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What Causes Diabetes Mellitus?
Question: doctor,my mother is 58 year old.she was diagnosed with typhoid 8 months ago.that time her diabetese test was negative.after that she became weak.for last 15 day she has been facing some pain in her right upper hand joint.yesterday doctor prescribed her some test in which HBA1C came 8.7 percent.as she was tested negative for diabetes 8 months ago,she was taking rice,bananas,glucose,apples everything continuously.now,for last 2 days she is not sleeping,feeling thrust and go to toilet every hour.even in day time she is not able to sleep.doctor has given some medicines (gemer p1,sompraz d40,combiglyze XR,nurokind gold) for 60 days.i am very much scared.is it life threatning disease?is her joint pain related to diabetes,as xray report is normal but E.S.R is 55%?can't it be cured?
Brief Answer:
Diabetes can be controlled
Detailed Answer:
Hi,
I am Dr. Prakash HM and I will answer your query.
Diabetes mellitus (DM) is a chronic disease due to reduced insulin or insulin resistance or both. DM Type II, which your mother is diagnosed is seen after forty years. Causes include genetics, obesity and other life style changes.
Every elderly is routinely evaluated for DM. Now HbA1c is standard for evaluation. The level in your mother is high but not too high to warrant hospital admission.
She has been prescribed oral hypoglycemics to control sugar levels and slowly dosage might be increased or decreased to maintain normal sugar levels.
Vitamin supplements are also added as nerve disorders are common in DM. Present joint pain could be secondary to DM as it can affect nerves and blood vessels. One month of therapy if pain disappears it could be due to DM.
HbA1c indicates only three months previous control, so we can safely assume it is a recent start.
DM presents with increased urination due to more sugar in body, and due to water lost, increased water intake is necessary. Your mother due to increased urination and recent stressful diagnosis might not be having adequate sleep.
Watch out for sugar control (diabetes test kit for sugar control at home can be bought), and annual eye, kidney, and heart checkups.
Maintaining a proper diet with good nutrition is essential. Weight loss, regular exercise, small multiple meals can help in sugar control.
ESR of 55 mm/hr could be due to joint pain. Alone ESR is not significant with normal x ray findings.
Control of blood sugar is necessary to have a healthy and productive life. Take care.
If you have any further queries, happy to help you again.
Dr. Prakash HM
Diabetes can be controlled
Detailed Answer:
Hi,
I am Dr. Prakash HM and I will answer your query.
Diabetes mellitus (DM) is a chronic disease due to reduced insulin or insulin resistance or both. DM Type II, which your mother is diagnosed is seen after forty years. Causes include genetics, obesity and other life style changes.
Every elderly is routinely evaluated for DM. Now HbA1c is standard for evaluation. The level in your mother is high but not too high to warrant hospital admission.
She has been prescribed oral hypoglycemics to control sugar levels and slowly dosage might be increased or decreased to maintain normal sugar levels.
Vitamin supplements are also added as nerve disorders are common in DM. Present joint pain could be secondary to DM as it can affect nerves and blood vessels. One month of therapy if pain disappears it could be due to DM.
HbA1c indicates only three months previous control, so we can safely assume it is a recent start.
DM presents with increased urination due to more sugar in body, and due to water lost, increased water intake is necessary. Your mother due to increased urination and recent stressful diagnosis might not be having adequate sleep.
Watch out for sugar control (diabetes test kit for sugar control at home can be bought), and annual eye, kidney, and heart checkups.
Maintaining a proper diet with good nutrition is essential. Weight loss, regular exercise, small multiple meals can help in sugar control.
ESR of 55 mm/hr could be due to joint pain. Alone ESR is not significant with normal x ray findings.
Control of blood sugar is necessary to have a healthy and productive life. Take care.
If you have any further queries, happy to help you again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
doctor,she has pain in her teeth.dentist advised her to remove her one of the teeth,but probably it won't be possible as her sugar level is high.can teeth removal be possible when sugar level comes down?please tell me,she can live long na?will she face sleeplessness ever?will she have to take sleeping pills always?
Brief Answer:
Do not worry.
Detailed Answer:
Hi again,
A person with diabetes mellitus (DM) under control rarely goes into complications and can live like a normal person (except for diet and medications). People have been diagnosed with DM at a very small age and they have survived for a long time. DM does not decide the survival, its control is very important.
Patients with DM have high blood sugar and are prone to infections. Delayed wound healing also is seen due to vascular disease. Once it comes under control, risk of infections is ruled out and she can get her tooth extracted. Healing might take a bit longer due to age and DM. If on good blood sugar control, good healing will occur.
As I told you earlier her sleeplessness is due to her disturbed sleep of increased frequency of passing urine and the associated stress of DM diagnosis.
