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August 21, 2002

Daily Care, Type 2

Question from Four Oaks, North Carolina, USA:

I was diagnosed with type 2 diabetes about 17 months ago following gestational diabetes, and at that time, my A1c was 11.7%. During the past year I managed to keep good control with A1c of 5.5-7.5%. I have not changed my eating habits within the year, but it seems to be getting higher every time I go to the doctor. For the past month, I have been unable to get rid of a sinus infection and my blood sugar has been running 175-300+ mg/dl [9.7-16.7 mmol/L] during the day. I am taking 8 mg of Avandia [rosiglitazone] and 10 mg of Glucotrol XL, and my doctor doesn't seem to be as concerned as I do. Is it possible my medication is not working any more? I am so tired of feeling so bad all the time. Could my infection make by blood sugar stay so high for so long?

Answer:

It is very important for you to know that type 2 diabetes progresses over time. It is like a story line in a book. What was once adequate therapy may not be today. What is important is that you realize you need more treatment by following your blood sugars and the hemoglobin A1c. You are not on a maximum dose of Glucotrol.

You will also have to continue to address lifestyle issues. It is also possible that there is an interaction between the sinus infection and the blood sugar control. For instance, higher blood sugars make it harder to clear infections and infections antagonize your blood sugars.

JTL