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Question: From the USA: For three years, I have been taking oral medications for type 2 diabetes with good control (hemoglobin A1c in low 6% range), but now I am getting random readings over 200 mg/dl [11.1 mmol/L], especially after noon meals, and my A1c has risen to 7.1%. The doctor has recommended a sliding scale of Humalog whenever the blood sugar is over 200 mg/dl [11.1 mmol/L], and I have complied, but then go very low (50s mg/dl [2.8 mmol/L] ) about three hours later. I get very shaky and feel awful. I have found that whenever I am high, I get a corresponding low several hours later, even without the insulin. Is there anything I can do to improve my control? Is there a way to tell if I am still producing insulin? Is there such a thing as producing insulin in a very "sluggish" manner? Answer: Conceptually, I am against using "sliding scale" insulin as a primary therapy. It is best used when sugars go up, and you need a supplement to what has already been given. Perhaps your physician can offer you an additional choice of long-acting NPH insulin or Lantus (insulin glargine) as additions to your regimen. Roughly 50% of patients with type 2 diabetes have secondary failure requiring insulin therapy as the primary form of treatment. This can be seen as a natural progression of type 2 diabetes. JTL DTQ-20020624121119 Original posting 9 Jul 2002 Posted to Daily Care and Type 2

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			Jump to a new section --[ Getting Around ]-- Home Page What's New Privacy Policy Search --[ People ]-- Family Support Network Adults with Diabetes Care Photos Chat Rooms Conferences Kids with Diabetes Parents Parent Humor Scholarships and Financial Aid Grandparents Humorous Tidbits Jobs Mailing Lists CWD Forums Poetry and Art Videos Polls Quilt for Life Surveys Blogs --[ Clinic ]-- Ask the Diabetes Team Alternate Site Testing Alternative Treatments Care Suggestions CWD Español Diabetes Basics Diabetes at School 504 Plans Diabetes Camps Diabetes Dictionary Insulin Pumps Nutrition Podcasts Presentations Products Product Marketplace Sports Studies Warning Signs --[ Sources ]-- News and Information Diabetes Advocacy Links to Other Web Sites Press Releases Regional Information Services Support Groups --[ Feedback ]-- About CWD Advertise Awards Contribute Your Experiences Disclaimer Letters to the Editor Logos and Linking Share our Brochures

Last Updated: Tuesday April 06, 2010 15:09:35
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