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Diabetes

Glucose levels

06/04/2008

Question:

I have type 2 diabetes (4 years) and feel that I have it under control. Take glimipiride daily, watch diet (sort of) and am not overweight.

I test my blood in the am and the levels seem too high. They range from 160 - 190`s. What am I suppposed to do about that? Exercise in my sleep? Not eat after 4 pm? It is definitely depressing and is causing me to not check my blook in the am.

Advice?

Answer:

The point of testing sugars is to provide both you and your healthcare provider with feedback as to whether your blood sugars are under control.  The blood sugar results you are giving me do not fit with your impression that your diabetes is under control.  So, I think that you need to step back and re-evaluate the situation.  You are clearly frustrated.  It is important for you to understand that diabetes is a progressive disease process in which there is a gradual loss of the insulin-producing cells at the same time that the body may have decreased responsiveness to the insulin either your pancreas can produce or that your get from taking shots.  You sound tied to an impression that if you undertake some simple measures, the diabetes will all go away.  There are a number of possibilities:  one is that you may need to advance down the progression of using additional diabetes medications.  Another is that you need to take a good hard look at what "sort of" means:  are your efforts at self care really at the level that you want them to be or are you fooling yourself?  I can't answer that with the information provided thus far.  A physician with a strong interest in diabetes and certified diabetes educators (nurse and/or dietician and/or pharmacist, generally) can help you with that re-evaluation.  It may be that you are expecting too much from your current medications and it is time to advance to the next stage.

Good luck and feel free to write back.

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Response by:

Robert M Cohen, MD Robert M Cohen, MD
Professor of Clinical Medicine
College of Medicine
University of Cincinnati