I was diagnosed with type 2 diabetes in 1990 when I was 31. My sugars have never been above 200 mg/dl [11.1 mmol/L] so I was surprised when my family doctor started me on insulin back then. I am taking about 50 units of a mixture of Regular and NPH insulins daily; this dosage having been dropped by about one-third in the past several months. Currently, my A1c was 6.0, and my sugars are basically 120-160 mg/dl [6.7-8.9 mmol/L] on average. I would like to stop the insulin and begin oral medications, such as Glucophage and Avandia. Would taking 500 mg of Glucophage three times a day and Avandia twice a day perform as well as the insulin?

You do not know whether the oral agents would be superior to the insulin. Your hemoglobin A1c is good. If you are only taking the dose once a day, you still might be able to switch to orals. However, there is no guarantee. You would want to have no less than a normal hemoglobin A1c value. The Glucophage would be more immediate in its action. The Avandia has a variable onset of action and may not work for weeks or months. You need to work out some type of arrangement with your physician that allows you safeguards so that if the orals result in high sugars, you can switch back. This may mean more frequent monitoring. It has not been proven that good control by insulin is superior to good control with pills. However, you do not want to settle for a poorer level of control for convenience.

JTL