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Diabetology: Dear Doctor, Good Morning. I Am Here Under Giving
Question: Diabetology:
Dear Doctor, good morning. I am here under giving my medical history to make you understand my case properly and give me a valuable suggestion..
I am 78 year old male.Height 5'8". Weight 65 kgs. Thin built. Not obese at any time. I have family history of Diabetes. I got diabetes in the year 2012. I got mild BP since 1981. Hypothyroid in 2014. For all , medicines are being taken and all are in normal levels .Regarding Diabetes I never had any symptoms so far.Right from 2012, I am taking Glycomet 500 mg twice. The fasting levels are between 110 to 125 and pp levels are between 130 to 165.My laboratory results during the past one year as follows
HB a1 C FASTING PP MEANBLOOD TSH
1/12/2018 6.5 128 141 154 3.7
15/4/2019 6.6 120 126 158 2.1
15/9/2019 6.7 116 126 161 1.8
18/12/2019 6.9 108 139 168 5.7
Taking Thyronorm 75 mg . The increase in TSH levels over sept 2019 levels is due to my endocrinologists suggestion to stop thyronorm on sat and sundays so that desired level of TSH can be arrived. As low level of TSH may lead to some complications. I walk for 4 km every day and not a sedantary type.My BMI is 21.
My lipid profile levels are : Cholestrol 111, Tryglycerides 134 , HDL 43, LDL 39, VLDL 29
Serum Urea and Serum creatinine are in normal .I mean minimum levels.
I am a vegetarian and eat moderately. I walk for 4 km every day since 40 years. I take coffee
without sugar twice a day. At times i eat sugars true to say. I am a chocolate lover.
My question is: There is a gradual increase in HBA1 c level from last year,though my fasting and pp levels are normal. If i increase the dosage of metformin , does this level come down? If so how much? Or do i have to add some gliptin like medicine along with metformin? if so which one do you suggest?
Do i have to stop taking coffee since half a glass of milk is being indirectly taken twice a day?
Is my stage is prediabetes or full blown diabates. If its not full blown how many years does it take to reach that stage?
Dear Doctor, good morning. I am here under giving my medical history to make you understand my case properly and give me a valuable suggestion..
I am 78 year old male.Height 5'8". Weight 65 kgs. Thin built. Not obese at any time. I have family history of Diabetes. I got diabetes in the year 2012. I got mild BP since 1981. Hypothyroid in 2014. For all , medicines are being taken and all are in normal levels .Regarding Diabetes I never had any symptoms so far.Right from 2012, I am taking Glycomet 500 mg twice. The fasting levels are between 110 to 125 and pp levels are between 130 to 165.My laboratory results during the past one year as follows
HB a1 C FASTING PP MEANBLOOD TSH
1/12/2018 6.5 128 141 154 3.7
15/4/2019 6.6 120 126 158 2.1
15/9/2019 6.7 116 126 161 1.8
18/12/2019 6.9 108 139 168 5.7
Taking Thyronorm 75 mg . The increase in TSH levels over sept 2019 levels is due to my endocrinologists suggestion to stop thyronorm on sat and sundays so that desired level of TSH can be arrived. As low level of TSH may lead to some complications. I walk for 4 km every day and not a sedantary type.My BMI is 21.
My lipid profile levels are : Cholestrol 111, Tryglycerides 134 , HDL 43, LDL 39, VLDL 29
Serum Urea and Serum creatinine are in normal .I mean minimum levels.
I am a vegetarian and eat moderately. I walk for 4 km every day since 40 years. I take coffee
without sugar twice a day. At times i eat sugars true to say. I am a chocolate lover.
My question is: There is a gradual increase in HBA1 c level from last year,though my fasting and pp levels are normal. If i increase the dosage of metformin , does this level come down? If so how much? Or do i have to add some gliptin like medicine along with metformin? if so which one do you suggest?
Do i have to stop taking coffee since half a glass of milk is being indirectly taken twice a day?
Is my stage is prediabetes or full blown diabates. If its not full blown how many years does it take to reach that stage?
Diabetology:
Dear Doctor, good morning. I am here under giving my medical history to make you understand my case properly and give me a valuable suggestion..
I am 78 year old male.Height 5'8". Weight 65 kgs. Thin built. Not obese at any time. I have family history of Diabetes. I got diabetes in the year 2012. I got mild BP since 1981. Hypothyroid in 2014. For all , medicines are being taken and all are in normal levels .Regarding Diabetes I never had any symptoms so far.Right from 2012, I am taking Glycomet 500 mg twice. The fasting levels are between 110 to 125 and pp levels are between 130 to 165.My laboratory results during the past one year as follows
HB a1 C FASTING PP MEANBLOOD TSH
1/12/2018 6.5 128 141 154 3.7
15/4/2019 6.6 120 126 158 2.1
15/9/2019 6.7 116 126 161 1.8
18/12/2019 6.9 108 139 168 5.7
Taking Thyronorm 75 mg . The increase in TSH levels over sept 2019 levels is due to my endocrinologists suggestion to stop thyronorm on sat and sundays so that desired level of TSH can be arrived. As low level of TSH may lead to some complications. I walk for 4 km every day and not a sedantary type.My BMI is 21.
