I am a 55 year old Chinese woman who has been taking Glucophage [metformin] and Amaryl [glimepiride] for three months, my fasting blood sugars are 125-140 mg/dl [6.9-7.8 mmol/L], I am still losing weight, and now weigh 103 pounds. I walk for a minimum of 30 minutes a day, but I am having pain in my legs and some numbness in my feet. Should I be during something else as my pain persists and my sugar levels are not going down? Is there a medicine which could help me more?

Several issues come to mind. Your sugars are not terribly high. Do these numbers represent glucose values throughout the day? If they do, I would suggest that additional issues are playing a role. First, if you have adapted a new diet, are you eating enough calories to maintain your weight or are you losing because of decreased intake?

Second, the numbness could be from neuropathy It does get better when sugars are less than 150 mg/dl [8.3 mmol/L]. Is there another cause? Should you be using another medication which decreases discomfort from the neuropathy?

I would use this as an introduction to speak with your physician more about the issues you raise. It would also be good for you to see a dietitian to review your food intake, especially in light of persistent weight loss.

JTL

[Editor’s comment: Also, see Diabetes and Foot Pain (at the Diabetes Monitor) for some additional thoughts about the management of painful diabetic neuropathy.

WWQ]