my stomach full so I don't over indulge. I usually have them swap the potatoes out of the meal so I can indulge in a few bites of dessert.

 

[KatherinePW]

I'd like to understand, so Prandin is supposed to control our postprandial bgs by interfering with carb metabolism /absorption (?), and people take it before each meal, correct?
Why wouldn't it work on occasional basis?

 

[KatherinePW]

Let me rephrase my question(s):
- seems like Prandin works to control my bgs after I eat carbs most of the time. So it's a matter of proper dose and handling potential lows. I think I can do both
- why morning high? This morning it was 160, when my usual reading is bet 90-110. Something happened at night after Prandin stopped working?

 

[Shanny]

I'd like to understand, so Prandin is supposed to control our postprandial bgs by interfering with carb metabolism /absorption (?), and people take it before each meal, correct?
Why wouldn't it work on occasional basis?

I believe it stimulates the pancreas to generate more insulin. In that respect, it is like the sulfonylurea drugs, but it is supposedly faster acting. I would be leery of anything that prods my overworked pancreas to work even harder.

 

[KatherinePW]

Also - does glucophage work in skinny people? My primary said that it was designed for or works better in overweight people?

 

[Shanny]

Also - does glucophage work in skinny people? My primary said that it was designed for or works better in overweight people?

No offense to your doc, but that's a crock. Glucophage (metformin) works for insulin resistance, whether the patient is fat or thin, tall or short, male or female, old or young. When your pancreas is functioning but your cells are still starving for glucose, that is insulin resistance. Glucophage - which is the brand name for metformin - works to open up the pathways so the available insulin can be accessed by the cells.

 

[Jen]

Hmmmm. I'm not sure why weight would have anything to do with the efficacy of glucophage. Hadn't read of that before. What was your doctor's explanation for that position?

Jen

 

[smorgan]

You are right metformin doesn't work right away and it works in the liver not the pancreas. It takes several weeks to a month to accumlate in your system to work. Prandin and Starlix work for a specified amount of time regardless of what you eat. So they can produce lows. Fast acting insulin might work but that also could produce lows if you count your carbs wrong. I think we all want to engage in a meal we know we shouldn't but if we do we pay the price. I find the better way is just to eat a very small portion of the meal so I feel I am not depriving myself. Lots of time before I go out to eat I will eat something high fiber at home to keep my stomach full so I don't over indulge. I usually have them swap the potatoes out of the meal so I can indulge in a few bites of dessert.

I think this advice about just restricting portion size drastically when you can't resist is the best of all. I eat LC/HF and really only miss a few things. One of them is Medjool dates. I used to eat a dozen or more at a sitting. At 15g of carbs in EACH DATE (and much of it is fructose, a mortal enemy of mine), that is obviously no longer doable. When I really crave them, I eat JUST ONE. Even for that I pay a price. I probably accumulate some glycogen and my next morning number will probably be a little higher but man, did that one date ever taste good - worth it once in a while.

I guess you could use fast-acting insulin to intentionally "fall off the wagon" once in a while but as others have pointed out that is also fraught with risks and problems. Remember the saying, "Highs take years to kill you, but a low can kill you in only hours." On the plus side, once you have to sit down and calculate the carbs in your planned indiscretion and the units of insulin required maybe this would be a good "cooling off" period and you could stop and think about it and just overcome the urge.

 

[KatherinePW]

After reading all of your responses.... First of all THANK YOU! I was just talking to my hubby- listening with an open mind to those who live it, as opposed to just reading about it in med school, I am grateful and appreciative to have you advise me on the daily grind of living with D. Going back to my strict diet and not willing to experimenting for a while. We all know it can be tough, but as long as it works.... Not ready for insulin , no pasta is worth it as long as long as I don't need to survive it. Thanks again

Ps going out tonite. My non-D friend designs her food around me, wonderful cheesecake with minimal sugar, no flour, used to work for me. Not any longer, I can't suggest stevia, not my call . The rest of friends can barely bare her minimal cheesecake, time for me to let her know. And not have a piece tonight.

PPs. Does anyone experience the lessening effect of kick butt exercise over the years? I smoke... Is this it (ashamed, but I smoked before I was born in the 7th month).