How to manage diabetes with vertigo and heart issues?

Question

Hello doctor,

I have been managing hypertension with CTD-L 6.25/25 and diabetes with Amaryl MV-1 for over five years. Despite this, my fasting blood sugar consistently remains above 200 mg/dL. In addition to diabetes and hypertension, I also experience vertigo, right bundle branch block (RBBB), and chronic constipation.

For the past three years, I have also had recurring itching in my lower legs typically in the right leg during winter and the left leg during summer. My job requires prolonged sitting. I am 5'9" tall and weigh 242 pounds, which has remained stable over the last five years.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Based on the information you have provided, I would like to highlight a few key areas to help guide your diabetes management more effectively. Diet is the foundation for the management of diabetes globally. To tailor recommendations more accurately, could you please share details about your regular eating habits and meal patterns?

Physical activity

As you mentioned, working as an accountant, it’s likely your job involves extended periods of sitting. Physical activity is essential for blood sugar control. Even during work hours or periods of limited mobility (like lockdown), try to include short five to10 minute walks around your home or office. Small but regular efforts can have a significant impact over time.

Medications

You have noted taking Amaryl MV-1, but haven’t specified the frequency. Could you clarify how many times a day you take it?Additionally, considering your current weight in relation to your height, it’s essential to note that Amaryl can sometimes lead to weight gain. There are newer medications available that not only control blood sugar effectively but may also aid in weight reduction. We can explore those options if appropriate.

To better assess your condition, could you please provide the following:

Do you have a family history of diabetes?
On a scale of 1 to 10, how would you rate your current stress levels?
Are you getting adequate sleep?
Do you wake up frequently at night to urinate? If so, how often?
Have you noticed any pain, burning, or unusual sensations in your legs?

Your responses will help us understand the full picture and plan next steps accordingly.

Probable causes

The likely contributing factors to your current condition are:

Obesity.
Uncontrolled blood sugar levels.

Recommended investigations

To proceed, please consider getting the following tests done:

Fasting Blood Sugar (FBS).
Post-Prandial Blood Sugar (PPBS).
HbA1c (Glycated Hemoglobin).
Lipid Profile.
Serum Creatinine.

Treatment plan

Continue your current medications for now. Once we have a more detailed diabetic history and lab results, we can make informed adjustments if necessary.

Preventive measures

Eat six to seven small, frequent meals per day.
Increase intake of leafy vegetables, fruits, and pulses.
Limit grains, refined flour (maida), and processed foods.

Looking forward to your response and lab reports so we can move forward with a personalized and effective treatment approach.

I hope this helps.

Kindly revert if there are any queries.

Thank you.