Dr. Nagaraj
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 50-year-old male taking the tablet Diapride M1 twice daily after breakfast and dinner. My fasting blood glucose levels are 150 mg/dL, and post prandial blood glucose levels are 200 to 210 mg/dL. Kindly help me set up a regime to achieve proper control. Thank you.
Hello,
Before I suggest something, I would like to know how long you have been taking these medications and your sugar level before starting them. How are your diet and lifestyle? Do you have any other medical conditions? If yes, are you taking any medicines for the same? I would also like to know your weight. Kindly help me with the details for better understanding and suggestions. Thank you.
Patient's Query
Thank you doctor for the reply,
My random blood sugar level was 250 mg per dL three years ago. I tried to change my lifestyle but saw no significant benefit. I have stopped eating rice for nine months. I have included more proteins in my diet, including one chapati for breakfast, lunch, and dinner. I occasionally have chicken. I have not had sugar for years and am taking sugar-free tea with skimmed milk. I am focusing more on sugar-free fruits and green vegetables. I am fairly active and walk three kilometers daily. However, I have not gotten satisfactory results even after taking these measures and medications. I also take Omega 3, multivitamin tablets, and tablet Nebistar 5 mg twice a day.
Hello,
Welcome back to icliniq.com.
I understand that you have been diabetic for nine months and take the tablet Diapride M1 (Glimepiride and Metformin). I still do not have any idea about your fasting, post-prandial, or the HbA1c (hemoglobin A1c) levels to compare the effectiveness of current medicines. I request you to provide me with the details of your fasting and post-prandial blood sugar levels before starting these medicines. Please mention your weight and height. Random sugar values are unreliable, and one cannot alter the medications based on these levels. I am glad to know that you exercise regularly and have a healthy diet because it is crucial for diabetes management.
Patient's Query
Thank you doctor for the reply,
Before taking medicines, my fasting blood glucose level is 190 mg/dL, and post prandial blood glucose levels are 260 to 270 mg/dL. After the lifestyle changes, my fasting blood glucose level has changed to 150 mg/dL, and post prandial blood sugar level is 250 mg/dL. I am taking the tablet Diapride M1 with breakfast and Teneligliptin 20 mg after breakfast. My height is 5 feet 8 inches, and my weight is 171 pounds.
Hello,
Welcome back to icliniq.com.
Your body mass index (BMI) is acceptable. As you are on three medications, I suggest you wait for three months and observe. After three months, you can check your HbA1c (hemoglobin A1c), fasting, and post prandial level levels. I am sure they will reduce. Although we have scope for increasing the dose of one of the medications you are taking, I would like to wait for three months and see the results before altering the medications. In the meantime, follow your routine and exercise regularly. Do not worry about your sugar levels, as you are already on medications. We can connect again after you get your lab reports after three months.
Patient's Query
Thank you doctor for the reply,
I agree that some time must be given, but I have been taking the tablet Diapride M1 for six months, and there has been no significant change. I got completely upset with this protocol, so I consulted you. I request you to suggest some other medication if you feel so. My HbA1c level was 7.7 % when I took the tablet Metformin 500 mg one year ago. I tried to change my lifestyle, but that did not improve my condition. I will consult you after three months when I get my HbA1c reports. Please suggest some multivitamins and Omega supplements that you feel will be additionally useful.
Hello,
Welcome back to icliniq.com.
I will look into your medications once I know the baseline values. It will help me understand the medication I need to choose to go forward. I would be happy to help you deal with your diabetes. I suggest you continue the same medications for three months. I do not usually prescribe any Glucomannan powder to my patients. Omega 3 fatty acids do not have a direct effect on blood sugars. However, reports say they could greatly improve the overall health as they contain anti-oxidants. I suggest you take over-the-counter Omega 3 fatty acid, which has flaxseed or fish oil. Thank you.
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