I am 53, female, newly diagnosed with type 2 diabetes, and my doctor has me on Starlix 30 minutes before meals. My fasting blood sugar is now down to 127 mg/dl [7.1 mmol/L], but at 11:00 pm, it is around 209 mg/dl [11.6 mmol/L], after five hours of not eating. Should my sugar be that high?

It is difficult to evaluate isolated high blood sugars. A hemoglobin A1c is necessary to determine your overall level of control. In principle, a value greater than 160 mg/dl [8.9 mmol/L] three to four hours after eating is too high, and quite probably a dietary modification at dinner might be of help.

I think that you should keep working as much as you can on your lifestyle habits such as exercise and diet in order to lose most of your extra weight. That’s actually the best therapy, and once you reach this goal, quite probably you might need to leave oral agents such as Starlix [nateglinide] and switch to insulin sensitizers such as Glucophage [metformin], Actos [pioglitazone], or Avandia [rosiglitazone].

MS