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Mom's control
81 yr. old Mom taking Glip/metform 5-500 1 1/2 pills breakfast/lunch/dinner and Januvia 5omg breakfast and dinner. Blood sugar still not under control. Can these be increased or is insulin next step?
Different physicians treat problems in different ways, but the next step should probably be injectable Lantus, the so-called "24 hour insulin". This would generally (at first anyway) prescribed in addition to the oral medications.
After a period of observation and blood sugar readings a decision would be made if other insulin protocols would be appropriate.
"Blood sugar out of control" does not identify the problem.
Control of blood sugars is very difficult, and almost impossible for most people without the assistance of an R.N. diabetic specialist who the person meets with every week at first and downloads their blood sugar readings into a computer. The nurse will monitor the readons, provide dietary advice and check the hba1c. These nurse specialists and clinics are very good at what they do. I would try to get her hooked up with one of these facilities.
I am not in favor of a general physician treating a diabetic. Not that they aren't knowledgeable. It's just that a person dealing with this disease needs lots of "TLC" (tender loving care) and with a high-priced physician the time isn't there, unless he is your nephew. You get "short-shrift" on the time. The nurses at the clinics are very bright and know as much about diabetes as any physician. They will talk to you on the telephone and provide valuable dietary advice. They will also take the time to adjust your medications and review the consequences.
If you require injectable insulin do not have any fear. The injections are virtually painless, and mean the difference between life and death.
After a period of observation and blood sugar readings a decision would be made if other insulin protocols would be appropriate.
"Blood sugar out of control" does not identify the problem.
Control of blood sugars is very difficult, and almost impossible for most people without the assistance of an R.N. diabetic specialist who the person meets with every week at first and downloads their blood sugar readings into a computer. The nurse will monitor the readons, provide dietary advice and check the hba1c. These nurse specialists and clinics are very good at what they do. I would try to get her hooked up with one of these facilities.
I am not in favor of a general physician treating a diabetic. Not that they aren't knowledgeable. It's just that a person dealing with this disease needs lots of "TLC" (tender loving care) and with a high-priced physician the time isn't there, unless he is your nephew. You get "short-shrift" on the time. The nurses at the clinics are very bright and know as much about diabetes as any physician. They will talk to you on the telephone and provide valuable dietary advice. They will also take the time to adjust your medications and review the consequences.
If you require injectable insulin do not have any fear. The injections are virtually painless, and mean the difference between life and death.
You don't say how long she has been type 2 diabetic. If it has been many years, then, yes, it is probably time for her to go on insulin. But she should not continue on with her blood sugar out of control, but should see her doctor right away to talk about whether other meds would help or insulin is called for. Sustained high blood sugar can have seious complications.
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