How to monitor diabetes?

Question

Hi doctor,

I am a 30-year-old male. My height is 5.6 inches, and my weight is 143 pounds. I was diagnosed as diabetic one year ago with HbA1c 7.8 and fasting sugar 163.

Then I took Kombiglyze XR 1000 mg one tablet a day for four months. Then the test revealed HbA1c of 6.6 and fasting sugar of 108. Then my doctor reduced the dose to 500 mg.

From then on, I have been taking Kombiglyze XR 500 mg one tablet a day. Last week, my HbA1c was 6.6. I have attached my entire blood test report. I am deficient in vitamin D, B12, and iron.

I had Tayo 60 k tablet one per week for three weeks. I have pain in the heel bone on both sides of my feet. I feel sharp pain on the side of my heel, especially in the early morning or after sitting for a while.

I feel fatigued sometimes. I do not have any other health issues. I am eating well, and my sleep is good. Can you recommend a diet plan or any changes in medication or vitamin supplements? I am a vegetarian.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

Instead of Kombiglyze (combination of Saxagliptin and Metformin hydrochloride extended release), take tablet Tenepride (Teneligliptin) and also take Metformin (Exermet or Glyciphage) extended release 1000 mg in the afternoon. Get an X-ray of the pain region and upload it, along with the radiologist's opinion, which will be provided by a radiologist at all scan centers. Tablet Tayo 60 k is the most important one for vitamin D.

Take one tablet a week. If possible, get sun sessions between 11 AM and 1 PM, and stand under direct sunlight for 15 minutes. Get a glucometer. Make a chart of your blood glucose readings as fasting morning (before breakfast, advisable to take only water), postprandial (take a tablet before breakfast and check 2 hours after breakfast), prelunch (just before lunch), and pre-dinner.

Maintain this chart on all seven days of the week. If the sugar level is below 100, then contact your doctor immediately. If tiredness, sweating, or other symptoms occur, check the sugar level immediately and note the time and the sugar level.

From your blood test, it is evident that you have high hs-CRP, high HbA1c, low vitamin D and B12, low iron, and low mean corpuscular hemoglobin concentration (MCHC). A chronic carbohydrate-based diet and less vitamin D caused diabetes in you. Stress also may be a factor.

I hope this helps you.

Thank you.