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ForumsSide Effects & ManagementHypoglycemia risk with concomitant sulfonylurea use — my results so far

Hypoglycemia risk with concomitant sulfonylurea use — my results so far

mike.trainer_LA Thu, Apr 4, 2024 at 5:38 PM 34 replies 2,155 viewsPage 1 of 7
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mike.trainer_LA
Senior Member
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Apr 2024
Los Angeles, CA
Apr 4, 2024 at 5:38 PM#1

The nausea I get is not really nausea, it is an aversion. Food I want in the abstract becomes repellent in front of me, which no side-effect list describes.

What I actually want to know is what distinguishes the nausea you can titrate through from the nausea that means stop.

If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

37 7Dr.AddMedPHL, newstart_MO, mia_MS2 and 34 others
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labquiet_amy
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Cambridge, MA
Apr 4, 2024 at 5:58 PM#2

Short answer first, then the reasoning. The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the fat fraction of meals in the two days after dosing, and do not lie down straight after eating. Most of what people call unmanageable nausea is a meal-size and meal-composition problem interacting with a stomach that is emptying slowly.

36 6HPLC_Greg, LibrarianMeg, bri_stats and 33 others
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julia.endo
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Cincinnati, OH
Apr 4, 2024 at 6:18 PM#3
labquiet_amy said:
The practical protocol is dull and it works: smaller meals, stop eating at the first sign of fullness rather than at the end of the plate, drop the…

No disagreement with labquiet_amy. One condition attached. The meal advice is right and incomplete without the hydration point. People stop drinking because drinking makes them feel full, then attribute dehydration symptoms to the drug.

Last edited: Apr 5, 2024 at 12:18 AM
35 5hans_munich, jason_sac26, chris_chi24 and 32 others
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tane_welly
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Sep 2024
Wellington, NZ
Apr 4, 2024 at 6:38 PM#4
mike.trainer_LA said:
The nausea I get is not really nausea, it is an aversion.

Same position here, arrived at the long way round. Holding genuinely reduces total burden rather than redistributing it, because the gastric-emptying component adapts. Receptor-level tachyphylaxis to the delayed-emptying effect develops over weeks while the central appetite effect persists, so the same dose is materially more comfortable at week six than at week two. A slower ladder therefore reaches the same dose with less cumulative nausea, not the same nausea spread thinner.

Last edited: Apr 4, 2024 at 9:38 PM
34 4marco_milano, pam_columbus, nick_SD_fit and 31 others
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lisa_labSD
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Oct 2024
San Diego, CA
Apr 4, 2024 at 8:27 PM#5

Adding the clinical framing, because it changes how the question reads. Worth answering the question that was asked rather than the one behind it. The narrow version usually has an answer; the broad version usually does not, and answering the broad one is how a thread stops being useful.

33 3cory_ATX, lori_vegas, Dr.PulmRoch and 30 others
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