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From Utah, USA:

I have had type 2 diabetes for nearly five years, controlled on oral medications with A1cs all in the sixes. My fasting morning level is usually between 95 and 110 mg/dl [5.3 to 6.1 mmol/L], but rises dramatically in the morning whether I eat anything or not, usually to 200 mg/dl [11.1 mmol/L] without breakfast, and 250 mg/dl [13.9 mmol/L] or higher with breakfast. I am very concerned about this, as I feel very tired during this time, and have trouble with my vision. I take my medication (Glucovance 2.5/500) at 6 a.m. and 6 p.m. My levels start to drop after about one to two hours, to 145 mg/dl [8.1 mmol/L] or so. My doctor tried me on Humalog, but even two units dropped me into the 40s mg/dl [about 2.2 to 2.7 mmol/L]. Because of the A1cs, he seems unconcerned. Is there anything you would suggest?


Elevated glucoses in the morning could mean that you need additional treatment. In many cases, the use of Lantus (glargine) insulin is preferable as it does not peak, so it should not cause hypoglycemia or low glucose. Humalog is a fast acting insulin generally indicated for meals, not early morning or basal treatment. I would discuss the use of Lantus with your physician. It may be an alternative to your treatment regimen.


Original posting 23 Jul 2004
Posted to Type 2 and Hyperglycemia and DKA


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