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Q. How to regulate high blood sugar?

Answered by
Dr. Hariharan V
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 22, 2015 and last reviewed on: Oct 09, 2018

Hi doctor.

I am suffering from type 2 diabetes. My last blood sugar level was 400 mg/dL. I am on Insulin. But it is not coming back to normal. What shall I do?

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#

Hi,

Welcome to icliniq.com.

Since you have not mentioned the duration of diabetes, I have to assume that you may be having it for a minimum of 5 years.

  • I have seen many patients who start with one drug and maintain sugar at nice levels in that single drug itself.
  • But for many patients, it is not that simple. They start with one drug, then two drugs, then multiple combinations, finally nothing will work and we have start Insulin.
  • Even after taking Insulin for some patients, control cannot be achieved. It is because for the first set of patients, diagnosis was early and some of their pancreatic function can be retained. But for many patients, due to poor control, their pancreas will stop functioning and blood sugar increases. It becomes a cycle.

Coming to your values, your blood pressure (BP) looks fantastic and you have excellent weight for height. We will control your sugar in stepwise fashion.

I think you are taking only Glimepiride. Change this to Glimepiride plus Metformin combination. Go for Euglim M2 one tablet in the morning before food and one at night before food.

  • Please provide few details about you for better treatment plan. How much and what type of Insulin you are taking? Also at what frequency?
  • Do you have any burning sensation in feet or hands?
  • What is your last cholesterol level? Please upload your lipid profile, urine tests and last ECG. Even, if you have taken long back also no issues, you can upload that.
  • Do not worry. PPBS (postprandial blood sugar) 400 mg/dL can be controlled. Just some modifications required.

The Probable causes:

Insulin resistance.

Investigations to be done:

1. Urine routine.
2. Lipid profile.
3. ECG.

Probable diagnosis:

Uncontrolled diabetes refractory to treatment.

Treatment plan:

1. Diet.
2. Exercise.
3. Altering drugs.
4. Control of complications.

Preventive measures:

Absolutely no sugar should be added in diet. Avoid chocolates, sweets and rice at night. Reduce the intake of oily foods.

Regarding follow up:

Revert back with the answers for the above questions to a diabetologist online.---> https://www.icliniq.com/ask-a-doctor-online/diabetologist

Hi doctor,

I have diabetes over 20 years and also suffering from stroke in brain since 10 year. Now I am taking Insulin thrice daily; 40 units in the morning, 30 units in lunch and 35 units at night. My doctor advised me to follow this as routine till my blood sugar gets reduced. I was taking Glycomet GP 2 before lunch. As my sugar level is high, I am taking human Insulin Mixtard now.

#

Hi,

Welcome back to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity).

  • You start taking tablet Glycomet GP 2 (Glimepiride) thrice a day before food.
  • After five days start with tablet Pioz 45 mg (Pioglitazone) one tablet in afternoon after food along with Glycomet GP 2. Continue Insulin in same dose.
  • Check fasting and postprandial blood sugar after 10 days and contact me.

If you do not have knee or joint pain, you can start morning walk in empty stomach. You can drink only water. Minimum 40 minutes every day and minimum 6 days a week. You should walk fast enough to get more sweat.

Eat more vegetables and less rice.

Are you sleeping well? Because, reduced sleep can increase blood glucose. Please do not sleep in daytime. If you are not getting proper sleep, better start doing relaxation exercise like yoga at night or start taking sleeping pills.

Revert back after 10 days for follow up to a diabetologist online --> https://www.icliniq.com/ask-a-doctor-online/diabetologist

Hi doctor,

I am confused now. Shall I take Insulin thrice daily along with Glycomet GP 2? I doubt whether I will become hypoglycemic or not. Please explain clearly.

#

Hi,

Welcome back to icliniq.com.

As you said that you are taking Insulin thrice daily and Glycomet GP twice daily, I advised you to go for Glycomet GP 2 thrice daily along with Insulin.

If it is not so, then you can start with tablet Glycomet GP 2 once a day plus Insulin three times a day. After five days check fasting and postprandial blood sugar and then twice a day tablet can be started.

My point is if Glycomet GP 2 can be taken thrice a day, if you are already taking twice a day plus Insulin.

If you are still confused, then me what drugs you are on now? Either only insulin thrice a day or Insulin thrice a day plus tablet Glycomet GP 2 twice a day.

For further information consult a diabetologist online --> https://www.icliniq.com/ask-a-doctor-online/diabetologist

Hi doctor,

My medicine schedule is as follows. I am taking Insulin twice a day during morning and night before food and Glycomet GP 2 only at lunch before food.

#

Hi,

Welcome back to icliniq.com.

  • Please take same dose of Insulin morning and night before food.
  • Take tablet Glycomet GP morning and night half an hour before food.
  • Do not take Glycomet GP at afternoon.

Check fasting and postprandial blood sugar level after five days.

Revert back after five days for follow up to a diabetologist online --> https://www.icliniq.com/ask-a-doctor-online/diabetologist



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