I've been on Actos for around 2 years now, and the diabetes is one major factor in my moving forward with VSG.

In all this time I've been on this medication, I find that I actually struggle to keep enough sugar in my system, especially between Breakfast and lunch. I find if I don't have a substantial enough breakfast, my BG takes a dive.

During my initial consult with the VSG surgeon, he said he wanted me to cut out the liquid calories, including any milk as part of my plan to lose ~ 10 pounds before the surgery. So, no more Cereal for breakfast. When I met with the dietitian, I asked him about recommendations, and he suggested replacing breakfast with a Protein shake/drink.

Well, today, I had one for breakfast, the 11 oz Premier Protein Drink you get at Sam's & costco. I started feeling like crap less than 2 hours after... meaning, that the meds are preventing that breakfast from lasting for me.

I'm considering stopping the Actos.

Have you had a similar issue? What did you do?

I hate to say it but the best thing to do is use glucose tabs. I know that all diabetics hate them but they do prevent those horrible lows. No way would I get off the medicine without the doctor's say so. There are too many lasting effects of high blood sugar. I'd stay on the medicine and take 2 glucose tabs when you feel the lows coming on.

I just don't think there is enough information here to offer any advise, even if I were a doctor...

I would suggest if you dont already start taking you blood at least 8x a day - it sounds like alot but you are going through major changes, and you really need to understand what is happening when. Once you have this parred with a food log, it will be a valuable tool in deciding what to do with your meds.

Actos may not be what you need anymore, I thought that was for people who had difficulty controlling highs, any meds causing you to have to "feed" diabeties is counter productive.

<diagnosed type 2 2007, went from +7 A1c to within 5's 6 months later, off meds just before surgery jan 4th 2012, and diagnosed in full remission late Feb/early March 2012. A1c in 4's ever since, no meds.

Wondering..... do you think you could try a glucerna shake or something with slighly more carbs? Not sure if its allowed.

Of course talk to your doctor!

For me if i eat low carb and take my meds i have terrible issues keeping my BS "up".. But i bet you're either gonna have to reduce, change or go off meds or start adding some type of carb/sugar with your meds.

My thoughts are that the meds work to reduce or keep your BS under control and its carbohydrates that cause insulin response... So i'm thinking if you are not creating a insulin response but taking meds there is an imbalance. At least i think thats whats happening to me... I think its better to keep carbs low and get rid of these meds anyday!

Anyway..i know your doc will help you out with this! Take care!