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August 14, 2002

Pills for Diabetes, Type 2

Question from Garner, North Carolina, USA:

I have been on several oral medications for diabetes since being diagnosed seven years ago, but nothing seems to work. They either make me have several incidences of low blood sugar or they just don't work. Recently, my morning fasting levels have significantly increased from 170 mg/dl [9.4 mmol/L] to 270 mg/dl [15 mmol/L], and I don't eat for hours because of the high numbers. My doctor says that if an increase in Actos doesn't work, he will have to put me on insulin. I have a real fear of medications, and it took me years before I would take them. I'm am terrified of insulin because of the possibility of low blood sugar which is just horrible because it takes me hours to overcome an episode. I'm so frustrated and fearful of the serious complications from this condition. What can I do?

Answer:

Is Actos [pioglitazone] the only diabetes medication you are taking? If so, I would consider combination therapy with more than oral hypoglycemic agent, such as Actos (which is an insulin sensitizer) with a sulfonylurea (which helps you make more insulin). It is not uncommon to take two and even three different types of diabetes pills together, since each category of pills works on a different defect of type 2 diabetes.

If you haven’t done so already, perhaps you should ask for a referral to a diabetes specialist.

JS