Question:
Glucophage makes me sick, Actos makes me gain weight..what to do??

I am 17 months post RNY and have lost about 130 pounds. Pre-surgery I was taking glucophage xr and throwing up all the time. Recently my PCP said he felt I needed to be taking something to address my insulin resistance and put me on Actos. It hasn't made me sick (thank goodness!) but I have gained almost 5 pounds in 3 weeks and that is freaking me out. I am so afraid of messing up what has been such a lifesaver for me. Does anyone else here have experience with Actos? Is there something else that I can take? Help!    — Tracy M. (posted on May 15, 2003)


May 15, 2003
What was your last insulin level? How was it, compared with a pre-op insulin level? I was on Glucophage XR 2000mg every day before surgery. I stopped it about 3 days before lap RNY and never have had to take it again. I am only down about 60lbs and 6 months out, but my insulin levels are well into the normal range. If you are taking Actos or Glucophage to help regulate your insulin levels, I would think that would help in weight loss. (Some people lose weight when placed on Glucophage.) I was lucky to have a great endocrinologist who started me out slowly on the Glucophage XR, and recommended taking it at night. That really helped ease the GI distress!
   — koogy

May 15, 2003
Hi, I'm almost three years post-op and just this past March I was placed back on glucophage for my insulin resistance/hyperinsulinemia. I take 1500 mgs a day plus 100mgs of Aldactone. I do have the "gastric distress" (read the "runs" every morning) but it is getting better. My levels went back to normal right after surgery so I stopped seeing my endo. I was feeling icky again so I found a new endo who is wonderful! Just remember, if you had RNY, you shouldn't be taking the XR version of the glucophage. We don't have the stomach or stomach acids for it to time release into! Ask your doc about taking the regular glucophage, but maybe upping the dose. I actually lost some weight that I had gained over the winter, and I'm still losing! Also, my periods have become lighter and with less pain and PMS. I'm working on getting my energy back. I hope some of this info helps!
   — heidiinPA

May 15, 2003
Ask your Dr. about a fairly new med for diabetes called Prandin. My endo put me on that after WLS, you take it before each meal and it works well for folks who have had WLS. I am no longer on it, totally diet controled now.
   — SARose61

May 15, 2003
I can't take Gluophage either due to teh stomach troubles with it. I also gained weight on Actos. My solution was Avandia. I am on 2mg twice a day and my levels are wonderful and NO SIDE EFFECTS :-) Amy (Hoping to have surgery this summer)
   — AmyLynn B.

May 15, 2003
I am on 2000 mgs of Glucophage daily. We upped the dose in stages, but I was sick as a dog for the first 6 weeks or so. I had WLS jan 24, 2001 and had stopped losing at about 80 pounds loss as soon as I stareted the Glucophage I started losing again. I never threw up prior to starting the glucophage and now I really have to watch it because things that were perfectly fine before make me sooo sick. I am not diabetic but have PCOS. Good luck!
   — Heidi B.

May 15, 2003
Glucophage XR made me ill as well. I take regular Glucophage now and am fine. I am pre-op, though, so I don't know how much the surgery will change that.
   — Maria N.

May 15, 2003
I sympathize with your feelings on Actos--I gained 26 lbs. in ONE MONTH prior to surgery on Actos!! After surgery, I was on Glucophage XR, but it didn't work very well because of the extended release. My doctor then put me on Glucovance, which worked much better. I have lost enough weight now that I was recently able to go off the meds. Good luck!
   — Want2bslim

May 15, 2003
I was on Actos and insulin, and I became very sick with a enlarged liver, and the doctor took me off of the Actos, he said that it was causing my liver to swell and for me to gain weight, after he took me off of Actos, I lost 10 lbs, but he put me on Lasix and potassium supplements to flush my liver, I am fine now. I am now just taking insulin, I can use the slide for blood sugar control, I am 82 days pre-op and I am glad to be off of oral diabetic meds, and hopefully off the insulin after surgery, I do not know your exact situation, but until you lose more weight, ask your doctor about insulin.
   — cindy

May 15, 2003
It's me again. My blood sugar levels are actually really good now. My last checkup was at 75. The doc suggested the meds again because he said my PCOS/insulin resistance wouldn't just "go away" if I have had it since I was a teenager. I guess the thinking is that even if I'm losing weight, I could still be insulin resistant. I don't know. One thing I read says one thing, another thing says another, and generally the doctor says another. I was worried because I had stopped taking glucophage xr pre-op because of all the vomiting and never returned to it. I asked the doctor about it and he said he thought I was right..that I should be on something - hence, the Actos. And now here I am thinking maybe I shouldn't be on it. I am going to write down the other meds mentioned (and suggestions) and see if he'll talk to me about it. Thanks for your help, everyone!
   — Tracy M.

May 16, 2003
Tracy, your blood sugars (especially fasting) as well as HbA1c can be perfectly normal in insulin resistance. That's why it's not easy to diagnose. Do you (or did you ever) check your blood sugars at 1 and 3 hours after a meal? My endo had me doing that when I first started on Glucophage XR. My blood sugars would be normal in the morning (fasting)but an hour after a meal, I would be close to 160, and 3 hours later it would be about 60. My pancreas was pumping out way more insulin than needed after a meal. Your body strives to keep things in balance, which is why your blood sugars can be normal, even if it takes a load of insulin to do it. She told me that's why I would be hungry a couple of hours after having a meal! It was my body responding to internal cues, not just me being a fat goober wanting to eat all the time! I also had my doc check INSULIN levels (not just blood sugar). My last one before WLS was near the top of the normal range even with the Glucophage XR 2000 mg! The last one I had done was below the mid-range normal on no Glucophage for months!
   — koogy

May 16, 2003
Hi again! I already posted, but do you make sure you eat some thing before taking your glucophage? I have to eat or else watch out!
   — Heidi B.

May 17, 2003
My blood sugar level of 75 was after eating 2 hours before, actually. My fasting blood sugar in June, 2001 (pre-surgery) was 130, fasting blood sugar in July, 2002 was 85 and my two hour blood sugar recently was 75. I am thinking maybe I no longer need anything for insulin resistance at all. I'm going to call my doctor next week and see if he concurs or if maybe he will refer me to the endocrinologist. Thanks to everyone who has responded to me!
   — Tracy M.




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