My glucose levels have been 178, 200, 240 over the last 3 months. Most recently they were 300. My docotor called me in to redo bloodwork 2 hours after eating and they were 181. I'm to see Doc again in 2 weeks. Just started Crixivan and Norvir two weeks ago because Viracept wasn't working that well. Also take delav,3tc,d4t.

1. Doc doesn't want to treat if unnecessary but has mentioned preferring insulin over oral meds. (I don't like that idea.)

2. WHEN should one start treatment of high sugar?

3. Should I work with an endocronologist?

Your diabetes needs to be treated. I can't go into the details of how it should be treated, which is complicated and would require me to know more about you than I do, but you should be treated.

The second concern is that you are now on an essentially untested PI combination which is being started after the development of diabetes and which could certainly make your diabetes worse. You didn't say what doses of Crixivan and Norvir you're on, but it's important that you know that Norvir raises Crixivan levels substantially. No one claims to know the right dose, if any, to be used in this combination. But if one WERE to experiment, it would probably not be a good idea to take more than 400 mg of each drug twice a day. The more standard approach to treating Viracept resistance is with the combination of Norvir/Fortvase.

Good luck!

JG