[Increased blood sugar in type 2 diabetes mellitus: what now?].
There are various reasons for an increased diabetes with type-2 patients. The most frequent reason for hyperglycemia is the metabolic insulin resistance often resulting from a sustaining bad control of metabolism. The problem of insulin resistance can be overcome by making use of high doses of short acting insulin. In case of a subcutaneous insulin resistance, a rare type of insulin resistance, normalising blood sugar can only be achieved by intravenous application of insulin. In many cases there are quite simple reasons for insulin resistance. An erroneous technique of insulin injection is very often attributable for an abnormal need of insulin. With type 2 patients distinctly oscillating blood sugar is anything but normal. Besides a gastroparesis, one needs, in this case, take account of latent autoimmune diabetes of adults (LADA). The most important reasons for hypoglycemia with type-2 diabetes are the following: sulfonylurea and high doses of intermediate-acting insulin.
Winter
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Medizinische Klinik, Fachbereich Gastroenterologie, Städtische Kliniken Esslingen, Akademisches Lehrkrankenhaus der Universität Tübingen. Winter@medklinik.gilead.de
D000328:Adult; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000628:therapy; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007275:Injections, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D007333:Insulin Resistance; D008875:Middle Aged; D013453:Sulfonylurea Compounds / Q000009:adverse effects / Q000627:therapeutic use
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D013453:Sulfonylurea Compounds