Brief Answer:
Please follow strict diabetic diet and take medicine and Vit B 12 regularly

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. You have a higher fasting and post prandial blood sugar level and the HbA1C is also on higher side. If this result is even after you are taking Melmet SR twice daily then you have to modify your diet and follow diabetic diet. I will discuss diet details below. Also you need to take Vitamin B 12 supplement because melmet SR reduces intestinal absorption of this vitamin and can cause deficiency state.

2. The potassium level is slightly hing and taking K bind for two weeks might restore your potassium levels to normal. Please get it checked after two weeks. Foods such as melons, orange juice, and bananas are rich in potassium so please avoid its intake in high amounts.

3. Your triglyceride is borderline high and this can be restored to normal with dietary changes. The good cholesterol will also come to normal level.

4. Target Hba1C should be around 6.5 for you. This is possible by following strict diet control and medicine.

5. Special XXXXXXX diet for diabetes can be found using the following link
http://www.diabetesindia.com/diabetes/diet_chart.htm

At your age the daily calorie intake requirement might be 2100 to 2400 kcal and you will find vegetarian and non vegetarian meal choices in the above website.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Monitor potassium level regularly and take Vitamin B 12 supplement

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

To control potassium levels in your blood it is suggested that you avoid foods with high potassium content and get pottassium checked regularly (every 3 months) and once it is stable then every 6 months or yearly.

Please avoid foods like bananas, melons, oranges and dry fruits. It does not mean you cannot eat then but take in small quantities as given to a young child.

Potatoes also have high potassium levels. Cutting the potatoes to small cube size and boiling them will reduce potassium levels. Please discard the water in which the potatoes were boiled.

Aspisol 75 mg and Amcard 2.5 mg are safe and you can continue taking it.

Since your sugar levels are mildly above high, therefore little bit of diet attention will help to bring it to normal along with taking melmet SR. The medicine melmet SR is otherwise good but you have to take Vitamin B 12 capsule one daily if you are not taking any other vitamin B 12 supplement. NERVIT OD (manufactured by Unix Healthcare) is a popular brand of vitamin B 12 supplement and can be taken once daily when on treatment with melmet SR.

Known side effects of melmet SR include nausea, vomiting, stomach upset, diarrhea, weakness, or a metallic taste in the mouth may occur. If these symptoms are severe then you must talk to your doctor. There is no need to add any more medicine at the moment as taking more medicine for decreasing sugar can cause low sugar level and that is also dangerous.

High potassium is unpredictable when correlated to sugar level or age and happens due to certain effects on the kidneys due to diabetes. It is best to keep it in check by regular monitoring and avoiding high potassium foods. Low potassium is also bad for health and therefore controlling it within normal range is essential.

Clinical examination of kidneys, eyes and nerves should be done at lease once every year.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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