She need not take any sleeping pills in future as DM does not affect sleep. For time being she can take it as required. Good sleep improves blood sugar control too. Once she comes in terms with her disease and she feels comfortable, she will be able to sleep.
If you have any further queries, happy to help you.
Dr. Prakash HM
Do not worry.
Detailed Answer:
Hi again,
A person with diabetes mellitus (DM) under control rarely goes into complications and can live like a normal person (except for diet and medications). People have been diagnosed with DM at a very small age and they have survived for a long time. DM does not decide the survival, its control is very important.
Patients with DM have high blood sugar and are prone to infections. Delayed wound healing also is seen due to vascular disease. Once it comes under control, risk of infections is ruled out and she can get her tooth extracted. Healing might take a bit longer due to age and DM. If on good blood sugar control, good healing will occur.
As I told you earlier her sleeplessness is due to her disturbed sleep of increased frequency of passing urine and the associated stress of DM diagnosis.
She need not take any sleeping pills in future as DM does not affect sleep. For time being she can take it as required. Good sleep improves blood sugar control too. Once she comes in terms with her disease and she feels comfortable, she will be able to sleep.
If you have any further queries, happy to help you.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Yogesh D
doctor,will she need insulin in future?actually she is working and this is creating a lot of stress to her that how she will be able to manage work as well as households with the disease.i have learnt that in diabetes patients sugar level can drop up to threatning level although it is high few hours before.how will other family members know it and what first aid they should know?actually my grandfather had diabetes,don't know type 1 or 2..but his sugar level was very high in the morning he died,then he felt gas in her stomach and when slept,couldn't wake up.a few said that his sugar level dropped thats'why he died.for now doctor had not prescribed cholesterol test for my mother,should we get this test done?her platelets count is also low,what she should eat?can she have coconut water?
Brief Answer:
Yes, Get cholesterol levels checked
Detailed Answer:
Hi XXXXXXX
Diabetes is a chronic disease with insulin requirement increasing day by day. If she is not able to modify her life style by reducing weight, she might have to go for regular insulin injections, maybe in another 10-15 years, depending on how her pancreas is responding to the drug treatment she is under.
She will be able to manage her work as good as non-diabetic individuals. Many Sportsmen like Wasim akram, affected are leading a strong life. If she manages her blood sugar with a proper diet, it should not be problem.
Hypoglycemia or low blood sugar is one of the serious complication. Symptoms like sweating or dizziness should alert her to it. She should always carry either chocolates, glucose biscuits, glucose or even plain sugar. If she feels any of the symptoms, she can have a bite to improve her symptoms. After diabetes medication, she needs to eat a proper diet, to avoid these symptoms.
It would be difficult to comment about your grandfather with the present data. I strongly suspect at this age, it could have been a heart attack.
Lipid profile needs to be done in all above 40 years to improve life style and if required take medication. Do get it evaluated.
You have not indicated the platelet count. If she has any bleeding from anywhere, or petechiae (Tiny hemorrhagic patches in skin) we need to worry. If the count is below one lakh, discuss it with your doctor. Overall nutrition can improve the blood cells. She can take vegetables, fish, eggs to improve her nutrition. However, discuss with a dietitian to have a diabetic chart.
Coconut water in diabetes in early stages can be taken maybe once in a week. But if renal functions are affected in diabetes, potassium and sodium in coconut water can be harmful. It is not beneficial in diabetes sugar control. Taken occasionally should not cause any problems.
Take care and do not worry. It is a disease which can be controlled completely.
If you have any further queries, happy to help again.
Dr. Prakash HM
Yes, Get cholesterol levels checked
Detailed Answer:
Hi XXXXXXX
Diabetes is a chronic disease with insulin requirement increasing day by day. If she is not able to modify her life style by reducing weight, she might have to go for regular insulin injections, maybe in another 10-15 years, depending on how her pancreas is responding to the drug treatment she is under.
She will be able to manage her work as good as non-diabetic individuals. Many Sportsmen like Wasim akram, affected are leading a strong life. If she manages her blood sugar with a proper diet, it should not be problem.
Hypoglycemia or low blood sugar is one of the serious complication. Symptoms like sweating or dizziness should alert her to it. She should always carry either chocolates, glucose biscuits, glucose or even plain sugar. If she feels any of the symptoms, she can have a bite to improve her symptoms. After diabetes medication, she needs to eat a proper diet, to avoid these symptoms.
It would be difficult to comment about your grandfather with the present data. I strongly suspect at this age, it could have been a heart attack.
Lipid profile needs to be done in all above 40 years to improve life style and if required take medication. Do get it evaluated.
