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Suggest if insulin injections be started for glucose levels of 160

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Practicing since : 2001
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I am diabetic since 5 years,for the last 5 years my fasting blood glucose in between 125-134 mg/dL and my blood sugar level two hours after eating is less than 200 mg/dL and A1c between 6.5 - 6.7 percent , Iam using Januvia 50 ml/ per day ,but in last month I suffered a problem and pressure so my fasting blood glucose became in between 145-160 mg/dL and my blood sugar level two hours after eating is less than 270 mg/d suddenly . I have also cholesterol 217, triglycerides 270 i would like to ask is that the beginning of the use of insulin injections or my current blood glucose related to the my psychological state and then it will go down and please advice me what shall I do . Best regards
Posted Wed, 20 Aug 2014 in Diabetes
Answered by Dr. Shehzad Topiwala 4 hours later
Brief Answer:

Detailed Answer:
Psychological stress has been shown in some studies to worsen glucose control but there are no large systematic studies in this domain to answer the question. It is generally believed that psychological stress does not aggravate diabetes to an extent that it causes significant rise in blood glucose levels, especially chronically enough to warrant insulin treatment.

So at any point you have to by your glucose control. If the glucose targets set by your endocrinologist based upon multiple individual factors are not met then treatment needs to be advanced to the next level. This could be further oral agents or insulin.
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