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June 11, 2001

Daily Care, Type 2

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Question from Chicago, Illinois, USA:

I am 52, was diagnosed with type 2 diabetes about a year and a half ago, and currently do not take medication. My daily glucose level is in appropriate ranges (80-120 mg/dl [4.4-6.7mmol/L] pre-meal, and under 180 mg/dl [10 mmol/L] after meals). Why would my pre-breakfast readings, after not eating for 10 hours or more, be above as high as 135 mg/dl [7.5 mmol/L]?

Answer:

You have asked a very important and commonly asked question. Your experience is like many with type�2 diabetes.

As the pancreas slows down in its ability to make insulin, the liver begins to spill out larger amounts of sugar. At our center we call this a “leaky liver”. It is a very common occurrence for people to go to bed, not eat, and see their fasting blood sugar higher than before. This is caused by the lack of enough insulin to turn off the leaky liver.

There are medicines available (Glucophage [metformin], for one) to turn off this leaky liver. If your hemoglobin A1c is above normal range, you might want to discuss the possibility of adding this medicine to your diabetes treatment plan. Also, increasing exercise will improve your sensitivity to your insulin so it will work more efficiently.

KS