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What Causes Fluctuations In Blood Sugar Levels?
Question: DIABETOlOGY
Dear Doctor,
I am 74. I had type ii diabetes in 2012. I have been taking Glycomet in different potencies over these years.Now I am taking 500 mg twice a day.I furnish hereunder the results for your perusal
Laboratory Results
FBS PP HB A1 C
6/5/17 134 147 6.7
30/12/16 113 6.7
23/8/16 114 141 6.4
18/5/16 122 6.8
glucometer readings
1/6/17 136
31/5/17 136
25/5/17 128
23/5/17 124
22/5/17 145
17/5/17 116
14/5/17 130 119
11/5/17 130
My fasting levels right from the begining oscillates between 110 to 125. And at times it goes to 135 Only once it has gone to 166 when i went for cataract operation.But post lunch (full meals in the afternoon) always oscillates between 125 to 145 .Only once it went up to 160.i felt twice or thrice weakness in the legs recently . .I have never experienced this in my whole life before. This was happened two hrs or two and half hours after breakfast and also with 500 mg glycomet. After i had lunch and taken rest , i felt active and agile and no weakness in the legs. I eat small 3 or 4 idlis in the morning for breakfast. I take sugarlesss coffee .What i feel is that the dosage of glycomet of 500 mg is high when compared with my breakfast and level is falling .So can i split the Glycomet dosage into two (250mg each) and take one half at breakfast and one half at lunch time and full 500 mg at dinner time.Can i do that.?
Is this feeling of weakness in the legs below the knees is a usal phenomena for old people? Or it is particularly for diabetics. I must say i do not know what is the feeling of weakness so far. I walk for 4.15 km every day since 40 years. I do not feel weakness then.
Regarding fasting blood sugar, is it something like reverse blood sugar .I take 2 chapathis only for dinner . I am told by somebody that chapathis escaletes blood sugar levels and taking small quantity of rice int the night is the best.Kindly advise.
My other parameters regarding my health is good, though, i have mild bp,Hyperthyroidsm , BPH, and IHD.
In my routine checkup every thing came normal . I request you sir to please go through my this lengthy letter and advise me. My medicines are Glycomet, Beta card,Amtas ,Deplatt cv,Thyronorm ,Ismo and urimax.
Dear Doctor,
I am 74. I had type ii diabetes in 2012. I have been taking Glycomet in different potencies over these years.Now I am taking 500 mg twice a day.I furnish hereunder the results for your perusal
Laboratory Results
FBS PP HB A1 C
6/5/17 134 147 6.7
30/12/16 113 6.7
23/8/16 114 141 6.4
18/5/16 122 6.8
glucometer readings
1/6/17 136
31/5/17 136
25/5/17 128
23/5/17 124
22/5/17 145
17/5/17 116
14/5/17 130 119
11/5/17 130
My fasting levels right from the begining oscillates between 110 to 125. And at times it goes to 135 Only once it has gone to 166 when i went for cataract operation.But post lunch (full meals in the afternoon) always oscillates between 125 to 145 .Only once it went up to 160.i felt twice or thrice weakness in the legs recently . .I have never experienced this in my whole life before. This was happened two hrs or two and half hours after breakfast and also with 500 mg glycomet. After i had lunch and taken rest , i felt active and agile and no weakness in the legs. I eat small 3 or 4 idlis in the morning for breakfast. I take sugarlesss coffee .What i feel is that the dosage of glycomet of 500 mg is high when compared with my breakfast and level is falling .So can i split the Glycomet dosage into two (250mg each) and take one half at breakfast and one half at lunch time and full 500 mg at dinner time.Can i do that.?
Is this feeling of weakness in the legs below the knees is a usal phenomena for old people? Or it is particularly for diabetics. I must say i do not know what is the feeling of weakness so far. I walk for 4.15 km every day since 40 years. I do not feel weakness then.
Regarding fasting blood sugar, is it something like reverse blood sugar .I take 2 chapathis only for dinner . I am told by somebody that chapathis escaletes blood sugar levels and taking small quantity of rice int the night is the best.Kindly advise.
My other parameters regarding my health is good, though, i have mild bp,Hyperthyroidsm , BPH, and IHD.
In my routine checkup every thing came normal . I request you sir to please go through my this lengthy letter and advise me. My medicines are Glycomet, Beta card,Amtas ,Deplatt cv,Thyronorm ,Ismo and urimax.
