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How To Control Blood Sugar Levels?
Question: I am 42yr old male, weight 68kg, Height 150cms from XXXXXXX with DMT2 since 5 years. My recent HbA1c was 9.6; Average Blood Glucose is 229, FBS in 178 and PPBS in 212. C Reactive Protein is 7.78; Iron is 57.3 (Photometry method). Vit D - 5.31. Serum Creatinine - 0.55; BUN - 16.5 (BUN: SCreat ratio - 29.18) Total Cholesterol, HDL, LDL, and TG are all in normal range. Family History of CHD +
What medications do I need to change? How do I manage my Diabetes?
What medications do I need to change? How do I manage my Diabetes?
Brief Answer:
Increase oral medications. Add insulin
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I had gone through your question and understand your concerns.
I have gone through your reports. Problems in your blood reports are:
1. Uncontrolled diabetes
2. Vitamin D deficiency
3. Iron deficiency
4. Borderline cholesterol values
5. Normal Kidney function
Most important among these is to control your blood glucose. Both your fasting and after food glucose values are high. I hope you are taking regularly Sitagliptin 50mg; Metformin 1000mg and Glimipride 2mg TWICE DAILY, which is an optimum dose of oral medications. If your sugars are still high it is always better to add on once daily insulin.
Your target blood values at this age are:
HbA1C less than 7%, Fasting plasma glucose less than 130 mg/dl after food less than 180 mg/dl and LDL cholesterol less than 100 mg/dl.
Insulin is the best add on medication to current treatment to achieve this target.
Mean while follow good diet control and regular aerobic exercise.
For other ailments:
Vitamin D supplementation, available as once weekly sachets or tablets, can be taken for 2 months to correct deficiency. Start on iron supplementation after consulting your physician.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Increase oral medications. Add insulin
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I had gone through your question and understand your concerns.
I have gone through your reports. Problems in your blood reports are:
1. Uncontrolled diabetes
2. Vitamin D deficiency
3. Iron deficiency
4. Borderline cholesterol values
5. Normal Kidney function
Most important among these is to control your blood glucose. Both your fasting and after food glucose values are high. I hope you are taking regularly Sitagliptin 50mg; Metformin 1000mg and Glimipride 2mg TWICE DAILY, which is an optimum dose of oral medications. If your sugars are still high it is always better to add on once daily insulin.
Your target blood values at this age are:
HbA1C less than 7%, Fasting plasma glucose less than 130 mg/dl after food less than 180 mg/dl and LDL cholesterol less than 100 mg/dl.
Insulin is the best add on medication to current treatment to achieve this target.
Mean while follow good diet control and regular aerobic exercise.
For other ailments:
Vitamin D supplementation, available as once weekly sachets or tablets, can be taken for 2 months to correct deficiency. Start on iron supplementation after consulting your physician.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Any recomendation on insulin to begin with? Basal or rapid acting? What should i begin with?
Brief Answer:
Basal insulin is more convenient to start
Detailed Answer:
Hi XXXXXXX
Welcome back.
We have 2 options while starting on insulin. Either to start on once daily basal insulin or twice daily premixed insulin.
If I were your treating physician I would have started you on basal insulin as it is more convenient,once daily and easy to adjust dosage. There are different basal insulins like NPH, Glargine, Detemir and degludec. You can discuss with your doctor and start the medications.
wishing you good health
Regards
Dr Ajish TP
Consultant Endocrinologist
Basal insulin is more convenient to start
Detailed Answer:
Hi XXXXXXX
Welcome back.
We have 2 options while starting on insulin. Either to start on once daily basal insulin or twice daily premixed insulin.
If I were your treating physician I would have started you on basal insulin as it is more convenient,once daily and easy to adjust dosage. There are different basal insulins like NPH, Glargine, Detemir and degludec. You can discuss with your doctor and start the medications.
wishing you good health
Regards
Dr Ajish TP
Consultant Endocrinologist
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
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