Hi my mother hba/c is 11 but sugar fasting is 190 and sugar pp is 290 .does she need insulin injection. At present she is taking tension m 500 ,azulix 2mf and glimy1 mg .for sugar. If sugar is controlled with medicines does hba/c matter .pls tell .regards.

Dr. Prabhakar Laxman JatharEndocrinologist48yrs exp

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Hello, thanks for the query. I have seen the details given. Following are my observations: 1) her hba1c% is too high, similarly fasting and pp glucose levels are also very high. This suggests her present treatment is not working well. There is an urgent need for up grade. 2) with a bmi of 31.45 kgs/sq meter, she is already in grade 1 obesity, carrying an excess of over 20 kgs. This itself is a hindrance in achieving better glucose control. 3) I need to know her dietary pattern, extent of daily physical activity, serum creatinine, urea, microalbuminuria and lipid profile. From the available details it does appear that there is a need to start insulin, preferably a long acting analogue like glargine or degludec, with some changes in oral medications, diet and exercise pattern. If you have any questions please do come back. I am sure you are aware that in a well controlled diabetic patient fasting glucose should be < 100 mg or closer to 100 mg, pp 150 to 170 mg and hba1c% < 7% at her age. Thanks. 

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