Brief Answer:
Suggestions
Detailed Answer:
Hi.
I am Dr Mittal.
I have read your message.
First.
The sugar levels will fluctuate. Whether it's FBS or PPBS. Minor fluctuations are expected. So do not worry.
Second.
The weakness might be hypoglycaemia, specially as the legs feel better after food. The dose can be split. Alternatively an extended release form can be used. Do check sugars with glucometer before making the change. And please inform your treating physician about the change as well.
However check your BP as well. You are on 2 BP medicines , and low BP causes same symptoms.
Third.
The debate on rice and chapati has been raging on for a long time . And the opinion remain's divided. It's actually the processed form like cornflakes that's bad. The normal XXXXXXX variety are fine. Hope no oils with chapati though.
I hope this information helps you.
Feel free to contact me for any specific information that you may like further.
Best of luck.
Dr Mittal
Suggestions
Detailed Answer:
Hi.
I am Dr Mittal.
I have read your message.
First.
The sugar levels will fluctuate. Whether it's FBS or PPBS. Minor fluctuations are expected. So do not worry.
Second.
The weakness might be hypoglycaemia, specially as the legs feel better after food. The dose can be split. Alternatively an extended release form can be used. Do check sugars with glucometer before making the change. And please inform your treating physician about the change as well.
However check your BP as well. You are on 2 BP medicines , and low BP causes same symptoms.
Third.
The debate on rice and chapati has been raging on for a long time . And the opinion remain's divided. It's actually the processed form like cornflakes that's bad. The normal XXXXXXX variety are fine. Hope no oils with chapati though.
I hope this information helps you.
Feel free to contact me for any specific information that you may like further.
Best of luck.
Dr Mittal
Above answer was peer-reviewed by :
Dr. Kampana
dear
doctor,
I thank you very much for your nice reply. So as you advised, i need not worry about rise in fasting levels. One more question is if the Hb A1 c is below normal or below normal limits, i need not bother about the fasting and bp levels in that particular 3 months period? Is nt it?.I must maintainHb A1 c always below 6.7 isnt it?Splitting of 500 mg into two (breakfast and lunch) doesnt cause any harm to my insulin production in my liver ? .Isnt it?
Kindly advise sir
Brief Answer:
Suggestions
Detailed Answer:
HELLO.
I will try to give you the exact answers.
First, I did not say that you need not worry about rising levels of sugars. I said you need not worry about the fluctuations as long as they are within the controlled range.
The perfect HbA1c in non diabetic is 6.
So your HbA1c is higher. But that is expected in a diabetic person.
HbA1c should be maintained as low as possible. However too low HbA1c predispose's one to hypoglycaemia, and it's considered widely that this is more dangerous. So 6.4 to 6.7 is fine.
HbA1C has the role of telling you about average sugar status of 3 months. FBS PPBS help us consider the daily sugars. And in some patients the daily dose of medicines. Both have different roles. So it's not like if HbA1c is done , sugar readings are not needed.
Metformin in divided doses will not affect the pancreas (that's where insulin is secreted) or liver. However, the change of dose regimen is likely to change the dynamics of sugar levels. So be prepared for that. In other words, since medicine dose is changing, part of the sugar control will change too.
Please feel free to contact me for any related query.
Best of luck. Dr Mittal
Suggestions
Detailed Answer:
HELLO.
I will try to give you the exact answers.
First, I did not say that you need not worry about rising levels of sugars. I said you need not worry about the fluctuations as long as they are within the controlled range.
The perfect HbA1c in non diabetic is 6.
So your HbA1c is higher. But that is expected in a diabetic person.
HbA1c should be maintained as low as possible. However too low HbA1c predispose's one to hypoglycaemia, and it's considered widely that this is more dangerous. So 6.4 to 6.7 is fine.
HbA1C has the role of telling you about average sugar status of 3 months. FBS PPBS help us consider the daily sugars. And in some patients the daily dose of medicines. Both have different roles. So it's not like if HbA1c is done , sugar readings are not needed.
Metformin in divided doses will not affect the pancreas (that's where insulin is secreted) or liver. However, the change of dose regimen is likely to change the dynamics of sugar levels. So be prepared for that. In other words, since medicine dose is changing, part of the sugar control will change too.
Please feel free to contact me for any related query.
Best of luck. Dr Mittal
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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