Hi. Last 2 weeks back I randomly checked my blood sugar. It was 478. I than went for a proper blood and urine test and the reading were 473 and 278. Personally I am not a very sugar person. The doctor prescribed diamicron and Metsmall. Initially in the morning with another medication before bed. 9 days down the line the readings were still above 200 average. Now the dosage has been increased to Metsmall after every meal. The doctor said she cannot prescribe further check till the blood sugar stabilizes below 170-160. What is the take on this? Is there a chance of kidney issue or what?

Dr. Prabhakar Laxman JatharEndocrinologist46yrs exp

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Mr. lybrate-user, Thanks for the query. The glucose ;levels mentioned are abnormally high. Such high levels are bad for almost every vital organ in the body. There is an urgent need to control and bring down to the levels mentioned by your doctor. I would have started you on Insulin injections for 3 to 4 months along with an oral drug. Then after achieving desired control, shifted on to only oral drugs. That is the best option in such high blood glucose level, as glucotoxicity causes beta cell damage. Quick reduction helps revive the cells. It is essential to achieve fasting glucose level of < 100 mg & PP 150 to 160 mg & HbA1c% <6.8. That too fairly rapidly, considering your age. Apart from taking drugs to control blood glucose it is necessary to take a restricted diet, plus exercise regularly. Looking at your weight and height with a BMI of 51.35 kgs/M2, you have morbid obesity. Normal BMI should be <23 kgs/M2. One of the major contributors for developing diabetes is your excess weight. That also needs to be seriously looked at. Only oral drugs are unlikely to give you desired benefits. Thanks.  

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