You have not indicated the platelet count. If she has any bleeding from anywhere, or petechiae (Tiny hemorrhagic patches in skin) we need to worry. If the count is below one lakh, discuss it with your doctor. Overall nutrition can improve the blood cells. She can take vegetables, fish, eggs to improve her nutrition. However, discuss with a dietitian to have a diabetic chart.
Coconut water in diabetes in early stages can be taken maybe once in a week. But if renal functions are affected in diabetes, potassium and sodium in coconut water can be harmful. It is not beneficial in diabetes sugar control. Taken occasionally should not cause any problems.
Take care and do not worry. It is a disease which can be controlled completely.
If you have any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Prasad
doctor is HBA1C sufficient to detect diabetes?can this sugar level(8.7%) be temporary and prove that this mother's diabetes is not permanent?actually from today she is feeling like as before the detection of the disease.and i am not able to find out the exact cause as my mother was very active physically and there was no case history of the disease in her family.apart from HBA1C what are the other tests to know recent glucose amount in blood.mother has taken her meal 2 hours ago.can i get her tested for glucose detection right now?if yes then which test,as a chemist suggested that it can be done.In relevent to the medicines she is taking as i told you before,are they ok?as my doctor is only an mbbs,do i need to see another doctor with higher degree?
Brief Answer:
You can get HbA1c retested
Detailed Answer:
Hi XXXXXXX
According to recent studies, and the tests I order, HbA1c is sufficient for diagnosis and confirmation of Diabetes mellitus. However, not every test or laboratory is 100% perfect.
You can take another opinion from another laboratory for HbA1c. It usually indicates a 3 months sugar control. If the blood sugar was indeed elevated above the normal, HbA1c would be abnormal. However if it is below 6.5% or normal levels according to laboratory method followed, it would prove you that it might have been a misdiagnosis due to laboratory error.
Now that your mother is on treatment, and blood sugar level is normal, then it suggests, that the diagnosis was right.
You can get her blood sugar tested through Fasting blood sugar and post-prandial blood sugar. You can get it done. If it is normal, it indicates medication should be maintained.
Get tested tomorrow morning and let me know the values if they are normal. I don't expect it to be. Best thing, if you are too doubtful would be to repeat maybe in another laboratory for HbA1c values.
If you have any further queries, I would be happy to help again.
Dr. Prakash HM
You can get HbA1c retested
Detailed Answer:
Hi XXXXXXX
According to recent studies, and the tests I order, HbA1c is sufficient for diagnosis and confirmation of Diabetes mellitus. However, not every test or laboratory is 100% perfect.
You can take another opinion from another laboratory for HbA1c. It usually indicates a 3 months sugar control. If the blood sugar was indeed elevated above the normal, HbA1c would be abnormal. However if it is below 6.5% or normal levels according to laboratory method followed, it would prove you that it might have been a misdiagnosis due to laboratory error.
Now that your mother is on treatment, and blood sugar level is normal, then it suggests, that the diagnosis was right.
You can get her blood sugar tested through Fasting blood sugar and post-prandial blood sugar. You can get it done. If it is normal, it indicates medication should be maintained.
Get tested tomorrow morning and let me know the values if they are normal. I don't expect it to be. Best thing, if you are too doubtful would be to repeat maybe in another laboratory for HbA1c values.
If you have any further queries, I would be happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
doctor,today in morning my mother's fasting blood sugar result came as 162(don't know about unit).what do you say?should she go for the test after meal also?last night she couldn't sleep at all as she didn't take sleeping pill also.but in morning after walk she slept for 2.30 hours.but still she is thinking that she will not be able to sleep tonight.she has not got rid of her stress,may be this is the reason!
Brief Answer:
Control sugar with medication & life style modifn
Detailed Answer:
Hi XXXX
Fasting blood sugar of 162 definitely confirms diabetes mellitus after a raised HbA1C. If she goes for test after meal, it will also be definitely increased and you can go for it if you want. Sleeping will be irregular mainly due to stress.
She should tried to avoid sleeping in day time. Maybe one hr in after noon is good. If she sleeps more, she will find it difficult to sleep at night. She can follow a few things to sleep at night like,
1. Follow regular schedule - into bed by 10 and wake-up by 6 to 6.30 for walking
2. No watching TV or listening to music after 9 pm
3. Dinner should be finished by 8 pm.
4. If she feels tired she can take a bath, but try avoiding bath immediately after food.
5. Avoid drugs for sleeping as much as possible. If dependence develops, it would be difficult.
It is a stressful time, she will slowly get accustomed. Blood sugar is not still under control. Medication and lifestyle management is essential. She can take counseling if required or discuss with other diabetics. She can cope up and will get back to normal life eventually.
If you have any further queries, happy to help again.
