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February 6, 2002

Type 2

Question from St. Paul's Bay, Malta:

I am 65 years old, have type 2 diabetes, and I am being treated with metformin (one pill after lunch and dinner). My blood glucose in the morning (before breakfast) is high in the range (7-8 mmol/L [126-144 mg/dl], before lunch it is lower (6 mmol/L [108 mg/dl] ), but before the evening meal it is 9 mmol/L [162 mg/dl]. What level is acceptable in my case? Am I on the wrong track?

Answer:

You are on the right track. It is just that you haven’t reached your final goal, in terms of your blood sugars. The question is whether you can go up on your metformin dose so that your sugars at breakfast and supper can come down towards the lunch values. Also, you should have a hemoglobin A1c test to determine your overall average blood sugar over three months. The hemoglobin A1c test has been best correlated with risk for microvascular complications. At the same time, work on lifestyle choices, such as diet and exercise.

JTL