My dad's postprandial blood sugar and creatinine levels remain high even after medications. Kindly help.

Question

Hi doctor,

My father is a diabetic patient for the last 32 years. He is taking 18U Novomix 30 along with Trajenta 5 at 11 am before lunch and 12 U Novomix 30 at 10 am before dinner. He has a good post prandial glucose level after lunch at around 140 to 150 mg/dL but his post prandial sugar after dinner rises to 200 to 210 mg/dL and the next day fasting glucose too remains high at around 160 mg/dL. He takes equal amount of food (50 gm rice with veggies) both during lunch and dinner. He is 64 years old with Creatinine level of 1.03 mg/dL. How can I lowered down the PP sugar at dinner so as to keep the fasting sugar at acceptable limits ? Moreover he have isolated systolic hypertension for three to four hours during day time. He takes Cilacar T (Cilnidipine 10 + Telmisarten 40) at 8 pm daily. Should he be taking one more Cilacar 10 in the morning or will it suffice ?

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for the query. I have seen the details mentioned. His overall glucose control seems fairly good. Post dinner and fasting glucose levels are a bit high. These can be controlled by following methods. Increase Insulin dosage by 2 to 4 units before dinner. It will reduce post dinner as well as fasting glucose levels. Increase daily physical activity (about which there is no mention at all). Another aspect is to reduce nighttime food intake by a few percent, which would result in lower glucose levels. Best option is increase Insulin dose by 2 to 4 units then check PP and fasting glucose that night and following day morning. If you have any questions please do come back. It would have been better if you had given the HbA1c% (Glycated hemoglobin), which gives a better idea about overall glucose control. Thanks.