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Controlling high diabetes - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   hi
User :   Hi
Doctor :   Dr. XXXXXXXX here.
Doctor :   please proceed with your health query
User :   My name is . I need to ask some questions and need solutiion to my father health.
User :   I am providing u his breif details below
Doctor :   ok. please proceed
User :   Name: xxxxx Age: 63 years Sex: Male Brief history of health: 1. Diabetes Mellitus Since 15 years and in OHA + Insulin (a) Metformin 850mg 1-0-1 (b) Glimperide 2mg 1-0-1 (c) Rosiglitazone 2mg 1-0-1 (d) Human Mixtard 30 Novolet Insulin 100IU/ml 22-0-18 2. Hypertension Since 15 years taking diuretics - Hydrochlorothiazide 15mg 1-0-0 3. Had PTCA to RCA procedure 2 years back - diagonised as CCF 4. Had IOL procedure for both the eyes around 10 years back. 5. Had disarticulation of greater toe of right leg on November 2009 due to severe infection. Other Medications taking: 1. Aztor 20mg 1-0-1 2. Ranitidine 150mg 1-0-1 3. Digene SOS 4. Clopidogrel and Aspirin 75mg 0-1-0 5. Becadaxemin (multi vitamin and mineral) 1-0-0 BP and Diabetic readings - 29th Aug 2010 PPBS reading - 370 BP reading - 110/65 3 days average (RBS) reading 350
User :   Please tell me what do I need to do to control his diabetes or bring back to normal readings.
User :   He is in strict diet and medication
Doctor :   please give me sometime to read what you have typed.
User :   But the result is not good.
User :   sure
Doctor :   was his HbA1C tested?
User :   very long back and it was 6%
Doctor :   are you sure about his 'strict diet control'?
User :   Yes he is in low carbohydrate diet for about 3 days.
Doctor :   was he on diet control after getting diagnosed with diabetes?
User :   no.
Doctor :   diabetes control is a 3 faceted approach with diet control, regular exercises and medications
User :   He always has RBS around 200-250
Doctor :   if any of these 3 is mismatched, the sugar levels will flucuate
User :   after his disarticulation he is not exercising or to say no physical activities at all.
Doctor :   he needs to be in strict control for diet and be on brisk walk for 30 minutes two times a day along with taking medications on time and with right dosage
User :   Is it required to change the medicines or insulin dosages or insulin type?/
Doctor :   since when he is on this dosage?
User :   about 2 yrs.
User :   He has CCF as I said above. Even though can he take the brisk walk?
User :   is it ok?
Doctor :   then I would suggest to you consult a diabetologist for proper sugar control with appropriate change in dosage
Doctor :   brisk walk should be in a pace that does not make him breathless. he can start with walk in the house itself
Doctor :   is he at home or hospital?
User :   ok
User :   in home
User :   Tell me some guidelines for now, as what needs to do apart from what u described above.
User :   Right now I could not able to take him to diabetologist.
User :   Please tell me what can be done for now to bring back to normal readings.
Doctor :   at first start with the diet control and the mild exercises like walking at home under supervision
User :   ok
Doctor :   and try to take consultation from diabetologist ASAP
Doctor :   where are you located? which is the nearest city from your location?
Doctor :   i will try finding a diabetologist whom you can consult.
User :   I knew before itself to consult Diabetologist. But I needed solution now. Then what is the need for this chat. I would have got better Tips on controlling diabetis if I searched on Internet. But, I needed the one solution to the problem and not to proceed to any further consultations with other doctors.
User :   I am really disappointed .
Doctor :   for changing the dosage to levels for complete sugar control, your father should be examined and then the change can be done since he has other problems also associated
User :   Rather than spending the money for this chat I would have preferred to go with the physicians itself'
User :   Thats why I described in detail to u
Doctor :   I am not examining him personally, so it is not possible to suggest changes, it might complicate issues
User :   I expected u to prescribe some medications.
Doctor :   it should be done under supervision
Doctor :   and with regular follow-ups
Doctor :   with monitoring of sugar levels on regular even daily basis
Doctor :   to adjust the insulin dosages to suit his needs.
User :   then this service is just to provide some tips to ur customers rather than any type of consultations right?
Doctor :   if the sugar levels persistently are above 200-300, then he will need to be admitted to be able to check sugar levels every time before giving insulin to calculate the dosage
Doctor :   it is called as 'sliding scale' treatment
Doctor :   you can discuss this with his current treating doctor
Doctor :   and see if this helps along with the suggestions given above
User :   ok then ur recomending to admit him to hospital and gets the sugar down.
User :   right?
Doctor :   yes, if the regular treatment is not working in conjunction with diet control and exercise, then this will be the last resort
Doctor :   to try to get sugars under control.
Doctor :   why was he not on diet control all these days after diagnosis? it is vital for proper sugar control. was it not advised to him?
Doctor :   he would not have faced uncontrolled sugars and other problems
User :   s it was advisied but he taken that very lightly.
User :   s u r right
Doctor :   is the CCF getting controlled? if the sugars are not controlled well, then it can affect CCF too
Doctor :   leading to infection and his condition detiorating
User :   s i know that.
User :   ok anyhow thanks for ur support and advice.
User :   bye for now
Doctor :   is there anything else I can help you with?
User :   no
Doctor :   thanks for consulting me. bye for now.
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