Would you start insulin just for comfort? Patient is not on any prednisone or steroids or anything. She is NIDDM, on metformin 1000mg bid. 3 weeks ago her daughter came to live with her and is doing all the work, plus feeding her better.
Blood sugars are 250 range the last few days in the mornings (she takes her blood sugar in the mornings when she thinks about it or remembers or feels like it). But the higher sugars are making her feel shakey and she is actually shaking more. Her sleep and routine is chaotic because she is sleeping for 2 days straight and then having wakeful periods for 1-2 days straight. We are trying to get her on a more routine but this is somewhat of a chronic problem for the patient she has long periods of wakefulness and long periods of sleep, so this is not helping her blood sugars either.
We have her for COPD and we may have her for a while because she doesn't seem to be declining especially since her dd is here now caring for her.