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February 28, 2007

Insulin, Type 2

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Question from Ahmedabad, Gujarat, India:

I have had diabetes for two years. I take 16 units of short acting insulin once a day. I am the only person in my family with diabetes. I weigh 54 kg (119 pounds). I am 25 years old, married, and have one child. My diabetes is currently under control, with blood sugars of 100 mg/dl [5.6 mmol/L] to 170 mg/dl [9.4 mmol/L]. Can I live without taking insulin? I don’t like taking it.

Answer:

You are asking me to make a decision about your treatment when I do not have all of the information to make that decision. Blood sugars of 100 mg/dl [5.6 mmol/L] to 170 mg/dl [9.4 mmol/L],without making a distinction as to whether they are fasting or before meals or after meals, is not clear enough. If you had fasting glucose levels above 120 mg/dl [6.7 mmol/L], that might be too high. I would recommend you also obtain a hemoglobin A1c. This is a measure of your average blood sugar over the previous three months. The test is obtained through your doctor’s office by through a blood test. If you have diabetes that is not limited by lows, your goal should be a normal value for the hemoglobin A1c test. Since this is not known, I would be very hesitant to stop your insulin because it is inconvenient to take. You need to obtain additional information. I would also request that you talk to your physician about these issues.

JTL