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December 7, 2003

Pills for Diabetes, Type 2

Question from Erie, Pennsylvania, USA::

I was diagnosed with Type II Diabetes 10 years ago. I've been able to keep by blood sugars in control wit Glyburide (1.5 mg/day). The past year by A1C results have consistently been climbing from 6.3 to 7.0 and now 8.5 even after my doctor has doubled by Glyburide. He has now put me on Actos and I've read a lot about its effectiveness, but I've also read that after 10 years (at least before Actos and other similar drugs) that not much change can be expected. Perhaps Actos is different and can help get my blood sugars down where they belong. I do all the right things -- diet, exercise, etc. Any information you can provide will be most appreciated.

Answer:

Your doctor is smart to put you on a second agent that will enhance the effect of the insulin secretagogue you are already taking. The glyburide helps you make more insulin and the Actos makes the insulin more sensitive in the muscle and fat cells. They can work together to help bring your A1Cs back down. The only problem you may have is that you cannot make enough of your own insulin to do the job. This happens over time when you have Type 2 diabetes. If that is the case, your doctor may want to start you on insulin or try an additional agent such as metformin which will also make your insulin more sensitize, especially in the liver.

JS