Publication Date: 9/6/2004
Remember that the information presented here is not intended to replace the care of your own doctor. Before making any changes in the management of your own illness, you should consult your physician or other qualified medical professionals.
Question
I have taken Starlix [brand name for nateglinide, a diabetes pill] for about 4 days once a day 30 minutes before dinner only. I eat a low carb lunch so I don't take it. My blood sugar is around 160 in the morning at 9:30 a.m. and 120 at 5:00 p.m. and has been this way for years and sometimes it gets higher and my heart hurts then I diet and bring it down. When I have been taking Starlix I really don't see a improvement. I ate at 6:45 p.m. My blood sugar at 5:30 before my evening meal was 116. At 9:20 p.m. it was 140 normal I believe. Then at 11:20 p.m. it was 156, then this morning it was 154. So it goes up slow stays up all night then is gets closer to normal by dinner? Could this problem be in my liver and not in my pancreas? I drink a lot when I was younger but I haven't drank in about 6 years not a drop. I am 5 foot 10 and one half inches tall and weight is 155 or so. I exercise three to four tomes a week and I am 50 years old. Could it be my food is not digesting fast enough? I have a non aggressive type of Hepatitis C and my viral load count is not high.Answer
The fact that your blood sugar is normal 3 hours after dinner and then rises by morning is not related to the Starlix because it has run out during the night. In people with type 2 diabetes, which it appears you have, the problem is insulin resistance. Often the AM blood sugar is one of the highest of the day because the liver continues to make sugar throughout the night because it is not shut off by the insulin as it should be. This is not related to hepatitis, it is because the liver and other tissues do not sense the insulin levels properly. During the day, the meals are able to stimulate enough insulin from the pancreas, so your sugars are about normal as you have noticed. If your doctor felt it was necessary to lower the AM sugar you would need to use a longer acting agent at dinner or bedtime. If your overall sugar control is good then no further medication is needed at this time, although it may be needed in the future.Copyright � Colorado HealthSite. Reproduced with permission.
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