Dear TJ:

 You need medication.  No mild diabetic controlled at first with diet and exercise has lasted more than a year (approx.) without needing medication.  You have moderately severe diabetes now. You are not "mild".

 You need to do the following.

1. Do a C-Peptide test to see if your pancreas is still able to produce adequate insulin.

2. Do an eGFR to determine how well your kidneys are working. All insulins go out of the body via the kidney so.....if you need insulin the type you use would be determined by your eGFR.  Other medications you will need (Januvia or Onglyza) have to be reduced in kidney insufficiency.

3. Get a good home glucose meter (I prefer Aviva) and check your blood sugar about twice daily before meals.  Your doctor MUST use the computer software provided by the company (free) to create a LINE GRAPH of your data. The line graph must be used to adjust your medications with every visit.

4. NEVER use the HgbA1c test to guide your therapy.  You are too severe. This is

dangerous. (Google ACCORD study in NEJM of June 8 2008 and see that hundreds of deaths resulted from aggressive lowering of the HgbA1c as the only guide.)

Roberto Illa, M.D.

www.chicodiabetesdoctor.com

 

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The Illa Protocol 3^rd Edition. Author House Publishing Co.  (available soon from all online booksellers)