Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
199 Doctors are Online

Have diabetes. Heart profile and urine report normal. Should I take insulin or oral medicine?

Jan 2013
User rating for this question
Very Good
Answered by

Internal Medicine Specialist
Practicing since : 2003
Answered : 1658 Questions
Hello i am 59 yrs male having type 2 diabetes since 30 yrs untill last month was on mAximum combination of oral tab amyl 4mg metamarfin 2500mg piglatozone 30mg glavus 100mg with sugar levels pp 250 f 180 added lantus 16 units stoped piglatozone sugar pp 200 f 130 few days back again sugar went out of control so stopped lantus stoped amryl reduced glyciphage to 2000mg started human mixtered 30/70 22 units break fast 15 units dinner and sugar levels are 400 pp break fast 300pp lunch And dinner and 250 fasting kindly advice if keep on increasing insuline or switch back to lantus with all tablets or add piglatozone with human mixtered or what you advice please my bp is 130/80 with cardace 7.5 mg also taking rosuvas f 10mg met xl 50 calcium alfusin D for prostate
nefrosave capsule fegucreek plus multivitamin anti oxidents regular diabetic diet and walk 1 hr with yoga daily all reports diabetic profile kidney heart profile normal glycostated hemoglobin hb1ca is 9.9 burning in urine reports all ok
Posted Wed, 27 Mar 2013 in Diabetes
Answered by Dr. Mayank Bhargava 1 hour later
Welcome to XXXXXXX forum.

With the available descried blood reports, there appears to be possibility of total destruction of beta cells in endocrinal part of pancreas.
With consideration of your age and positive response with oral medicine in past suggests that you are suffering from Type II diabetes.
When type II diabetes is diagnosed, beta cells (which secrete insulin) in pancreas have already destructed by body's immune mechanism and less than 20 % remains in pancreas.
This beta cell destruction is progressive in nature and further destructive mechanism was active during last 30 years in your case.
Rate of destruction of beta cell vary person to person.

So a person who is suffering from Type II diabetes and taking oral medicine for control of sugar, this may be possible that oral medicine have stopped working at any time of life and insulin is required.

You are living a very active life with taking all measures for control of blood pressure, lipid derangement, and kidney protection.

You should again consult with your treating doctor/ XXXXXXX medicine specialist/ endocrinologist and should go for serum C peptide level.
Serum C peptide is secreted by beta cells along with insulin and values below normal reference range also suggest decrease insulin production and no more beta cells in body.

In such cases, a diabetic patient may require insulin and amyrl 4 mg won't work and its useless to continue to take these medicines.
As you have fluctuating blood sugar level, you should first stop all medicine under guidance of your treating doctor.

You should follow dietary measure as advised by dietitian or your treating doctor.
At times because of high dosage of insulin, patient's blood sugar always remain in lower range with increased appetite.
This will further increase your insulin demand and patient start taking much more diet and much more insulin.

You should take Lantus insulin at night times as per advice of your treating doctor and postprandial sugar must be look after by use of regular insulin doasges.

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Medical Topics

The user accepted the expert's answer

Ask a Diabetologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor