July 1, 2002
Daily Care, Type 2
Question from Portland, Oregon, USA:
My husband has type 2 diabetes which was well controlled with once daily glipizide until three days ago. Since then, the lowest he's been able to get it is 173 mg/dl [9.6 mmol/L], and he goes over 300 mg/dl [16.7 mmol/L] after meals. We've been having 90 degree weather, he is a construction worker, and for the last few days he has come home feeling cold. This morning his temperature is 96.3F (he's normally a human furnace). He has been really watching his diet and has increased his medication to twice daily to get his blood sugar under 200 mg/dl [11.1 mmol/L]. His insurance doesn't kick it for about a month, but I will make a doctor's appointment if he is in serious trouble. However, I hope you might have some ideas. Do you have any suggestions for home care?
In general, it does not sound like your husband’s blood sugar is appropriately controlled. Sounds like it is high most of the time, and he is not on a maximum dose of the glipizide. However, I am not in favor of recommending any changes without a physician to follow the results.
If he already has a physician, the cost of a follow-up is minimal, compared to complications from diabetes. If he does not have a physician, that is a more difficult situation. It may be that his diabetes will not respond to the current therapy and more therapy needs to be given. I agree high sugars are not good when working construction. However, his health is at stake.