HomeAnswersEndocrinologytype 2 diabetes mellitusCan insulin help stabilize my fluctuating sugar levels?

Among medicines and insulin, which is best to control sugar?

Share

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Shaikh Sadaf

Medically reviewed by

iCliniq medical review team

Published At April 3, 2018
Reviewed AtFebruary 17, 2024

Patient's Query

Hello doctor,

I am a 30-year-old female. I had diabetes during pregnancy, and it continues after childbirth. Now I have been a diabetic patient for the past three years. My average sugar levels range from 100 mg/dl to 245 mg/dl. My sugar levels are not stable at all, and I consulted my first doctor, and the prescription was Metformin 850 mg and Amaryl 1 mg. Unfortunately, the results after taking these medications are not stable. Therefore, I consulted my second doctor, and he prescribed me Insulin. However, I am confused about whether I should keep taking medication or Insulin. Kindly advise.

Answered by Dr. Shaikh Sadaf

Hello,

Welcome to icliniq.com.

I just read your query, and from what you have mentioned, it appears that you have diabetes. However, your blood sugar is not so uncontrolled that you must take insulin. You can do one thing, do an HbA1c test and then get back to me to put you on better treatment. Hope you find my advice beneficial.

Patient's Query

Thank you, doctor,

As per your concern, I have done an HbA1C test and attached the results to this query. Kindly advise which treatment is recommended to me, because it has been up to three years since I could not find a suitable treatment with better results. Please suggest me a diabetic food plan as well. My situation is worse than ever. Please help.

Answered by Dr. Shaikh Sadaf

Hello,

Welcome back to icliniq.com. I just read your reports, and your HbA1C levels are quite high.

I suggest you start tablets Teneligliptin 20 mg and Metformin 500 mg once daily in the morning at breakfast time. Continue with Metformin 850 mg and Amaryl 1 mg at dinner time. Take the tablet Neurobion forte twice a day for three to six months. Consult your specialist doctor, discuss with them and take the medicines with their consent. Your diet plan is as follows,

1.Take dry wheat flat bread two each for lunch and dinner.

2. Take more sauteed vegetables for lunch and dinner.

3. Avoid eating high-glycemic foods like rice and white flour.

4. For breakfast, take low-fat tea without sugar or sugar-free with some crackers, oatmeal, or low-fat yogurt.

5. Eat more carrots, cucumbers, fruits, and vegetables.

6. Avoid cold drinks, juices, junk food, and fried foods. Instead, eat your meals on time.

Exercise plan - Walk briskly daily for 30 to 45 minutes. Drink eight to ten glasses of water. Get 30 minutes of sun exposure daily. Sleep well at night for seven to eight hours. Repeat your HbA1C after three months, and then we will review it again.

Hope you find my advice beneficial. Good luck.

Patient's Query

Hello doctor,

Thank you for your kind effort. Teneligliptin 20 mg is not available here. My pharmacists said, "nice medicine for sugar, but not available." Please advise an alternate medicine.

Answered by Dr. Shaikh Sadaf

Hi,

Welcome back to icliniq.com.

Try to find a tablet of Vildagliptin 50 mg once daily, a tablet of Saxagliptin 5 mg once daily, or a tablet of Sitagliptin 100 mg once daily. I found that these drugs are available in your country. Please use any one of these. I had mentioned Teneligliptin lowers the cost of medications and provides good drug benefits. However, as it is unavailable, the drugs mentioned above would work just as well.

Patient's Query

--file attached--
Answered by Dr. Shaikh Sadaf

Hi,

Welcome back to icliniq.com.

I understand your concern.

During pregnancy, it is not advisable to take any medication for diabetes, and you must take only insulin as prescribed by your doctor and monitor your blood sugar regularly. Usually, the HbA1c test is not of any benefit during early pregnancy. Only fasting and random blood sugar readings are enough. The prescribed Insulin in pregnancy is Apidra three times daily and Levemir at night once daily. What is the current dose of Insulin that you are taking? You need close monitoring of your blood sugar by a nearby doctor throughout your pregnancy.

You also need a tablet of Folic acid 5 mg once daily. The symptoms that you mentioned look like low blood sugar symptoms. Whenever you feel like this, check your blood sugar; if it is lower than 100 mg/dl, you must eat something immediately. Sometimes these can happen in patients who are recently started with insulin. Do not worry, it will be just during the pregnancy period. Only then, later on, after the birth of your child, will you be put back on tablets, hopefully. Until then, keep in close contact with your doctor and monitor your blood sugar thrice or four times fasting, 2 hours after meals, evening, and before dinner, and have an ultrasound regularly. Maintain a low-carb diet at all times.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shaikh Sadaf
Dr. Shaikh Sadaf

Endocrinology

Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Ask your health query to a doctor online

Endocrinology

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy