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Vakul Aren
Vakul Aren, Doctor
Category: Endocrinology
Satisfied Customers: 4157
Experience:  MBBS,DTM&H,34 years of experience
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THe MD switched to Glipizide ER 10mg instead of 2.5 single

Customer Question

THe MD switched to Glipizide ER 10mg instead of 2.5 single tablets 3x daily of which i was giving dad 2 per day since he mostly eats two meals. I did not get to the pharmacy in time to get the new 10mg tablets but i have two pills left from an old prescription from Dec when he was using this prescription before getting the smaller individual ones. Can i admin the 10mg tonight since his BS test was 235 at 8pm three hours after eating..... I forgot to tell the dr that my dads morning BG reading is approx 120 - 145 from using 2 Glip tabs each day. I use low carb diet except for when my dadd goes to the senior center where they pass out candy cake chips and jelly crackers juice and can not refrain from stopping other elders from bringing their snacks to share. By giving the glipizide 10mg tonight, will that bring his blood sugar dangerously low overnight and make him dizzy if he goes to the bathroom during the night? He just had honeydo melon at 8:45pm and i gave a tsp of fish oil. SHould i just give some cinnamon capsules, and a spoon of coconut oil instead of the glipizide and start in the morning with the Glipizide?.
Submitted: 1 month ago.
Category: Endocrinology
Expert:  Vakul Aren replied 1 month ago.

Hello,I am Dr. Aren and i will help with your query.Glipizide can be taken once before breakfast instead of twice daily with meals.An Extended Release (ER) tablet will release the drug slowly reducing the chances of sudden lowering of blood sugar.You can give him one of the old 2.5 mgm tablets now and start the 10 mgm ER tablets from the morning.This drug can initially be started in divided doses initially and later be given as a single morning dose.Giving him a 10 mgm dose now and repeating it in the morning may cause double dose effects in the morning increasing risk of hypoglycaemia.

Customer: replied 1 month ago.
I don't have any 2.5 anymore. What will happen overnight if I give nothing and just start tomorrow am . We are doing two eggs, or 30-40 grams of protein and low starch veggies, and fat in the first meal and then it's FDA approved senior meals which creates the highest blood sugar results as it leaves no playing room for snacks that the friends pass around.
Customer: replied 1 month ago.
FDA senior center food at noon
Customer: replied 1 month ago.
The juices, low fat milk, puddings, potatoes and rolls leave no wiggle room in addition to zero or low fat in the lean meal
Expert:  Vakul Aren replied 1 month ago.

If you give no antidiabetes drug tonight,no harm will come to him.You can then start the drug in 10 mgm Er dose from the morning.

Customer: replied 1 month ago.
Even if he had the last 2.5 glipizide last night
Customer: replied 1 month ago.
Why is it not worrisome?
Expert:  Vakul Aren replied 1 month ago.

The blood sugar levels are high but not very high,thie bloos sugar will soon be controlled by the increased dose of the drug.KIt is best to avoid night time dosing of Antidiabetes drugs as night time hypoglycaemia can be very dangerous.

Customer: replied 1 month ago.
Thank you so much i did not know that about night time hypoglycemia....
Customer: replied 1 month ago.
Can you clarify one more thing that confuses me?
ONe doctor said my father is ok to have blood sugar at 180, but the other doctor said no more than 100... who is right? and why the conflict?
Expert:  Vakul Aren replied 1 month ago.

The blood sugar range which would be acceptable would be 90- 120mgm fasting blood sugar,Post prandial blood sugar can range from 130-180mgms.So both would appear to be right in their own way.

Customer: replied 1 month ago.
if post eating blood sugar remains around 260 for a while or sometimes 300 after two three hours whether on a 2.5 pill of glipizide and other times NOT on any glipizide..... yet slowly goes down, What does that do to the body if the meal had protein, veggies, fats mixed in with the simpler carbohydrates under the same two different situations? One with the glipizide and the other without.
Expert:  Vakul Aren replied 1 month ago.

Ideally the blood sugar control should be good and the blood sugar after meals should not exceed 160-170mgm,occasional reading above the mark can be excused .Uncontrolled blood sugar peaks for longer periods persistently will cause rapid microvascular damage to the eyes,heart and kidneys apart from damage to other organs.THe type of foods which are unhealthy like simple carbohydrates and sugars can cause the most harm.

Customer: replied 1 month ago.
I forgot to ask if the morning meal is a protein and saucy veggies, would starting out with a 10 mg glipizide be a waste or should it be consumed later wth the lunch meal .
Expert:  Vakul Aren replied 1 month ago.

Glipizide 10 mgm can be taken once a day as it will perform as well as the lower dose taken thrice daily.Ideally it should be taken before breakfast if a single dose needs to be used.This has been confirmed by various trials.

Expert:  Vakul Aren replied 1 month ago.

Do you need any more information before rating my answer?

Customer: replied 1 month ago.
My dad is famished now and that was not the case before. If a person has a low carb diet, using protein and low starch veggies, is it possibly NOT a good thing to use diabetic medications ? What needs to be understood because sometimes my dad only has his breakfast at lunch time because he is not hungry in the AM... So this kind of throws things off.
Expert:  Vakul Aren replied 1 month ago.

A balanced diet would be the best,preferably low fat and low in simple carbohydrate will be fine.Kindly rate my answer as 4 or 5 stars thank you.I will be available to answer any follow up queries after that.