My lipid profile levels are : Cholestrol 111, Tryglycerides 134 , HDL 43, LDL 39, VLDL 29
Serum Urea and Serum creatinine are in normal .I mean minimum levels.
I am a vegetarian and eat moderately. I walk for 4 km every day since 40 years. I take coffee
without sugar twice a day. At times i eat sugars true to say. I am a chocolate lover.
My question is: There is a gradual increase in HBA1 c level from last year,though my fasting and pp levels are normal. If i increase the dosage of metformin , does this level come down? If so how much? Or do i have to add some gliptin like medicine along with metformin? if so which one do you suggest?
Do i have to stop taking coffee since half a glass of milk is being indirectly taken twice a day?
Is my stage is prediabetes or full blown diabates. If its not full blown how many years does it take to reach that stage?
Dear Doctor, good morning. I am here under giving my medical history to make you understand my case properly and give me a valuable suggestion..
I am 78 year old male.Height 5'8". Weight 65 kgs. Thin built. Not obese at any time. I have family history of Diabetes. I got diabetes in the year 2012. I got mild BP since 1981. Hypothyroid in 2014. For all , medicines are being taken and all are in normal levels .Regarding Diabetes I never had any symptoms so far.Right from 2012, I am taking Glycomet 500 mg twice. The fasting levels are between 110 to 125 and pp levels are between 130 to 165.My laboratory results during the past one year as follows
HB a1 C FASTING PP MEANBLOOD TSH
1/12/2018 6.5 128 141 154 3.7
15/4/2019 6.6 120 126 158 2.1
15/9/2019 6.7 116 126 161 1.8
18/12/2019 6.9 108 139 168 5.7
Taking Thyronorm 75 mg . The increase in TSH levels over sept 2019 levels is due to my endocrinologists suggestion to stop thyronorm on sat and sundays so that desired level of TSH can be arrived. As low level of TSH may lead to some complications. I walk for 4 km every day and not a sedantary type.My BMI is 21.
My lipid profile levels are : Cholestrol 111, Tryglycerides 134 , HDL 43, LDL 39, VLDL 29
Serum Urea and Serum creatinine are in normal .I mean minimum levels.
I am a vegetarian and eat moderately. I walk for 4 km every day since 40 years. I take coffee
without sugar twice a day. At times i eat sugars true to say. I am a chocolate lover.
My question is: There is a gradual increase in HBA1 c level from last year,though my fasting and pp levels are normal. If i increase the dosage of metformin , does this level come down? If so how much? Or do i have to add some gliptin like medicine along with metformin? if so which one do you suggest?
Do i have to stop taking coffee since half a glass of milk is being indirectly taken twice a day?
Is my stage is prediabetes or full blown diabates. If its not full blown how many years does it take to reach that stage?
Brief Answer:
Suggestions and explanations to the specific Qs asked
Detailed Answer:
Hello.
I am Dr. Mittal.
I have read your message.
I think I can help you understand the issues further.
First and foremost, yes you have diabetes.
You are taking the medicines for the same.
And despite the medicines, the HbA1C is gradually rising.
Your initial sugars were high as well, for Fasting as well as PP state.
Now for your rising levels of sugars-
1. I think it would be suitable to get a glucometer and keep a sugar chart across all three meals. I think you would find that across one of the meals your sugars are higher than acceptable levels.
2. Certainly, dietary intake is a significant factor that influences the HbA1C levels. So a restriction of the sugars would help better control the HbA1C- especially the chocolates. You see HbA1C is a record over 3 months. So, if sugars are high during one episode the HbA1C will rise despite the fact that your sugars may be normal otherwise.
3. And therefore, I would not recommend increasing the medication dose just yet. Control your diet again over 3-4 months, retest the sugars. If the HbA1C remains high, then we will need to increase the dose of medicine, and in the meantime, the sugar chart (Made with the use of glucometer) would be complete. And the medication can be increased appropriately thereafter.
I hope that helps answer you.
Best of luck, Dr Mittal
Suggestions and explanations to the specific Qs asked
Detailed Answer:
Hello.
I am Dr. Mittal.
I have read your message.
I think I can help you understand the issues further.
First and foremost, yes you have diabetes.
You are taking the medicines for the same.
And despite the medicines, the HbA1C is gradually rising.
Your initial sugars were high as well, for Fasting as well as PP state.
