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Pills for Diabetes

I have a client with a HbA1c of 9%, elevated microalbumin of 2000, medical chart review shows elevation of microalbumin. The patent is on 30/70 insulin BID, and takes Metformin 250 BID. Due to increased blood sugars I recommended increasing insulin, the doc opted to increase Metformin to 850 TID. In light of increased microalbumin was this the best move?

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My daughter has had type 1 for four years. Her blood sugars are consistently high, so her doctor put her on Avandia, then Actos. It was my understanding these were for people with type 2 and people over age 18. What do you think of this situation?

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Following my November 2003 diagnosis, I took Glucovance for three months. My blood sugars stablized so I stopped my nightly dose, then my morning dose. My random blood sugars are fine. Is this a honeymoon period?

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I am having high fasting blood sugars despite the diabetes medications I am taking. Are there any alternatives?

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Since my creatinine was 1.4 mg/dl, the doctors switched me from metformin to Avandia. Then, my A1c went up and they are considering insulin. Are there any alternatives?

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Can I increase my oral medication on the days I eat more? Can I skip it the days I eat nothing more than soup?

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I recently discovered that I was taking too much metformin on a daily basis due to wrong instructions on the bottle. What kind of damage could this have caused? I often don’t feel well.

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Can metformin’s effect be attributed just to its acidic (lactic) effect causing vasodilation and more transcapillary movements of glucose and insulin?

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I have diarrhea, which my doctor thinks is related to my metformin. She has suggested Januvia along with my insulin. I am not comfortable with this. What do you suggest?

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Why should Glucophage be temporarily discontinued if you are going to have X-rays or surgery with dyes involved? What dire things can happen if you do not discontinue use and have those dyes injected? What type of blood test checks for lactic acidosis?

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