November 3, 2005
Hyperglycemia and DKA, Type 2
Question from Missoula, Montana, USA:
I am 40 years old and was diagnosed with type 2 diabetes in 1999. It has gone uncontrolled most of the time since diagnosis, with high blood sugar readings of 300 to 400 mg/dl [16.7 to 22.2 mmol/L]. I’m finally working to get it under control and want to know the “fastest” method of reducing levels. My doctor prescribed 5 mg of glyburide, once daily, and, of course, a healthy diet and exercise. It’s been two weeks since I started this regimen and my sugar remains 250 to 300 mg/dl [13.9 to 16.7 mmol/L]. I’m frustrated that it will not lower to the acceptable range. How long could I expect it to take to begin going down? My doctor says to give it more time.
Answer:
This may be about style, but if you have not seen any improvement and remain symptomatic with frequent urination and thirst, I would be tempted to increase the medication. It should be noted that I would not recommend you do this without the consent of your supervising physician. In fact, in some patients who continue to have high blood sugars, insulin therapy has been used to get on top of the blood sugars. When the hyperglycemia has been removed, there is some improvement in pancreas function, termed glucotoxicity.
JTL
