Thread: Diabetic with a morning sugar of 259 mg/dl.?

61 year old male with history of type two diabetes and high colesterol. Blood sugar before bed was: 330mg/dl. Took Metformin 500mg, 2 tab, before bed. In the morning his blood sugar is: 259mg/dl. This patient doesn't have a primary care physician. Should he seek emergency room care to maintain a better blood sugar?

Is there a reason he does not have a primary physician? How is he getting his Metformin Rx? I would say that would be the first thing on the agenda. Also, he should have a diabetes education discussion regarding his diet, what and when to eat. Those numbers are too high at present. It could what he is eating, or he may need additional medication. His cholesterol problem should be addressed as well.

He's in no immediate risk unless he has ketones or his glucose levels rise to 600 mg/dl or higher which is the upper limit of glucose meters so they would just read "HI".

However if he doesn't bring down his A1C to 7% ( average of 154 mg/dl ) then he will suffer long term effects such as kidney failure, blindness, gastroparesis and possibly amputation.

He should take the time to see a Doctor at a free clinic. At his age, it may become a matter of whether or not the consequences of high glucose will occur while he's still alive so a Doctor may not be as concerned about strict glucose regulation but he will be better off if he can keep them to normal levels and it may simply require some insulin to do so and he would feel better if he did so.

Type N and type R insulin is relatively inexpensive at $25 per 10 ml vial at Walmart and can often be purchased without a prescription, it's possible to construct a full insulin treatment program with just those two insulins, it's just that the insulin manufacturer's would prefer you to use their long lasting insulins such as Lantus and Levelin and their rapid acting insulins such as Novolog and Humalog instead as they would receive much higher profits.

ER would be excessive unless there are ketones or evidence of HHS ( glucose greater than 600 mg/dl ) but he should seek help.