Bula dutta, age 69 (f) sugar (f) 178, hba1c-9.1, total cholesterol high, tg -high, current medicine- glucobay25, 1 tab at morning gluconorm pg2, 1 tab at lunch jalra m 50/500 + pioglit 15, 1 tab at dinner time is there any possibility to control the sugar without using the insulin only through medicine? As patient is stay alone so, insulin is high risk for her. Need suggestion/advice.
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Bula Dutta ji, Thanks for the query. I have read the details given. The fasting glucose & HbA1c% are quite high. Therefore, Insulin might have been advised. Plus already there are multiple oral drugs like Glimiperide, Metformin, Acarbose, Vildagliptin & Pioglitazone. WHich means the whole oral range is there. So to attain desired control no further oral drug can really be added. Another important aspect is there is a need to look at her daily dietary intake & extent of exercise to see if any adjustment can be made there to help reduce blood glucose. At this age HbA1c% should be < 7% and fasting should be around 100 mg & PP 150 to 170 mg. Therefore, Insulin must have been suggested. Plus if a long acting analogue like Glargine or Degludec is used, then there very little chance of developing any problem. Still if you have any questions please do come back. Thanks.
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1.no alcohol 3. No smoking/ tobacco/drugs/ avoid pollution 4. Diet - no ghee/ butter, have mix of vegetable oils - mustard, til, ground nut, olive oil, have more green vegetables and fruits, have whole grain atta, no fried. Fast. Spicy / processed/ junk food. Less sugar, potato, rice 5. 30 mts brisk walk daily 6. Deep breathing exercise for 10 mts daily 7. Meditation daily for 10 mts. 6-8 hrs of sleep at night 8. Expose your body to sun for 15-20 mts daily after some oil massage to get vit d. 9. Take more water medicine can not be advised for open question ,for medicine and further advise contact on private consults good luck.
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there are better insulins like tresiba or toujeo which has very less chance of hypo risk. Unfortunately insulin is needed and it is not available as a tablet. Other options are GLP 1 agonists like semaglutide which is given weekly as injection, but has good results. The risk of kidney disease is high with this level of glucose impairment.
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