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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Blood Sugar Levels Be Kept Under Control?

I have been taking metformin and glipizyde for many years. All of sudden it is not keeping my blood sugar under control. I am seeing my doctor Thursday, but was wondering what should be my next steps for medicine. I am now 71, work out several days a week and try to eat healthy.

Thanks,
Barry
Tue, 5 Dec 2017
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Ayurveda Specialist 's  Response
**
Thanks for contacting with your health concern

1. As you are a case of type II diabetes and under supervision thus regular follow-ups with your Doctor/Endocrinologist is essential [as he will be aware of your current situation and in the future and what line of management should be prescribed] and because keeping a good lifestyle modification programme, thus following is my observation:

i. check with HbA1c as it is measured primarily to identify the three-month plasma glucose concentration.

ii. Natural ways to reduce blood sugar levels along with necessary instructions:

DIETARY REGIME
- Take:
i. Cereals: barley, a special variety of grains [sanvaka, kodrava], wheat.
ii. Pulses: green gram, horse gram, pigeon pea, alasi, chickpea.
iii. Fruits & vegetables: patola, karela, amalaki, haridra, kapittha, black pepper Others: betel nut, rock salt.
iv. Lifestyle: walking, playing, physical exercise, bathing.
a. have 'vijaysar' plant water to drink.
b. have roti of chickpea with 20 ml bitter gourd juice
c. chewing leaves of bael with black pepper is good.

- Avoid:
i. Cereals: freshly harvested grains, rice.
ii. Pulses: black gram.
iii. Fruits & Vegetables: mangoes, grapes, Others: milk, curd, clarified butter, jaggery, oil, alcohol, sugarcane products, eating before digestion of previous food, incompatible food.
iv. Lifestyle: day sleeping, sudation, smoking, suppression of natural urges, therapeutic bloodletting, riding.

A. say NO to: Sugar, all sweets, cakes, sweetened biscuits-drinks, sweet fruits like mangoes and grapes, jam, honey, canned sweet fruits.
. Eat in Plenty: all leafy vegetables, tomato, cucumber, brinjal, cauliflower, lady's finger, soup [tomato/vegetable], buttermilk, sugar-free drinks, tea/coffee with sweeteners, all cereals, sprouted pulses.
. Eat restricted quantities: chapati, bread, corn flour, plain or salted biscuits, rice, meat, eggs, chicken, fish, skimmed milk.
. Regularize timings and quantity of meals.
. be careful in festivals and marriages, compensate for extra sweets by reducing previous and subsequent meals. . do not remain starving for long periods, avoid alcoholic drinks.
. wash the feet daily, dry them, inspect them & then sprinkle a lot of talcum powder.
. avoid walking barefoot, even at home.
. wear soft cotton socks and canvas shoes, avoid tight fitting shoes and chappals.
. cut nails carefully and always after a bath, when they are soft.

PS. what to look for clinically
A. 1. Weight
2. blood pressure [must be checked on every visit]
3. Check peripheral pulses on the legs [even if the patient does not have any leg complaints]
4. Examine the feet: especially the interdigital spaces and soles, for infections, ulcer, and sensory loss
5. Recommended investigations during follow up:
. ask for EKG [electrokardiogram],
. Retinoscopy,
. Urine for microalbuminuria and Glycosylated Hemoglobin
. Lipid profile.
. Ultrasonography of abdomen for the pancreas.
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How Can Blood Sugar Levels Be Kept Under Control?

** Thanks for contacting with your health concern 1. As you are a case of type II diabetes and under supervision thus regular follow-ups with your Doctor/Endocrinologist is essential [as he will be aware of your current situation and in the future and what line of management should be prescribed] and because keeping a good lifestyle modification programme, thus following is my observation: i. check with HbA1c as it is measured primarily to identify the three-month plasma glucose concentration. ii. Natural ways to reduce blood sugar levels along with necessary instructions: DIETARY REGIME - Take: i. Cereals: barley, a special variety of grains [sanvaka, kodrava], wheat. ii. Pulses: green gram, horse gram, pigeon pea, alasi, chickpea. iii. Fruits & vegetables: patola, karela, amalaki, haridra, kapittha, black pepper Others: betel nut, rock salt. iv. Lifestyle: walking, playing, physical exercise, bathing. a. have vijaysar plant water to drink. b. have roti of chickpea with 20 ml bitter gourd juice c. chewing leaves of bael with black pepper is good. - Avoid: i. Cereals: freshly harvested grains, rice. ii. Pulses: black gram. iii. Fruits & Vegetables: mangoes, grapes, Others: milk, curd, clarified butter, jaggery, oil, alcohol, sugarcane products, eating before digestion of previous food, incompatible food. iv. Lifestyle: day sleeping, sudation, smoking, suppression of natural urges, therapeutic bloodletting, riding. A. say NO to: Sugar, all sweets, cakes, sweetened biscuits-drinks, sweet fruits like mangoes and grapes, jam, honey, canned sweet fruits. . Eat in Plenty: all leafy vegetables, tomato, cucumber, brinjal, cauliflower, lady s finger, soup [tomato/vegetable], buttermilk, sugar-free drinks, tea/coffee with sweeteners, all cereals, sprouted pulses. . Eat restricted quantities: chapati, bread, corn flour, plain or salted biscuits, rice, meat, eggs, chicken, fish, skimmed milk. . Regularize timings and quantity of meals. . be careful in festivals and marriages, compensate for extra sweets by reducing previous and subsequent meals. . do not remain starving for long periods, avoid alcoholic drinks. . wash the feet daily, dry them, inspect them & then sprinkle a lot of talcum powder. . avoid walking barefoot, even at home. . wear soft cotton socks and canvas shoes, avoid tight fitting shoes and chappals. . cut nails carefully and always after a bath, when they are soft. PS. what to look for clinically A. 1. Weight 2. blood pressure [must be checked on every visit] 3. Check peripheral pulses on the legs [even if the patient does not have any leg complaints] 4. Examine the feet: especially the interdigital spaces and soles, for infections, ulcer, and sensory loss 5. Recommended investigations during follow up: . ask for EKG [electrokardiogram], . Retinoscopy, . Urine for microalbuminuria and Glycosylated Hemoglobin . Lipid profile. . Ultrasonography of abdomen for the pancreas.