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May 16, 2003

Pills for Diabetes

Question from Van Nuys, California, USA:

I am a 38 year old female who has had type 2 diabetes for three months, and because diet and exercise didn't lower my blood sugar, my doctor put me on Glucophage twice daily. I had high morning fasting readings so we increased to three times per day, but my morning readings are still high. I know it's not the dawn phenomenon because I tested for three days at 3:00 am and did not experience a low, so its also not a rebound effect. Should I take a fourth Glucophage just before I go to bed to keep the medication in my system on a 24-hour basis? Does Glucophage only work when eating a meal (i.e., lunch or dinner)?

Answer:

It is unlikely that the Glucophage [metformin] is not at high enough concentrations in your blood. Given just twice a day, this should be adequate. In addition, the manufacture of Glucophage has now made an extended release version of the drug that can be given only once a day. If your dose is over 2 grams per day, it is probably appropriate to add an additional agent. This should be discussed with your physician.

JTL