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June 8, 2003

Complications

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Question from West Babylon, New York, USA:

I’m 75 years old, have had type 2 diabetes for about 13 years, and after trying several oral medications, I am now 1 mg of Prandin usua1ly 30 minutes prior to eating. My fast readings are usually below 120 mg/dl [6.7 mmol/L], but my one-hour post meal blood sugar will go to 220 mg/dl [12.2 mmol/L] or more, and then by the fourth hour it sometimes goes as low as 70 mg/dl [3.9 mmol/L]. I am now experiencing tingling in my hands and forearms and my legs, which I have never had before, and my doctor says he doesn’t have the answer to improve it. Is there a way to reduce the tingling sensations? Is my condition worsening?

Answer:

From: DTeam Staff

It is not clear to me that the tingling is from diabetic neuropathy. The electrophysiologic test, called an electromyogram (EMG), is nonspecific. For this reason, diabetic neuropathy is usually a clinical diagnosis. Your physician needs to evaluate you for this.

In terms of your sugars, you are taking a low dose of Prandin [repaglinide], but I am not sure it needs to be increased if the two-hour post-meal glucose is doing well. I would also suggest that a hemoglobin A1c test would also help to decide how much more aggressive to be.

JTL