Q. My fasting glucose level is 226 mg/dl and PP is 390 mg/dl. How to control it?

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 21, 2020

Hi doctor,

I need a consultation on my diabetes. My fasting plasma glucose is 226 mg/dL and in PP it is 390 mg/dL. I am currently on Diamicron MR, Volix 0.3, and Novomix pen 30/70. Please suggest.



Welcome to

Your sugar is uncontrolled and Vitamin D is low as well. You did not tell how much you are using Diamicron, Volix and Novomix. Please let me know the doses.

Another thing is you should get checked urine albumin creatinine ratio and I think you may need a change in medication. Your overweight is also due to these medications.

Thank you doctor,

I will take urea creatinine and HbA1c and share the report. Regarding my doses, I take Novomix 30 flex pen 10 units 1-0-1, Volix 0.3 mg 1-0-0, and Diamicron XR 60 1-0-0. My height is 5.4 feet. Please let me know if I have to alter my medications.



Welcome to

I also asked for urine albumin creatinine ratio. It is a urine test to check protein in it. It will tell if your kidneys are affected or not. In diabetes, it is not just the numbers of sugar that we need to bring down in a normal range but to save the whole body from bad effects of keeping high sugar.

First of all, you need to stop carbohydrates from your diet like bread, rice, pasta, and potatoes. No sugar in tea or coffee. No ice cream and sugary juices. Walk at least 40 minutes a day. Take more vegetables and salad with green leaves. Fruits should be consumed in a small amount like sweet dish. Mango, grapes, and banana can increase sugar levels. Berries are better.

Coming to your medication, your medications are increasing your weight. Both Novomix and Diamicron are letting you become more obese. I think it is better to stop them. Your ideal weight is 60 kg and if you lose some weight your sugar will be more controlled as well.

You can start Sitar M (Metformin and Sitagliptin) 50/1000 one tablet in the morning and evening, Jardiance (Empagliflozin)10 mg only in the morning. Check your fasting sugar levels for the first few days. It may take a week for you to control the sugar. But you need to comply with diet and medication.

I hope this helps.

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