August 6, 2002
Community Resources, Daily Care
Question from Grayling, Michigan, USA:
My 19 year old fiance, who has had diabetes for a year and half, has been taking one shot a day of NPH since his diagnosis, and his sugar has been fine (usually 70-120 mg/dl [3.8-6.7 mmol/L]) since the first few months. If anything, we were always worried about him going too low. However, for the last month or so, he has been running higher and higher (usually 110-200 mg/dl [5.6-11.1 mmol/L]). His diet has not changed, nor has his life style or exercise. We cut some carbs out of his diet, and he increased his insulin, but it still hasn’t gotten better. We’re concerned about the high sugars even though his recent A1c was 6.5%.
He does not have a diabetes team, his family physician is now hundreds of miles away, and I called every endocrinologist in the area, but no one will see him. Either they are no longer seeing new patients, he’s a year too old, or they don’t accept his insurance. What should we do? Should he see a doctor? If so, where? The hospitals all say “sorry” there isn’t anyone else in our area! What do they expect us to do? Is the situation critical?
Answer:
It sounds to me like your fiance has real diabetes, the insulin dose isn’t enough, and he likely needs more intense management. Someone also needs to decide if he has type�1 or type�2 diabetes.
We can’t manage diabetes in this forum, but can only advise you that your fiance needs to see someone who can sort it all out. A good internist could do it too, if asked, as well as an endocrinologist.
LD
