Hello XXXXXXX,
Thanks for writing in.
I am a qualified and certified cardiologist and medical specialist. I read your mail with diligence.
From life Insurance point of view let us review risk factors which are for coronary artery disease at any age and affect longetivity. Seven are modifiable and for three non modifiable no one can do much. If modifiable risk factors are controlled there is Ombudsman whom you can approach against refusal of Insurance.
1. High Blood Pressure
2. High Bad Cholesterol or its component that is Total Cholesterol, LDL and
Triglycerides
3. Low Good Cholesterol or its components HDL is the main
4. Stress in fact Hypertension is stress in action.
5. Diabetes
6. Smoking
7. Obesity and Sedentary life style.
in elderly deficiency of folic acid leading to increased homocysteine and in Indians especially, Lipoprotein a (LPa) are additional risk factors.
Non Modifiable Risk Factors:
1. Family History
2. Being a man (women are protected till the age 45)
3 Increasing age

So, you have uncontrolled Diabetes (HbA1C 8.4, FBS 184 mg%) that is only factor one can conclude for which you are taking AZULIX-MF tab: salts- glimepiride 1 mg, metformin hydrochloride (SR) 500 mg. You have to get your Glycated Hemoglobin measured after modifying your drug, diet and exercise regime. This reflects previous 12 weeks control. HbA1C below 7 with Fasting Blood Sugar between 80 to 110 mg should see you through. You have to modify your drug and now considering your height and weight please avoid high calorie food along with a regimen of exercise.
Take these 3 steps:

1. Under supervision and prescription from a doctor, increase glimiperide from 1 to 2 mg, and increase metformin to 1000 mg Sustained release, take both of these twice a day before breakfast and before dinner. If FBS is still high an additional drug can be added. In health care magic, drugs are not prescribed only recommended.

2. Take a diabetic diet chart of 1600 calories with foods of low glycemic index and stick to it. Avoid sugar or sugar containing sweets altogether.The diet depends upon you are vegetarian or non vegetarian. The chart can be obtained from WWW.WWWW.WW or by asking a direct question to me.

3. And finally to counter Diabetes (which some 60 million other Indians are suffering from) you must aim for doing adequate exercise, which is brisk walk at the speed of 5 KM/Hour for forty minutes a day is sufficient cardiac exercise. If you have any question for me I will be happy to answer Good luck.
Best Regards.

With best wishes.
Dr Anil Grover,
Cardiologist and Internist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)http://www/ WWW.WWWW.WW

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Thanks for writing back.
The constipation/Diarrhoea is because of Diabetes and drugs like Metformin. It will settle once you start taking high fiber diet. Please do not take drugs like Lomofen which is banned in most of the countries. And take Lomotil only with doctor's advice.
For getting diet chart you will have to log in to WWW.WWWW.WW and choose various options of lifestyle and diet advices. You can write to me on my page
http://www/ WWW.WWWW.WW and give your email address I shall be able to mail you the diet chart. General advice is high fiber, low calorie, low glycemic index, low fat XXXXXXX meals to add to 1600 calories per day. For vegetarian you can see the fat content and calories of any food from internet and device your own menu. Alternatively, you can choose either of the two above mentioned methods. Good Luck.
With Best Wishes.
Dr Anil Grover

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