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August 2, 2001

Daily Care, Type 2

Question from Santa Fe, New Mexico, USA:

My 59 year old husband has had type 2 diabetes for the six years, and on strong regimen of medication, but he still feels horrible and his average sugar this week was 297 mg/dl [16.5 mmol/L]. Nine months ago, he had arthroscopic knee surgery, but he still has the pain in his knee and foot, and we are bounced back and forth between the two doctors who constantly blame each other. Can you please help me? My husband is my life, and I am not ready to lose him to this battle!


Your husband probably feels horrible from the high blood glucoses. It would be important to know what his last hemoglobin A1c was.He should try to keep this number down below 7%. If his blood glucose averages are typically high, his risk of diabetes complications is much higher.

Hopefully, one of his doctors is caring for his diabetes. Sometimes no provider is actually taking responsibility for the care of the diabetes. Communication about that needs to occur between your husband and these providers.

When you say a strong regimen of medications, it is important to know what medications he is taking. Some diabetes oral hypoglycemic agents assist the pancreas, some suppress the liver from producing too much sugar, and some assist the muscle in taking up more sugar. It may be that he is not on the right medication for his particular case. In addition, it may be possible that he needs insulin or a different combination of diabetes pills.

As diabetes progresses, many patients require insulin since the pancreas does not function as well. It does not mean that he has not cared for the diabetes well. It might also benefit the patient to see a Certified Diabetes Educator to make sure his self care is going well. Hopefully he is testing often and has a current meter.


[Editor’s comment: His pain is also a problem, as it causes direct elevation of blood sugar from stress, and lessens his desire to exercise. A program of pain management, using prescription medications, physical therapy, and controlled exercise, may be very helpful.

You asked how we can help you, and the other point to make is that you should be going to the office with your husband, and be fully aware of what the doctors are advising, so you can help your husband cope.