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Question:

From Ottawa, Ontario, Canada:

I am a recently diagnosed Tpee 2, 49 year-old male. I have excellent control with metformin [a pill for type 2 diabetes], diet and exercise. I expect that medication will be discontinued once weight loss is achieved.

My only control difficulty is with fasting level glucose. They tend to be a bit elevated: 6.8 to 7.8 range. Otherwise, levels are normal. Are there measures that can be taken to improve fasting level glucose readings?

Answer:

First of all, you are not alone with this problem: it's even got a name, the dawn phenomenon. Getting the fasting blood sugar down is one of the difficult problems in type 2 diabetes.

Several thoughts:

  1. If you are eating a bedtime snack, discuss with your doctor or dietitian about changing or stopping it.
  2. The metformin should help: perhaps a bigger dose might be tried (again, talk to your doc!)
  3. If nothing else works, either (a) live with it, especially if your glycohemoglobin remains in a good range, or (b) start a small dose of NPH insulin about 10 P.M.: this insulin would have its peak effect at the dawn, when the problem is occurring.

WWQ

Original posting 10 May 1998
Posted to Medications: Pills for Diabetes

  
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Last Updated: Tuesday April 06, 2010 15:08:58
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