Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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How Can I Control High Overnight Glucose Readings?

Monday, 03 May 2010 08:58 AM

Question: I take glipizide for Type 2 diabetes. I recently went from 5 to 10 mg twice daily (before breakfast and dinner). That, along with fewer carbs, has helped to maintain normal glucose reading during the day, but my overnight readings are still in the 150-160 range. What to do?

Dr. Hibberd's Answer:

Many diabetics share the same dilemma you have noted. Nighttime elevated glucose readings are clearly a problem for most diabetics on oral medications. We like to correct these elevations by providing a low dose of insulin at night. This is very easy to add and will be far cheaper than juggling multiple oral regimens.

Also, we favor using other agents to improve your body's utilization of glucose. Ask your doctor if you are a candidate for metformin treatment. Sometimes adding it to glipizide will control glucoses as well as insulin. I would normally try adding metformin before adding insulin at night.

Remember that nasal insulin delivery (non-injectible) may be an option for some, though its marketing and use has somewhat been de-emphasized after local nasal issues interfered with its use in some patients.



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