Can I manage type 2 diabetes effectively at age 45?

Question

Hello doctor,

I am 45 years old and have had type 2 diabetes for the past 6 years. My recent HbA1c level is 8.2 percent, and my fasting blood sugar is 168 mg/dL, despite taking Metformin and Glimepiride daily.

Lately, I have been experiencing tingling in my feet. Does this mean that nerve damage has already started?
Would switching to an injectable GLP-1 medication help bring my blood sugar levels down faster?
How safe is intermittent fasting for people with diabetes who are on oral medications?
My lipid profile is also slightly high. Should I completely change my diet, or is reducing carbohydrates enough?
Is there any chance of reversing diabetes if I can bring my weight under control?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

We need to set a target for the HbA1c (glycated hemoglobin), which reflects the average blood sugar level over the past 90 days. Your HbA1c is not under control, and we need to revise your medications. No, you do not need to switch to injectable treatment right now, as you are currently taking only two classes of antidiabetic drugs.

I would like you to share the dose of the Metformin and Glimepiride combination, as well as the number of doses you are taking per day. We may need to add a few more medications to achieve better glycemic control. Strict dietary restrictions are also required. Daily exercise for about 30 to 35 minutes, at least five days a week, will be necessary.

Diabetes primarily affects the nerves, eyes, and kidneys, as well as other organs. You should get your serum creatinine levels checked and follow up accordingly. Tingling in the legs and feet, especially at night, suggests diabetic neuropathy (nerve damage caused by prolonged high blood sugar in diabetes). Please also get a fundoscopy (a crucial eye exam using a special light) done to rule out changes related to diabetic retinopathy (a diabetes complication damaging the retina's blood vessels).

Please share a PDF (portable document format) of your reports so that I can assess your lipid profile and advise on medications accordingly.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.