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By the way, doctor: Diabetes treatment

Updated: May 01, 2009

Q. I've had type 2 diabetes for 12 years; I'm now 81. I take metformin plus Januvia. My doctor has never suggested that I monitor myself on a daily basis with a meter. My hemoglobin A1c has been creeping up and is now at 7. Should I be getting more aggressive in my treatment?

A. You have type 2 diabetes, which used to be called adult-onset diabetes. This type of diabetes is caused mainly by insulin resistance. Normally, insulin helps usher blood sugar (which is the same thing as glucose) out of the bloodstream and into cells where it is used for energy. When people develop insulin resistance, cells turn away insulin, so the amount of sugar circulating in the blood goes up, and sugar-laden blood leads to numerous problems, including damage to the eyes, kidneys, and nerves and a higher risk of heart attacks and strokes.

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