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December 11, 2004

Hyperglycemia and DKA, Pills for Diabetes

Question from New York, USA:

It seems that I can't stabilize my blood sugar results lately. It varies from 150 to 200 mg/dl [83 to 11.1 mmol/L] sometimes in the morning. I'm not overweight. I am 5 feet, 7 inches and weigh 150 to 155 pounds. I'm exercising, but not a lot. I'm taking metformin - 850mg 3x day; Glyset - 100mg 3x day; Glucotrol XL 1x day; and Actos - 45mg 1x day Are there any alternatives?

Answer:

Fasting high blood sugars is one of the hallmarks of diabetes. It sounds like you are on maximum doses of oral agents. You need to speak with your physician about adding a dose of long-acting insulin at bedtime. This can be either NPH or Lantus. The goal of the insulin intervention is to allow your fasting blood sugars to be normal when you start your day. The goal should be 80 to 120 mg/dl [4.4 to 6.7 mmol/L]. I would anticipate your numbers are not there and this is adding to a higher than desired hemoglobin A1c value.

JTL