I am 26 years old with an increased blood sugar level. Please advice me on how to control it.

Question

Hello doctor,

I am a 26-year-old male and am taking the tablet Metformin 500 mg twice daily for my blood sugar, but it is still 230 mg/dL in the morning (fasting) and 300 mg/dL postprandially. Please help me with what I should do and guide me on how I can control my sugar. I am panicked about this and need proper advice on how to handle it.

Kindly advise.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

What is the HbA1c (glycated hemoglobin) value that shows your average sugar over the last two to three months? Diabetes has many complications, so it is not just about bringing down the numbers, but to monitor and treating complications associated with diabetes. Check your eyes for retinopathy. Check your kidneys for the urine albumin creatinine ratio. Check your feet. Lifestyle modifications are the best diabetes treatment.

Take a low-carbohydrate diet and no added sugar. No sugary juices. No bread, rice, pasta, or potatoes. If you cannot stop, at least take as little as possible. More vegetable salads and fiber. Fruits are only a sweet dish. Do not take mango, grapes, and bananas. Apple has no more than one piece. Strawberries and other berries are fine, along with peach, apricot, and small amounts of plums.

Intermittent fasting will also help to control your diabetes. You can fast for 16 hours, like taking your dinner at 7 PM and breakfast at 11 AM, and not eat anything between that. During fasting, drink water and green tea without sugar. You can extend fasting to 24 hours, then 36 hours once your body adapts. You can do fasting two times a week, or as you feel it will control your sugar.

Drink more water and sleep well. Exercise, such as walking, for at least 30 to 40 minutes daily. The more you practice these things, the better your control will be. Check your sugar frequently. Your fasting target should be 90 to 130 mg/dL, and two hours after eating, 150 to 160 mg/dL. HbA1c should be less than 7. These targets can vary in individual patients depending on their diabetes duration and other relevant issues.

As your sugar is high and it is not controlled with the tablet Metformin alone. You need to change your medicine. Start tablet Janumet 50/1000 (Sitagliptin 50 mg and Metformin 1000 mg) morning and evening. Follow the above diet and lifestyle modifications.

I hope this helps you.

Thank you.