Common causes
Asymptomatic hypoglycemia , especially at 2 to 3 AM , is probable the most common cause. Other common causes for unexplained changes in blood sugars is a mild infection or medications such as steroids.
*Asymptomatic urinary tract infection is a common cause in women. This can be rule out with a
urinalysis.
* Steroid injections or pills , often used for musculoskeletal problems and allergies , will cause an
increase in blood sugars.
* Sometime a low potassium level ,secondary to diuretics in blood pressure medications, can also cause
an increase in glucose levels.
* Stress , sometimes life situations will rule the day
Persistent glucose elevations
Persistent elevation of the fasting blood sugars , in the absence of correctable causes , suggest more significant insulin deficiency and the and the need for additional medication.
Lantus insulin is very good for correcting fasting blood sugars in some patients. Unfortunately , the choice of insulin is often the last considered instead of a reasonable second choice
I have attached links to some of my July posts discussing some of the newer medications. Read the article reviewed in "New strategies for treating diabetes " regarding the use of lantus insulin first.
Have fun , Be smart and discuss all of your treatment options with your doctor
David Calder,MD
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