Dr. Prakash HM
Control sugar with medication & life style modifn
Detailed Answer:
Hi XXXX
Fasting blood sugar of 162 definitely confirms diabetes mellitus after a raised HbA1C. If she goes for test after meal, it will also be definitely increased and you can go for it if you want. Sleeping will be irregular mainly due to stress.
She should tried to avoid sleeping in day time. Maybe one hr in after noon is good. If she sleeps more, she will find it difficult to sleep at night. She can follow a few things to sleep at night like,
1. Follow regular schedule - into bed by 10 and wake-up by 6 to 6.30 for walking
2. No watching TV or listening to music after 9 pm
3. Dinner should be finished by 8 pm.
4. If she feels tired she can take a bath, but try avoiding bath immediately after food.
5. Avoid drugs for sleeping as much as possible. If dependence develops, it would be difficult.
It is a stressful time, she will slowly get accustomed. Blood sugar is not still under control. Medication and lifestyle management is essential. She can take counseling if required or discuss with other diabetics. She can cope up and will get back to normal life eventually.
If you have any further queries, happy to help again.
Dr. Prakash HM
Above answer was peer-reviewed by :
Dr. Yogesh D
doctor,can in three days sugar level down to 160 be considered significant and after one week can it come down to 90 or 100?one thing more,her platelets count is 1.40 lakhs and rbc count is 4.01 millions/cmm.what should she prefer to eat?i have learnt that in diabetes heart and kidneys become affected gradually,can't this damage be prevented?what measures should be taken for this?right now she is taking gemer p1,sompraz d 40,kombiglyze xr and nurokind gold.by what amount decrement in glucose concentration will decide which medicine should not be taken?
could hba1c test if would have done three months ago say her about possible threat of the disease?and finally,doctor where do you practice?
could hba1c test if would have done three months ago say her about possible threat of the disease?and finally,doctor where do you practice?
Brief Answer:
Good Blood glucose control necessary
Detailed Answer:
Hi XXXXXXX
Blood sugar level is coming down and it is a good sign that pancreas is responding well to oral anti-diabetic drugs. Blood sugar level is dependent on two important factors - 1. Medication and 2. Diet control. Bringing down the blood sugar is not important but maintaining at that level is very important. Remember hypoglycemia can cause immediate life threatening problems, while hyperglycemia of 160 would not.
Medications dosage will be slowly increased, usually in two weeks period to improve blood sugar control. We do want to cause hypoglycemia. Blood sugar level also keeps varying with diet, so we need a maintain a proper balanced diet. You can get a glucometer to check at home ocassionally.
Diabetes affects blood vessels (heart, eye and kidneys) and nervous system. As i told you earlier, a good blood sugar control would prevent all the above complications. Regular medication, balanced diet and life style modifications like loosing excess weight and exercise can help you to maintain good sugar control.
Gemer and kombiglyze are diabetic medications. Dosage will be increased/decreased or changed based on your mothers pancreas response and also measures like diet and life style modifications to maintain good blood sugar control.
HbA1C test done once every three months indicates the blood sugar control over preceding three months. Daily variation in blood sugar can be there due to various factors but HbA1C indicates overall three months control. You can get it done annually twice or thrice for your mother.
I practice in XXXXXXX Tamilnadu.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you and your mother good health.
Dr. Prakash HM
Good Blood glucose control necessary
Detailed Answer:
Hi XXXXXXX
Blood sugar level is coming down and it is a good sign that pancreas is responding well to oral anti-diabetic drugs. Blood sugar level is dependent on two important factors - 1. Medication and 2. Diet control. Bringing down the blood sugar is not important but maintaining at that level is very important. Remember hypoglycemia can cause immediate life threatening problems, while hyperglycemia of 160 would not.
Medications dosage will be slowly increased, usually in two weeks period to improve blood sugar control. We do want to cause hypoglycemia. Blood sugar level also keeps varying with diet, so we need a maintain a proper balanced diet. You can get a glucometer to check at home ocassionally.
Diabetes affects blood vessels (heart, eye and kidneys) and nervous system. As i told you earlier, a good blood sugar control would prevent all the above complications. Regular medication, balanced diet and life style modifications like loosing excess weight and exercise can help you to maintain good sugar control.
Gemer and kombiglyze are diabetic medications. Dosage will be increased/decreased or changed based on your mothers pancreas response and also measures like diet and life style modifications to maintain good blood sugar control.
HbA1C test done once every three months indicates the blood sugar control over preceding three months. Daily variation in blood sugar can be there due to various factors but HbA1C indicates overall three months control. You can get it done annually twice or thrice for your mother.
I practice in XXXXXXX Tamilnadu.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you and your mother good health.
Dr. Prakash HM
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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