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September 17, 2002

Daily Care

Question from Middletown, Maryland, USA:

I've have been taking various medications for my type 2 diabetes that help for a week or two and then the numbers start to go back up to 200-300 mg/dl [11.1-16.7 mmol/L] If I go on insulin, I will lose not only my job but my health insurance. Is there anything out there that is in testing stage that I can volunteer for? At this point, I will try anything.


There are no guarantees that a suitable medication will be found to normalize your sugars and prevent you from taking insulin. Fifty percent of all patients with type 2 diabetes end up on insulin, even though they may have been having good blood sugar results early on.

If you have a desire to work with a research institution, you have to make contact with one. You may want to contact a local institution and ask for the diabetes and endocrinology section. There are usually staff to help with such questions in most places where clinical research is conducted. Ideally, it would be good to have a relationship with the investigators you will work with, rather than have it be just anyone who promises a new medication.

I am concerned you will reach for anything that is an alternative to insulin. Many of the medications being tested may not be satisfactory because they will not be potent enough to bring the blood sugars down where they should be. Finally, what kind of lifestyle or job asks you not to take care of yourself? I know there are serious financial problems associated with changing jobs. In the long run, does this serve your best interest?

Additional comments from David S. Holtzman, Esq.:

I do not have a specific answer without knowing what exactly the job is; e.g., airline pilot, school bus driver, over the road trucker. However, in general, if insured through an employer’s group health plan, one is entitled to continued coverage through COBRA. This may not appeal to you, as you will then have to assume the full cost of the insurance coverage. But it is better than nothing and will give an opportunity to find new coverage. (Note: self-insured employer sponsored plans do not have to provide COBRA coverage in all jurisdictions.)