I guess it depends upon what your goals are.

First course of action is to reduce carbohydrate consumption and
increase exercise, especially muscle mass building.  For mild type 2,
these will often be enough to bring good bg control.

Glyburides stimulate your pancreas to release more insulin to keep bg down.

Metformin works to reduce liver glucose production and to sensitize you
to your own insulin.  It has protective qualities against cardiovascular
disease.

Endocrinologists seem to prefer metformin for it's protective qualities,
given a choice between the two, and a patient willing to modify diet and
activity appropriately.

Susan

There are two schools of thought on this. One would be that Metformin is
supposed to have additional effects aside from helping control blood
sugar, among these helping protect against heart attacks. Thus, some
would advocate that you take this regardless of whether you need it to
control blood sugar. Another school would be that, whether you take
medication or not, you need some combination of diet and exercise to
fully manage diabetes. Given this need, the alternative point of view
would be to see to what extent you can control blood sugar on an
on-going basis with diet and exercise, and only move to medication such
as Metformin when you've gone as far as you can go with diet. There are
several considerations involved in deciding what to do. One is your
temperament. Which way would *you* prefer to go, all other things being
equal? Another is the rest of your medical situation. Only you and your
doctor can evaluate this. For instance, you might have other medical
conditions that make exercise difficult. Or you might have other dietary
constraints. And so forth. However, my impression is that *if* you and
your doctor decide to go the medication route, Metformin is the ordinary
starting point (assuming the gastric effects don't take too much of a
toll on you).

There is no such thing as "mild" type 2.  And the preferred treatment
depends on your Dr. and what he/she thinks is best.

James E. wrote in message ...

   Metformin is gaining ascendance as the "first med" for Type 2 diabetes.
There are a host of reasons,  some of which are:

1.   The most serious problem faced by 80-90% of new Type 2 diabetics is
high heart attack risk derived from high Insulin Resistance.    Metformin
acts as an anti-Insulin Resistance med and thus lowers the heart attack risk
while fighting elevated blood sugars.

2.  There is evidence that Type 2 diabetes is associated with a premature
death process for beta cells.    This process is accelerated by the
manufacture of excessive amounts of insulin.     By reducing Insulin
Resistance,   metformin acts to reduce the amount of insulin manufactured by
the weakened beta cells.     In contrast,  Glyburide forces the weakened
beta cells to make extra insulin.

IOW,   Glyburide attends to a single symptom of the disease and probably
accelerates the premature beta cell death effect of the disease;   Metformin
reduces the need for large amounts of manufactured insulin and thus,  de
facto,  attends to a root cause of the disease.    (Note that you can
defeat metformin by pigging out on carb)

3.  There is evidence that sulfonylureas per se increase the risk of
premature heart attack observed in Type 2 diabetics.   The evidence is
fragmentary and contradictory but evidence for a cause and effect
relationship is growing.    I have seen references which now assign
sulfonylureas such as Glyburide to a tertiary role in diabetes management
behind metformin and either of the two TZD anti-Insulin Resistance meds
(Actos and Avandia).

While you're thinking about this stuff,   note that you can write your own
prescription for a Type 2 Diabetes "Miracle Treatment",  i.e.

  a.  Lose fat lb
  b.  Gain muscle lb
  c.  Exercise every day
  d.  Ration your total carb intake,  eat slowly-digesting carb,  spread
your daily carb over several small meals.

We have testimonies from posters who have achieved spectacular results with
this approach.

Keep coming back.   Diabetes is one of the odd diseases in which the patient
does all the work and most of the management.   The docs mostly sit on the
sidelines,  cheering us on and writing the occasional prescription.   The
more you learn about the disease and the faster you learn it,  the better
your chances for living a long,  pain-free life.   Reading the diabetes
newsgroups every night has produced substantial improvements in my health,
my quality of life,  and, I'm sure,  my life expectancy.

Regards
 Old Al

Hi James

A little more info please.

My initial preferred treatment was exercise and diet
modified by testing -
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm
But the right person to ask is your doctor.

Define "mild Type II" please. Is mild the sort where they
only amputate one leg or you only lose the sight in one eye?
I don't like the term applied to diabetes, but I suppose I
would accept it if your A1c is under 6% and your
post-prandials never exceeded 7(126) no matter what you ate.
Does that describe your mild type 2?

Cheers, Alan, T2, Australia.
d&e, metformin 2x500mg

The best thing is to pay attention to the "Drug Tolerance", this by giving
the least potent medication with least dose that enouh to control BG very
well.
Saref

Thank you all for your kind help.

I am 77 and have been a Type II for 25 years, asymptomatic. I have been on
2000 mg Metformin for the last 5 years.

I am trying to get away from medications and was wondering if I might
substitute Glyburide for those big Metformin pills. I guess not. I tried one
2.5 mg Glyburide pill. Immediately, my fasting BG dropped to 68 and stayed
low for 2 days. I am just experimenting. Therefore my query.

I am 40 lbs overweight. I know that weight loss would be very beneficial. My
diets last about 3 days. Very discouraging and demoralizing!

Thanks again.

Hi, James welcome to our group.

I know some people take metformin and others take the other med, but I
really dont know how that is determined.  

I really just wanted to say hello

Loretta

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