June 18, 2001
Daily Care, Type 2
Question from Cornelius, Oregon, USA:
I have type 2 diabetes, and I currently take glyburide and Amaryl twice a day to control my blood sugar, but I think I may be becoming resistant to my medication because lately my blood sugar has been staying in the 200+ mg/dl [11.1 mmol/L] range. Are there other medications that would work better for me? I cannot take Glucophage [metformin] as it gives me constant diarrhea.
It is quite usual for people with type 2 diabetes to need more medication to control their blood glucose as time goes on. There are several other medications available other than the ones you are taking. Both the glyburide and Amaryl [glimepiride] which you are taking are sulfonylureas, which work by helping the pancreas to produce more insulin. It might be better to have you take a medication that works through a different mechanism, such as decreasing insulin resistance, instead of one of the ones you are taking. You should check with your doctor about what medication regimen would be best for you. This may take some time to see how you respond to different medications. If the glucose levels cannot be controlled with oral medications, insulin injections may need to be considered.
[Editor’s comment: It’s not clear whether you have been seeing a diabetes team, but if not, you might ask for a referral.