Sir I am 59 yrs. My sugar level is as follows: PP after 2 hrs 235 and after 4 hours (i.e. At 12.45 p, m. Before lunch) sugar level is 65. The same reading is reached every day. I am taking following medicines: Gemer P1 OD (Before breakfast) Gulvas met (Vildagliptin and MetforminHCL) OD (Before dinner) Telmisartan 20 mg BD, Rosvas 10 mg OD, After 5 PM also the sugar level false to around 60. The sugar level is high after 2 hrs of breakfast. The sugar level falls very fast but after two hours of breakfast and before lunch. But before two hours the sugar is high. Is any change of medicine required, if so please advice. Should I take one tablet of galvus met before breakfast also. Any other advice is welcome thanks nkjain.

Dr. Sajeev KumarGeneral Physician32yrs exp

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It usually take longer time to fall in most people with insulin resistance and as it falls down in evening you are fine. I know very personally this effect .Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. It is a difficult task to control blood sugar in the desired normal range. Whatever we eat is metabolised to sugar in the body to provide energy for our daily activities. For the absolute control, one has to monitor his / her blood sugar at regular intervals (Self-Monitoring of Blood glucose ? SMBG). Though difficult, this can be done by a glucometer and keep a record. Get an idea of Fasting sugar (FBS) and 2 hours after food (PPBS), & HbA1C (inform me) and check before dinner and after every major food. The basic idea is to reduce the food intake to 1/3 of what you take now. The dictum of sugar control is diet, exercise, diet + medicine and at later stage medicine+ Insulin will be needed. There are different diet plans of varying calories for each person depending on his activity & life style. For diabetes, hypertension (high BP) and many long-term illness control there is the need for regular advice and follow up. Just one time consultation or advice is not enough to guide a diabetic in scientifically & medically correct manner. For giving you regular follow up you ask me with all details like your daily eating pattern and medicines you take. I assure you a proper guidance. If you keep in touch personally.  

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