How can I safely reduce my high blood sugar at age 47?

Question

Hello doctor,

My blood sugar numbers are completely out of control, and I am getting panicked about it. I am 47 years old, diagnosed three years ago, and despite taking Metformin twice daily, my HbA1C (glycated hemoglobin) just came back at 10.2. My morning readings are consistently over 200 and sometimes spike to 350 after meals. I have been trying to follow the diabetic diet, but it is so confusing with all the carb counting.

Work stress has been intense lately. I am working 12 hours every day and grabbing fast food constantly. Started getting this tingling in my feet at night that keeps me awake. Also noticed my vision seems blurry when reading small print. I can not afford so many test strips due to the high cost and insurance issues. The nurse mentioned possibly starting insulin, but that terrifies me because of the needles. My grandmother lost her leg to diabetes, and I keep thinking about that.

Please tell me;

What other medication options are there?
How quickly can I bring my blood sugar down safely?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your sugar is uncontrolled, but we will definitely work on it, and it should be controlled. You have HbA1C 10.2 percent with a fasting blood sugar level of more than 200. You have issues like tingling feet and blurry vision. It means Metformin (a biguanide, which acts as an anti-diabetic) alone is not enough. You likely need stronger treatment quickly.

Short-term insulin is safest and can improve sugars within days, while other medicines may take weeks. Lots of insulins are available nowadays. Modern insulin pens use tiny, nearly painless needles. Also, it helps to prevent worsening nerve and vision damage. Your weight, height, and serum creatinine with EGFR (estimated glomerular filtration) are necessary to calculate the insulin dose.

If you have needle phobia, you can use an insulin pen. Non-insulin options for you include,

GLP-1 (glucagon-like peptide-1) agonists (Ozempic, Trulicity).
SGLT2 (sodium-glucose cotransporter 2) inhibitors (Jardiance).
Sulfonylureas (Glipizide).
DPP-4 (Dipeptidyl peptidase-4) inhibitors (Januvia).

Along with this, you must live a healthy life. Even during busy work, cut sugary drinks, choose grilled over fried, skip fries, and watch your feet daily. Also, daily exercise and a healthy sleeping pattern can improve your blood sugar level.

I hope this information helps you.

Feel free to ask further queries.

Thank you.