Hyperglycemia [posted 7/30/98]
Question: 65 year old white male with Micronase 5 mg qid awakens in the morning with BS of 287 to 300 before meal. Patient is also taking Lasix 40 mg qd, glucophage tab 1 tid, Pravachol 40 mg qd, lanoxin 0.25 mg qd, Secondary failure of medication or drug interaction?

Answer: No obvious interaction. What are the glucose reading the rest of the day? That is, are they also high - suggesting he needs another medication added to micronase or insulin. Or are they well controlled. If relatively low, I would check his glucose about 3 a.m. There are patients who experience hypoglycemia at this point in the morning and the morning rise reflects the bodies reaction to hypoglycemia. Further medications will only make this worse. If his 3 a.m. is high, he needs additional medications.

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