October 26, 2001
Daily Care, Type 2
Question from Stockton, California, USA:
I am a 49 year old female who was diagnosed with diabetes two weeks ago, and my doctor rushed me out the door with prescriptions and no instructions! I am currently taking a sulfonylurea, the dosage having been doubled after one week. My initial fasting level was 210 mg/dl [11.7 mmol/L] which dropped to 155 mg/dl [8.6 mmol/L] while on 10 mg daily and following the diet guidelines I had saved from my experience with gestational diabetes 20 years ago.
The added 10 mg daily does not seem to affected my levels at all. If anything, they have risen (fasting levels: 175-193 mg/dl [9.7-10.7 mmol/L]. My primary doctor indicated that she wanted to lower my levels gradually, but I’m going to 300 mg/dl [16.7 mmol/L] levels on a daily basis! Isn’t this playing with continuing possible damage to my body? The headaches are killing me, my blood pressure has gone nuts [185(and higher)/110], I have significant hair loss, along with tingling and numbness in my toes, and blurry vision..
I was healthy! I thought the idea was to get the levels down immediately. There is no endocrinologist that accepts my insurance either.
Answer:
With continued elevation of blood sugars, more treatment is required. This may be done by adding another oral agent [or insulin]. In addition, blood pressures like yours need to be treated, most likely with an ACE inhibitor. Finally, you need more follow-up with a diabetes education team. I would suggest you speak with your physician’s office or the local hospital to determine where the closest diabetes education team is located in your area.
JTL
[Editor’s comment: With continuing symptoms, you should call the doctor’s office and be sure that he/she is aware that the present program is not working. If your doctor is unable or unwilling to spend time with you, or to refer you to diabetes experts, switch doctors.
WWQ]
[Editor’s comment: Also, in light of your insurance, you may have to convince them to let go “out of network.” Contact your local American Diabetes Association affiliate if you have problems with this.
SS]
