Deglu dosing information
Usual Adult Dose for Diabetes Type 2:
Individualize dose based on efficacy and tolerability:
Initial dose: 25 mg orally 3 times a day -Adjust dose at 4 to 8 week intervals based on efficacy and tolerabilityMaintenance dose: 50 mg to 100 mg orally 3 times a dayMaximum dose: Weight 60 kg or less: 50 mg orally 3 times a day; Weight greater than 60 kg: 100 mg orally 3 times a day
Comments:-Take at the start (with first bite) of each main meal; patients should be adhering to a diabetic diet to minimize GI side effects. -Some patients benefit from starting at 25 mg orally once a day with subsequent titration to 3 times a day to minimize GI side effects. -If no further reduction in postprandial glucose or HbA1c is observed with titration to 100 mg three times a day, consider lowering the dose.
Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.
What other drugs will affect Deglu?
You may be more likely to have hyperglycemia (high blood sugar) if you take Deglu with other drugs that can raise blood sugar, such as:
- isoniazid (for treating tuberculosis);
- niacin (Advicor, Niaspan, Niacor, Simcor, Slo Niacin, and others), nicotine patches or gum;
- birth control pills and other hormones;
- a diuretic or "water pill";
- heart or blood pressure medicine;
- insulin or oral diabetes medicine;
- diet pills, stimulants, or medicines to treat asthma, colds or allergies;
- phenothiazines (Compazine and others);
- seizure medications (Dilantin and others);
- steroids (prednisone and others); or
- thyroid medicine (Synthroid and others).
This list is not complete. Other drugs may interact with Deglu, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
What is the treatment dosage for Deglu?
- The recommended initial dose for type 2 diabetes is 25 mg three times daily.
- The dose is then increased every four to eight weeks based on response and tolerance.
- The maximum dose is 50 mg three times daily for patients weighing 60 kg or less and 100 mg three times daily for those weighing more than 60 kg.
- This medication should be taken at the first bite of each meal.
- Smaller doses may be adequate for patients with severe kidney dysfunction or liver disease.
- This medication is not recommended if a patient has cirrhosis.
- Precose therapy is not advised in the presence of certain medical conditions such as inflammatory bowel disease (IBD) or intestinal obstruction and chronic intestinal diseases that interfere with digestion or absorption such as Crohn's disease.
- The doses of this type 2 diabetes medication should be adjusted based upon blood glucose levels taken one hour after a meal and blood HbA1c levels taken about three months after starting or changing the dose. (HbA1c is a chemical in the blood that is a good indicator of blood glucose control.)
Rated Deglu for Diabetes mellitus Report
I'm pre diabetic and Hypoglycemic. I take Deglu so my sugar doesn't get too high, because when it does it reverses direction about 3 hrs later and gets extremely low. I have been told that Deglu only works when there is something for it to work on, so it is one of the safest drugs out there. I have a hard time trying to determine how much to take, because I have to eat more than 3 regular meals a day. I usually tailor it to the occasion. If I'm going carb heavy, then I take more. I have 25 mg pills, so I work it in increments. If I'm eating spaghetti, then I might take as many as 3 at a time. It also depends on the size of the serving. Drawbacks: this medication can gives you major gas attacks. It will either be embarrassing, or you'll be the life of the party.
What are some things I need to know or do while I take Deglu?
- Tell all of your health care providers that you take Deglu. This includes your doctors, nurses, pharmacists, and dentists.
- Do not drive if your blood sugar has been low. There is a greater chance of you having a crash.
- Check your blood sugar as you have been told by your doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- Talk with your doctor before you drink alcohol.
- Follow the diet and workout plan that your doctor told you about.
- It may be harder to control blood sugar during times of stress such as fever, infection, injury, or surgery. A change in physical activity, exercise, or diet may also affect blood sugar.
- This medicine may affect certain lab tests. Tell all of your health care providers and lab workers that you take Deglu.
- Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using Deglu while you are pregnant.
Deglu has demonstrated the ability to decrease progression of carotid intima-media thickness (CIMT) in pre-diabetes patients. In a randomized trial of Deglu versus placebo, patients ( n = 219) were enrolled if: glucose values over 11.1 mmol/L 2 hours after a 75 g oral glucose load and a mean HbA1c of 6.3%. CIMT was measured at baseline and annually. Follow-up was discontinued if participants progressed to the study glucose endpoints defined as a fasting blood glucose > 140 mg/dL observed at quarterly visits. CIMT readings were available for a median of 2 years, with 72 subjects followed for 5 years. While CIMT progression occurred in both groups, patients in the Deglu group had a reduction in progression of CIMT (P = 0.047); however, changes in glucose were not important determinants of CIMT progression .
