Q: My 56 years old mother is having diabetes for the last 10 years. She takes Metformin daily as prescribed by the doctor. Her glucose level never comes down from 350 mg/dl (minimum) and her weight is 67 kg. Now she has pain in her teeth. Is it due to diabetes? How can it be treated?

A:A patient having blood glucose of 350 mg/dl and diabetes of 10 years duration should take insulin to control blood glucose and once controlled, one can try to switch over to oral medications. Options are:

1. Oral medication with basal insulin like Lantus or Levimir.
2. Human Mix 30/70 twice daily along with Metformin.
3. Analog Mix 30/70 along with Metformin.

Doses, etc. have to be prescribed by a physician / endocrinologist along with diabetic education. If Insulin is totally unacceptable to her then she can take Glimipride 3 mg before breakfast and Metformin 1 gm twice daily. Ensure that her kidneys are normal before starting these oral medications.