Ask The Expert
Diagnosis & Symptoms

Congratulations on your successful weight loss and your great progress!

What glucose level is too low:

First, certain medications can cause hypoglycemia, while others do not. The Amaryl is a sulfonylurea which stimulates your pancreas to produce more insulin. If the dosage is more than you need, (or if you do not eat enough, miss or delay a meal, or do unexpected activity), your glucose can get too low—i.e. to hypoglycemic levels which are usually defined as being below 70 mg/dL-- if you take medication that can cause hypoglycemia. However, if you are on no medication, or if you take a medication that does not cause hypoglycemia (such as Glucophage), then technically you cannot get too low.

When do you stop oral medication:

For economic and practical reasons, if your glucose levels were frequently running below 110 mg/dL and often in the 70-80 mg/dL range, (and under 140 mg/dL after meals) then many healthcare professionals would consider that it is time to try to taper off the medication to see if you still needed it.

• In some situations, after the medication is out of the system (it can take up to 2 weeks after stopping some medication), I have seen blood glucose levels rise back up to unacceptable levels (i.e. over 130 mg/dL before meals, or over 180 mg/dL after meals), meaning that the person still required the medication to keep their glucose levels in target range.
• In other instances, the glucose levels remained in the same range, indicating that the medication was no longer needed. In this situation, the excess weight had contributed to insulin resistance, so losing the weight reduced the insulin resistance.

Do you still have diabetes?:

This is a common question. Most experts would say that technically yes, you still have diabetes, but you are considered a very well controlled person with diabetes. The reasons are:

• If you regain the weight, your glucose levels would most surely go up again and you would again require medication.
• If you have a serious illness or surgery, or receive a medication that can raise blood glucose (such as cortisone), your glucose may rise.
• Even if you don’t regain the weight, diabetes usually progresses over time, so while it is possible that you may never need medication, it is also possible that you may require medication again later as you age. Because of this, your healthcare team will likely tell you to continue testing your glucose; however, if all the readings are in the normal range, your team may reduce the frequency of your blood glucose testing.

Please read the related questions on the right side of this page as they will elaborate on the points in this answer.