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Is A Fasting Glucose Reading Of 399 A Cause For Concern?
Question: My mother is 75 yr old Caucasian pre diabetes and no other health issues aside from seasonal allergies. Healthy eating, watches carb intake, quantity intake, drinks approx 10 12oz cups of water daily. Walks 1-3 miles daily. All labs are in normal range and have been. Lab to check insulin production is in normal range. Weight is 189# 5' 6". For the last 2.5 months having steady rise in fasting finger stick glucose readings. Usual range on 1 metformin 500mg BID was 90-118. This mornings reading was 399. She is asymptomatic. She has been creeping up steadily for the 2.5 months. Different meters give similar results. Diet, lifestyle, exercise still the same. Dr. P. Added glipizide 5mg QD. Then when numbers still going up made it 2 glipizide QD. He is a bit stumped. Any ideas?
Brief Answer:
My suggestions
Detailed Answer:
Hi
I am Dr Mittal.
I have read your message.
I think I can help you.
The sugars were quite well controlled, in fact I usually prefer to keep the sugars slightly higher.
I think that like all diabetes patients she is beginning to develop renal problem.
In this, the normal medicine is too much for her.
She may be developing hypoglycemia.
Therefore, the body produces more sugar by the hormone glucagon.
So during the morning hours you get hyperglycaemia.
The addition of medicines will not help her.
You need to test sugars more frequently .
In this I prefer to use the old system of sugar testing.
Fasting blood sugar,
2 hours after breakfast,
Pre lunch,
2 hours after lunch,
pre dinner,
2 hours after dinner
and 3 am.
I suspect that the 3 am sugar would be low.
Since she is sleeping at the time the symptoms won't be obvious.
Monitor the sugars as suggested.
I think simple dose modification would help her.
You can show the sugars to your normal diabetes specialist for the same.
Best of luck. Dr Mittal.
My suggestions
Detailed Answer:
Hi
I am Dr Mittal.
I have read your message.
I think I can help you.
The sugars were quite well controlled, in fact I usually prefer to keep the sugars slightly higher.
I think that like all diabetes patients she is beginning to develop renal problem.
In this, the normal medicine is too much for her.
She may be developing hypoglycemia.
Therefore, the body produces more sugar by the hormone glucagon.
So during the morning hours you get hyperglycaemia.
The addition of medicines will not help her.
You need to test sugars more frequently .
In this I prefer to use the old system of sugar testing.
Fasting blood sugar,
2 hours after breakfast,
Pre lunch,
2 hours after lunch,
pre dinner,
2 hours after dinner
and 3 am.
I suspect that the 3 am sugar would be low.
Since she is sleeping at the time the symptoms won't be obvious.
Monitor the sugars as suggested.
I think simple dose modification would help her.
You can show the sugars to your normal diabetes specialist for the same.
Best of luck. Dr Mittal.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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