Now for your rising levels of sugars-
1. I think it would be suitable to get a glucometer and keep a sugar chart across all three meals. I think you would find that across one of the meals your sugars are higher than acceptable levels.
2. Certainly, dietary intake is a significant factor that influences the HbA1C levels. So a restriction of the sugars would help better control the HbA1C- especially the chocolates. You see HbA1C is a record over 3 months. So, if sugars are high during one episode the HbA1C will rise despite the fact that your sugars may be normal otherwise.
3. And therefore, I would not recommend increasing the medication dose just yet. Control your diet again over 3-4 months, retest the sugars. If the HbA1C remains high, then we will need to increase the dose of medicine, and in the meantime, the sugar chart (Made with the use of glucometer) would be complete. And the medication can be increased appropriately thereafter.
I hope that helps answer you.
Best of luck, Dr Mittal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Suggestions and explanations to the specific Qs asked
Detailed Answer:
Hello.
I am Dr. Mittal.
I have read your message.
I think I can help you understand the issues further.
First and foremost, yes you have diabetes.
You are taking the medicines for the same.
And despite the medicines, the HbA1C is gradually rising.
Your initial sugars were high as well, for Fasting as well as PP state.
Now for your rising levels of sugars-
1. I think it would be suitable to get a glucometer and keep a sugar chart across all three meals. I think you would find that across one of the meals your sugars are higher than acceptable levels.
2. Certainly, dietary intake is a significant factor that influences the HbA1C levels. So a restriction of the sugars would help better control the HbA1C- especially the chocolates. You see HbA1C is a record over 3 months. So, if sugars are high during one episode the HbA1C will rise despite the fact that your sugars may be normal otherwise.
3. And therefore, I would not recommend increasing the medication dose just yet. Control your diet again over 3-4 months, retest the sugars. If the HbA1C remains high, then we will need to increase the dose of medicine, and in the meantime, the sugar chart (Made with the use of glucometer) would be complete. And the medication can be increased appropriately thereafter.
I hope that helps answer you.
Best of luck, Dr Mittal
Suggestions and explanations to the specific Qs asked
Detailed Answer:
Hello.
I am Dr. Mittal.
I have read your message.
I think I can help you understand the issues further.
First and foremost, yes you have diabetes.
You are taking the medicines for the same.
And despite the medicines, the HbA1C is gradually rising.
Your initial sugars were high as well, for Fasting as well as PP state.
Now for your rising levels of sugars-
1. I think it would be suitable to get a glucometer and keep a sugar chart across all three meals. I think you would find that across one of the meals your sugars are higher than acceptable levels.
2. Certainly, dietary intake is a significant factor that influences the HbA1C levels. So a restriction of the sugars would help better control the HbA1C- especially the chocolates. You see HbA1C is a record over 3 months. So, if sugars are high during one episode the HbA1C will rise despite the fact that your sugars may be normal otherwise.
3. And therefore, I would not recommend increasing the medication dose just yet. Control your diet again over 3-4 months, retest the sugars. If the HbA1C remains high, then we will need to increase the dose of medicine, and in the meantime, the sugar chart (Made with the use of glucometer) would be complete. And the medication can be increased appropriately thereafter.
I hope that helps answer you.
Best of luck, Dr Mittal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Clarification to the specific doubt
Detailed Answer:
Hello.
There are 7 types of blood sugars that are tested regularly.
Before meals-breakfast, lunch, dinner (3).
2 hours After meals- breakfast, lunch, dinner (3).
And 3 AM (1).
In your case, the last one is not needed.
So you can test the other sugars.
Once every 3 days should be fine.
Target separate meal times on separate days.
A record, on and off, over the 3 months will help.
Let me know if any further clarification is needed.
Best of luck, Dr. Mittal
Clarification to the specific doubt
Detailed Answer:
Hello.
There are 7 types of blood sugars that are tested regularly.
Before meals-breakfast, lunch, dinner (3).
2 hours After meals- breakfast, lunch, dinner (3).
And 3 AM (1).
In your case, the last one is not needed.
So you can test the other sugars.
Once every 3 days should be fine.
Target separate meal times on separate days.
A record, on and off, over the 3 months will help.
Let me know if any further clarification is needed.
Best of luck, Dr. Mittal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Clarification to the specific doubt
Detailed Answer:
Hello.
There are 7 types of blood sugars that are tested regularly.
Before meals-breakfast, lunch, dinner (3).
2 hours After meals- breakfast, lunch, dinner (3).
And 3 AM (1).
In your case, the last one is not needed.
So you can test the other sugars.
Once every 3 days should be fine.
Target separate meal times on separate days.
A record, on and off, over the 3 months will help.
Let me know if any further clarification is needed.
Best of luck, Dr. Mittal
Clarification to the specific doubt
Detailed Answer:
Hello.
There are 7 types of blood sugars that are tested regularly.
Before meals-breakfast, lunch, dinner (3).
