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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?

Answer:

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.

JTL