My mother is currently taking Glucophage [metformin] and a sulfonylurea, but this weekend her blood sugar went as high as 390 mg/dl [21.7 mmol/L], and she was only able to bring it down to 271 mg/dl [13.1 mmol/L]. Is there anything besides her medication she should be doing to bring it down even more?

I think, given the high blood sugar readings (fasting I guess), your mother might need insulin. This is only a suspicion based on the scarce information I have from your letter. Diet is another important issue in diabetes management as well as other intercurrent stresses such as infections etc. She needs to ask her doctor for further help.

MS

[Editor’s comment: The first thing to add would be extra fluids, to avoid dehydration and the risk of DKA [diabetic ketoacidosis], which can occur in type 2 patients if under enough stress. The second thing to do is more blood sugars; if they continue considerably higher than normal, call the doctor or visit an emergency room if she’s nauseated or vomiting — insulin will definitely be needed if she can’t tolerate fluids by mouth.

WWQ]