I was recently diagnosed with type 2 diabetes. I am taking 10 mg of glipizide and 500 mg of metformin twice a day. My A1C was 12.5, but I have been feeling better, and I even stopped taking the glipizide every morning. My blood glucose average is now 170. Is that good, or should I continue to take my glipizide every morning?
Rhonda Woods, Chicago
Craig Williams, PharmD, responds: Unfortunately, the medications that are used to help manage blood glucose in people with diabetes do not fix the underlying causes of the diabetes itself. As a result, the medications generally cannot be stopped without losing the blood glucose control that they were providing.
Lifestyle changes can alter the need for long-term medications, and sometimes enable people to stop taking them altogether. For those who have lost a substantial amount of weight or have significantly increased their exercise routines, it is not uncommon to be able to reduce the dosages of medications, or even to try stopping medication for a period. Reducing or stopping your therapies, however, should always be done under the supervision of your health care provider.
When we do stop therapies or reduce the dosages that are used, our goals for good control remain at an A1C of less than 7 percent, a fasting morning blood glucose below 130 mg/dl, and random or post-prandial (after eating) blood glucose levels not above 180. If those targets can be maintained with lower doses or no drugs at all, then it is safe to change your regimen. Because your A1C and average blood glucose are not in those ranges, you probably need to start your medication again to achieve better blood glucose control.