March 24, 2004
Pills for Diabetes, Type 2
Question from Fullerton, California, USA:
I have had type 2 for 14 years. My latest A1c was 5.7%. I am tired all the time. My doctor says I am in good control so there is nothing to worry about. If I am in such good control, why am I tired all the time? My fasting sugar is always in the 120-160 mg/dl [6.7-8.9 mmol/L] range. I was put on metformin to lower it, but it has not helped. What should I do? The doctor said there was nothing else he could do other than put me on insulin at bedtime. Is that my only option?
Answer:
I do not think I would pursue the symptoms of fatigue as being associated with your blood sugars. I would recommend you and your physician looking for causes for the fatigue separate from the diabetes.
If the hemoglobin A1c stays in the normal range, I am not sure I would add bedtime insulin and risk hypoglycemia and weight gain. If, however, the hemoglobin A1C were to rise, and the fasting blood sugars remain elevated, I would consider adding bedtime NPH as one option for lowering blood sugars at that particular time of day. It is a reasonable consideration.
JTL
