Glipicide user, 5 mg. Take prior to eating

by Noreen
(Park Ridge, IL 60016)

For sometime now I’ve had extreme bouts of diarrhea, prior to this I was on metformin with even worse diarrhea. I told my dr. I wanted something that wasn’t going to hit me like this.

That’s when I started glipicide which didn’t bother me for some time- then the bouts started again. I saw my gastro dr. who says I should take Imodium 2-3x a day when bouts ensue.

I’ve had a colonoscopy that i feel wasn’t conclusive. I’d like to know if it’s the diabetic med or something else.

It is difficult to go out anywhere when you never know if you’re going to have an accident or stomach pains. This is demoralizing and I want it to stop. I was also told I have a weak spincther muscle. Is there no cure? Or treatment?

I’ve been on different meds for about 5 yrs. and I’d like to be off them; with some of the side effects, I’m reading about. Even with all the BMs I’m not losing weight and I really only eat one meal a day.

My sugar isn’t terribly high, but if my pancreas isn’t right I need to know why I’m told I’m insulin resistant. Thanks.

Answer by Dr. Albana Greca, MD, MMedSc

Hello,

I read your message carefully, and I understand how upsetting this has become for you. Frequent diarrhea, stomach pain, and fear of having an accident can affect your work, travel, social life, and emotional well-being. This is not something you should simply tolerate without a proper review.

First, the correct medicine name is glipizide, not “glipicide.” Glipizide belongs to a group of diabetes medicines called sulfonylureas. It helps the pancreas release more insulin and is usually taken before a meal, exactly as prescribed by your doctor.

Could Glipizide Be Causing Diarrhea?

Yes, it is possible. Diarrhea can occur as a side effect of glipizide, although it is more commonly linked with metformin side effects. Because you had worse diarrhea on metformin and now have bouts again while using glipizide, your diabetes medicine plan should be reviewed.

However, diarrhea may also come from causes unrelated to glipizide, such as irritable bowel syndrome, infection, food intolerance, bile acid diarrhea, thyroid problems, pancreatic enzyme problems, inflammatory bowel disease, microscopic colitis, diabetic autonomic neuropathy, or other medicines and supplements.

Do Not Stop Glipizide on Your Own

Please do not stop glipizide suddenly without speaking with your doctor. If you stop it without a replacement plan, your blood sugar may rise.

Instead, contact your diabetes doctor and explain clearly that the diarrhea is affecting your quality of life. Your doctor may consider changing the dose, changing the timing, switching to another diabetes medicine, or checking whether glipizide is still the best option for you.

The safest choice depends on your HbA1c, kidney function, weight, age, heart history, risk of low blood sugar, other medicines, and your usual eating pattern.

One Meal a Day Can Be Risky With Glipizide

You mentioned that you usually eat only one meal a day. This is important because glipizide increases insulin release. If you take glipizide and then eat very little, you may be at higher risk of low blood sugar.

Please discuss your eating pattern with your doctor. You may need a diabetes medicine plan that matches your real daily routine, not an ideal meal schedule that you cannot follow.

What About Imodium?

Imodium may help reduce diarrhea during flare-ups, and your gastroenterologist has advised it. But it is still important to find the cause of the diarrhea instead of only controlling the symptom.

You should contact your doctor urgently if diarrhea comes with fever, blood in the stool, black stools, severe abdominal pain, dehydration, unexplained weight loss, or diarrhea after antibiotics.

Weak Sphincter Muscle: Is There Treatment?

Yes. A weak anal sphincter can cause bowel leakage or accidents, but there are treatment options. Depending on the cause and severity, your doctor may recommend:

• Pelvic floor exercises


• Biofeedback therapy


• Bowel training


• Diet and fiber adjustment


• Medicines to make stools less loose


• Referral to a colorectal specialist


• Procedures or surgery in selected cases

Ask your gastroenterologist whether you need anorectal manometry, pelvic floor testing, stool tests, or referral to a pelvic floor therapist or colorectal specialist.

Why Am I Told I Am Insulin Resistant?

In type 2 diabetes, your pancreas may still produce insulin, especially in the earlier years. The problem is that your body’s cells do not respond to insulin normally. This is called insulin resistance.

Over time, the pancreas may become tired and may not produce enough insulin to keep blood sugar controlled. This is why some people with type 2 diabetes need medicine that helps insulin work better, medicine that helps the pancreas release insulin, or sometimes insulin treatment.

What to Discuss With Your Doctor

• Whether glipizide may be contributing to your diarrhea


• Whether another diabetes medicine would be safer for you


• Your HbA1c and daily blood sugar pattern


• Your kidney and liver function


• Your risk of low blood sugar, especially because you eat one meal a day


• Whether stool tests or further bowel evaluation are needed


• Whether thyroid disease, vitamin B12 deficiency, celiac disease, pancreatic enzyme problems, or microscopic colitis should be checked


• Treatment options for weak sphincter muscle and bowel leakage

Related Questions

• Can metformin cause diarrhea?


• What are common side effects and symptoms linked with diabetes?


• How do I know if my blood sugar is too high or too low?


• What should blood sugar be before and after meals?


• What are the main diabetes complications?