I’m 56, have had type 2 diabetes for about two and a half years, and I have recently switched from premeal Prandin to twice daily Avandia. With Prandin I was always tired and got cramps in my feet and calves at night. I now have much more energy and stamina, but I also have had a six to seven pound weight gain which I can’t seem to get rid of. Any suggestions? By the way, I’m very active as it is.

Avandia [rosiglitazone] and Prandin [repaglinide ] have different mechanisms of action for lowering blood sugars. Avandia improves your body’s response to the insulin you make. Prandin increases insulin secretion at the time you take it, through your body’s own secretion of insulin.

I have no answer about the cramps at night, other than it may be a unique side effect of the drug. The only way to know for sure is to re-challenge you with the medication.

The weight gain with Avandia is an issue. It seems that the adipose tissue is the tissue that is significantly changed in its ability to take up glucose. Therefore, it is not a surprise that patients gain weight on the medication. This is less weight gained, compared to patients with type 1 diabetes who initiate intensive insulin therapy. Keep working on diet and exercise.

JTL