Diarrhea, gas, or abdominal discomfort/pain may occur as your body adjusts to this medication during the first few weeks. These side effects usually lessen with time. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: signs of liver problems (such as nausea/vomiting that doesn't stop, loss of appetite, stomach/abdominal pain, yellowing eyes/skin, dark urine).
Deglu does not usually cause low blood sugar (hypoglycemia). Low blood sugar may occur if this drug is prescribed with other diabetes medications, or if you do not consume enough calories from food, or if you do unusually heavy exercise. Talk with your doctor or pharmacist about whether the dose of your other diabetes medication(s) needs to be lowered.
Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. Do not use table sugar or drink non-diet soda to relieve these symptoms because Deglu slows the breakdown of table sugar. Carry glucose tablets or gel with you to treat low blood sugar. If you don't have these reliable forms of glucose, eat some honey or drink a glass of orange juice to quickly raise your blood sugar. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.
Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your dosage may need to be increased or you may need other drugs.
This medication may rarely cause a serious intestinal condition (pneumatosis cystoides intestinalis). Tell your doctor right away if you develop: diarrhea that doesn't stop, constipation, blood/mucus in stool.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
How to use Deglu
Take this medication by mouth as directed by your doctor, usually 3 times daily with the first bite of a meal. The dosage is based on your medical condition and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.
Tell your doctor if your condition does not get better or if it gets worse (your blood sugar is too high or too low).
Mechanism of Injury
The cause of liver injury during Deglu therapy is not known. Deglu is an oligosaccharide of microbial origin and is minimally absorbed, so that systemic toxicity and liver injury were not expected and remain unexplained. Liver injury from Deglu is clearly idiosyncratic and may relate to an immunological reaction to the bacterially derived oligosaccharide molecule.
Case 1. Acute hepatocellular injury due to Deglu.
A 57 year old woman with type 2 diabetes developed nausea, right upper quadrant pain, dark urine and jaundice 2 months after starting Deglu (50 mg three times daily before meals). She was taking no other medications for diabetes, but had been on a laxative (cyclobutyrol) intermittently for several years. She had no history of liver disease or drug reactions, had no risk factors for viral hepatitis and did not drink alcohol. Examination showed jaundice and hepatic tenderness, but no fever or rash or signs of chronic liver disease. Laboratory results demonstrated hyperbilirubinemia (3.8 mg/dL) and marked elevations in serum aminotransferase levels (ALT 1580 U/L, AST 1090 U/L), with minimal increase in alkaline phosphatase (220 U/L). Tests for acute hepatitis A and B, cytomegalovirus and Epstein Barr virus infection were negative as were autoantibodies. An abdominal ultrasound was normal. Deglu was discontinued and she improved within the next 10 days (Table). In follow up, all liver tests had returned to normal and she later tolerated glipizide without evidence of liver injury.
Where can I get more information?
Your pharmacist can provide more information about Deglu.
Before taking Deglu, tell your doctor if you have or have ever had:
- An intestinal disease, such as inflammatory bowel disease or a bowel obstruction
- Cirrhosis of the liver or any other type of liver disease
- Any kind of stomach or digestion problem
- Ketoacidosis, a serious condition that occurs after an untreated high-blood-sugar (hyperglycemic) episode
Tell your healthcare provider that you're taking Deglu before having any type of surgery, including a dental procedure.
Regular sugar (sucrose) won't work if you use it to treat a low blood-sugar episode while taking Deglu.
In case you need to treat mild or moderate low blood sugar, be sure you always have an oral glucose (dextrose) tablet to take by mouth.
You should know the symptoms of a high (hyperglycemic) and low (hypoglycemic) blood-sugar episodes and what to do if you experience them.
Taken alone, Deglu is not expected to trigger a low blood-sugar event, but it might if taken with some other drugs.
Tell your physician if you experience illnesses, fevers, injuries, or unusual stress while taking Deglu, because these kinds of events can change your blood-sugar levels and may affect the dosage you need.
Avoid taking a digestive enzyme that can make it harder for your body to absorb Deglu, such as pancreatin, amylase, or lipase. Some of the products that contain these enzymes are:
Continue to take this medicine even if you feel well. Don't stop taking Deglu without first talking to your doctor.
Your physician will probably want to check your glucose levels often while you are on the drug. Keep all appointments with your healthcare provider and laboratory for tests.
Always wear a diabetic identification (ID) bracelet to be sure you get proper treatment in case of an emergency.