How to manage high blood sugar levels?

Hello,

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Thank you for reaching out. I completely understand your concern. Your blood sugar readings are significantly high (attachment removed to protect the identity of the patient), which indicates that your current medications are no longer sufficient to control your diabetes safely.

You are currently taking two effective diabetes medications: Istamet 50/1000, which contains Sitagliptin and Metformin (medicines that improve insulin action and reduce glucose production), and Ajulix 1 mg, which contains glimepiride (a medicine that increases insulin release from the pancreas). Despite this treatment, your blood sugar levels remain very high. This suggests that oral tablets alone may no longer be enough to bring your sugars down quickly or safely.

At this stage, the most effective and safest next step is to start insulin therapy (a hormone that helps glucose enter the body’s cells for energy). Starting insulin does not mean that your diabetes has worsened permanently. It simply provides your body with the additional support it needs right now. Once your blood sugar levels improve and your body stabilizes, insulin doses can often be reduced or even stopped later under proper medical supervision. Insulin is the fastest and safest way to prevent complications such as persistent fatigue, recurrent infections, kidney damage, blurred vision, and nerve problems.

If you are not yet ready to start insulin, you may consider adding dapagliflozin 5 mg (a medicine that lowers blood sugar by removing excess glucose through urine), provided your kidney function is normal. However, with blood sugar levels as high as yours, this medication alone may not be sufficient. Therefore, insulin remains the strongly recommended option at this stage.

Regarding lifestyle measures, increase your walking duration to at least 30 to 45 minutes daily, preferably after meals. Completely avoid sweets, fruit juices, refined flour products, and white rice until your blood sugar levels come under control. Focus on a balanced diet rich in vegetables, whole grains, lentils, and protein-rich foods such as paneer, eggs, or fish. Ensure adequate hydration unless your doctor has advised fluid restriction.

It is also important to get further investigations done, including HbA1c (a test that shows average blood sugar control over three months), kidney function tests, liver function tests, and urine microalbumin (a test that detects early kidney damage due to diabetes). Please consult at the earliest so insulin can be initiated and a proper follow-up plan can be made.

With appropriate treatment, blood sugar levels often improve within one to two weeks, and you should notice better energy levels, improved sleep, and an overall improvement in well-being. Do not worry. Diabetes is manageable, and with timely and correct treatment, you can regain good control and prevent long-term complications.

I hope this helps you.

Kindly revert if there are any queries.

Thank you.