This query is for my 71-year-old grandmother. She is facing some issues in fasting sugar and glucose levels for three to four days. Other conditions are blood pressure, thyroid and minor arthritis issues.
Since four days she is having low levels of fasting sugar. Before having a meal the levels are around 65-70 mg/dl and just after eating it reaches 114-118 mg/dl. Also, her stomach aches when she feels hungry and the sugar gets low. Please guide us so as to how we regulate her sugar level. Even on having something sweet the level is not increasing appreciably.
She is following the below medications:
Empty stomach: Metformin Hydrochloride.
After breakfast: Pioglitazone hydrochloride and Peneligliptim (15 mg).
Insulin: Basalog, 8 units every day in the night two hours after dinner. Please reply.
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She needs to decrease her Basalog to 6 units and check her blood sugar fasting if it is between 90-120 it is fine. But if it is still less than 90 the next day decrease another 2 units and give 4 units then. If fasting blood sugar increase over 130 then you can increase 2 units of Basalog. So by titrating Basalog you need to keep her fasting sugar between 90 to 130 mg/dL.
It is better to do HBA1c (glycated hemoglobin) which will show your average sugar over two to three months previously. Diabetes has many complications so it is not just to bring down the numbers but to monitor and treat complications associated with diabetes. Check your eyes for retinopathy. Kidneys with urine albumin creatinine ratio. Check your feet.
Lifestyle modifications are the best treatment of diabetes. Low carbohydrates diet and no added sugar. No sugary juices. No bread, rice, pasta, and potatoes if you cannot stop at least take as less as possible. Take more vegetable salads. Consume fruits only as a sweet dish. Do not take mango, grapes, and banana. Apple not more than one piece. Strawberries and other berries are fine.
Sleep well. Do exercise at least walk 30-40 minutes daily. The more you will practice these things the better will be your control. Check your sugar frequently. Your fasting target should be 90-130 mg/dL, and two hours after eating 150-160 mg.dL. Your HBA1c should be less than 7.
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