Hi, thank you for posting your concern in the HCM. A poor controlled diabetes with high blood glucose level should be evaluated further to rule out infection. A complete hemogram with CRP is needed. You have not mentioned the current medications. However, she should be put on a proper regimen of Insulin. The long standing poor control may be due to insulin resistance or poor dietary and lifestyle measure. In the presence of dietary restriction for calories and regular walking, she should be on metformin to fight insulin resistance. With such high levels of blood glucose, she also needs evaluation of her renal status. A serum urea creatinine and routine urine examination should be done. Examination by ophthalmologist is needed to rule out retinal complications of diabetes . You can also add a vitamin b complex supplement combined with antioxidants. A neurologist consultation is also needed to rule out any neuromuscular complication. Finally, such high blood sugar can precipitate DKA at any point of time. So immediate measures as outlined above should be taken to prevent the same. For any further query please write back. Regards.