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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Ways To Control Diabetes

Dear Dr
I am Aloke Debnath, 45 years old suffering Type 2 diabetic last 10 years. Every morning I walking 45 minutes and 20 minutes free hand exercise, I am taking Gemer-1 tablet before breakfast . Now a days my Fasting Sugar shows high vary from 116 to 140. My PP is vary from 125 to 148 last 4 to 5 years. I am also suffering from Non Alcoholic Fatty Liver. No medicine taken for this. My last tested (15days ago) HbA1c 7.3 and SGOT is 34 & SGPT 46. Why my fasting is high ? Please suggest how to control my fasting sugar.

Thanks
Aloke Debnath
Thu, 14 Jul 2016
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General & Family Physician 's  Response
Hello Mr. Alok.

Your lifestyle habits seems to be good as you exercise for a good amount of time everyday. I hope your dietary habits are also good.

Coming to the management of your sugars, your HbA1c is more than what I would like it to be, less than 7 is desirable. Your fasting and postprandial values hence seem to be consistently on the higher side as evidenced by your HbA1c.

I would suggest a few options which can be considered at this point of time -

1. Improvement in dietary habits - intake of foodstuffs devoid of simple carbohydrates, low in fats and reducing the total calories to about 1200-1500kcal/ day (according to your weight). A dietitian should be consulted for the optimum diet.

2. If everything is right with the diet, we may consider increasing the dosage of your medications. As time goes by, the body starts becoming more and more resistant to insulin and hence requirement of medications goes up Inspite of all other measures. You have done well so far with the medication you are on. At this point of time your diabetologist may consider increasing the dosage of your medication to either twice a day or increasing the dose of glimeperide to 2mg.

Kindly follow up with your diabetologist for the same.

Hope this helps.

Regards,
Dr Geeta
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Suggest Ways To Control Diabetes

Hello Mr. Alok. Your lifestyle habits seems to be good as you exercise for a good amount of time everyday. I hope your dietary habits are also good. Coming to the management of your sugars, your HbA1c is more than what I would like it to be, less than 7 is desirable. Your fasting and postprandial values hence seem to be consistently on the higher side as evidenced by your HbA1c. I would suggest a few options which can be considered at this point of time - 1. Improvement in dietary habits - intake of foodstuffs devoid of simple carbohydrates, low in fats and reducing the total calories to about 1200-1500kcal/ day (according to your weight). A dietitian should be consulted for the optimum diet. 2. If everything is right with the diet, we may consider increasing the dosage of your medications. As time goes by, the body starts becoming more and more resistant to insulin and hence requirement of medications goes up Inspite of all other measures. You have done well so far with the medication you are on. At this point of time your diabetologist may consider increasing the dosage of your medication to either twice a day or increasing the dose of glimeperide to 2mg. Kindly follow up with your diabetologist for the same. Hope this helps. Regards, Dr Geeta