Thyroid/insulin

My girlfriend has type 2 diabetes and has been unable to control her counts using insulin.  Today, her readings are around 30 while taking 12 units of insulin at bedtime, and metformin (500 mg) six tablets per day (BLD) and glyburide (5mg) twice a day.  Her specialist is sending her for ultra sound to explore her thyroid.  The wait for ultrasound is four (4) weeks.  What do you think is happening?  Is there anything to be concerned about?  He has also increased her insulin dose by three units until her readings are under 10.  Thank you.

[Anita Ramsetty, MD]

Hi,
Thank you for writing on behalf of your girlfriend.
Those readings, which I think are in the metric system(?) are quite high and definitely need some aggressive attention to get them down.It is very rare that someone does not respond to insulin--the usual problem is that the dose is still too low and/or the type of insulin needs to be changed. So she should definitely be in close contact with her physician and have her medications changed without too much delay. If she has not already done this, a consultation with a diabetes nutritionist is also very helpful.
In terms of the thyroid, I am afraid I cannot comment there without further information. Obtaining a thyroid ultrasound is usually done if either thyroid tests are abnormal or the thyroid did not feel completely normal on physical exam. And there are many reasons behind each of those possibilities. Hopefully her doc explained why he/she was ordering the ultrasound, but if not you should definitely ask for further details.

Take care.