2 hours After meals- breakfast, lunch, dinner (3).
And 3 AM (1).
In your case, the last one is not needed.
So you can test the other sugars.
Once every 3 days should be fine.
Target separate meal times on separate days.
A record, on and off, over the 3 months will help.
Let me know if any further clarification is needed.
Best of luck, Dr. Mittal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Doctor i thank you very much for your advise.As suggested by you i shall record glucose levels 3 times a day.Is it after every 2 hrs after each meal? i did not understand.kindly eloborate.And how long do i have to record.In case if i wish to contact you again, will you give me your email address?
Dear Doctor i thank you very much for your advise.As suggested by you i shall record glucose levels 3 times a day.Is it after every 2 hrs after each meal? i did not understand.kindly eloborate.And how long do i have to record.In case if i wish to contact you again, will you give me your email address?
Thank you for your advice.i shall follow your advice.however i am herewith giving the glucometer readings during this month.it may throw some light.
fasting pp
4/12/19 137
6/12/19 174
7/12/ 122
10/12 159
11/12 151 177
12/12 124 150
18/12 119
23/12 133
26/12 162
In this connection i have to inform you that in the year 2013
i.e 6 years back also Hba1c touched 6.9.But later till 2018 it has never crossed 6.7.
All these 7 years fasting oscillated between minimum 100 and XXXXXXX 128.And PP 113 and XXXXXXX 161.only once in 2012 touched 161.
in the light of the above please advise.sorry for the trouble.
fasting pp
4/12/19 137
6/12/19 174
7/12/ 122
10/12 159
11/12 151 177
12/12 124 150
18/12 119
23/12 133
26/12 162
In this connection i have to inform you that in the year 2013
i.e 6 years back also Hba1c touched 6.9.But later till 2018 it has never crossed 6.7.
All these 7 years fasting oscillated between minimum 100 and XXXXXXX 128.And PP 113 and XXXXXXX 161.only once in 2012 touched 161.
in the light of the above please advise.sorry for the trouble.
Thank you for your advice.i shall follow your advice.however i am herewith giving the glucometer readings during this month.it may throw some light.
fasting pp
4/12/19 137
6/12/19 174
7/12/ 122
10/12 159
11/12 151 177
12/12 124 150
18/12 119
23/12 133
26/12 162
In this connection i have to inform you that in the year 2013
i.e 6 years back also Hba1c touched 6.9.But later till 2018 it has never crossed 6.7.
All these 7 years fasting oscillated between minimum 100 and XXXXXXX 128.And PP 113 and XXXXXXX 161.only once in 2012 touched 161.
in the light of the above please advise.sorry for the trouble.
fasting pp
4/12/19 137
6/12/19 174
7/12/ 122
10/12 159
11/12 151 177
12/12 124 150
18/12 119
23/12 133
26/12 162
In this connection i have to inform you that in the year 2013
i.e 6 years back also Hba1c touched 6.9.But later till 2018 it has never crossed 6.7.
All these 7 years fasting oscillated between minimum 100 and XXXXXXX 128.And PP 113 and XXXXXXX 161.only once in 2012 touched 161.
in the light of the above please advise.sorry for the trouble.
Brief Answer:
Explained
Detailed Answer:
Hello again.
I have seen the message.
I have seen the sugars that you have quoted.
Some of them are indeed going above 150.
You need to contemplate the difference in diets on the days sugars were high compared to the better sugars.
I also need to know the details of these sugars- which are fasting and which are Post prandial.
And the time the medication was taken, before or after checking the sugars.
That would be needed.
I hope that helps.
Dr Mittal
Explained
Detailed Answer:
Hello again.
I have seen the message.
I have seen the sugars that you have quoted.
Some of them are indeed going above 150.
You need to contemplate the difference in diets on the days sugars were high compared to the better sugars.
I also need to know the details of these sugars- which are fasting and which are Post prandial.
And the time the medication was taken, before or after checking the sugars.
That would be needed.
I hope that helps.
Dr Mittal
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Explained
Detailed Answer:
Hello again.
I have seen the message.
I have seen the sugars that you have quoted.
Some of them are indeed going above 150.
You need to contemplate the difference in diets on the days sugars were high compared to the better sugars.
I also need to know the details of these sugars- which are fasting and which are Post prandial.
And the time the medication was taken, before or after checking the sugars.
That would be needed.
I hope that helps.
Dr Mittal
Explained
Detailed Answer:
Hello again.
I have seen the message.
I have seen the sugars that you have quoted.
Some of them are indeed going above 150.
You need to contemplate the difference in diets on the days sugars were high compared to the better sugars.
I also need to know the details of these sugars- which are fasting and which are Post prandial.
And the time the medication was taken, before or after checking the sugars.
That would be needed.
I hope that helps.
Dr Mittal
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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