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Diet for patient with high diabetes and liver dysfunction - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3622 Questions
Doctor :   hi
Doctor :   how can i help you
Doctor :   r u there
Doctor :   I have to close this window since there is no response from your side, please get back to us if you need further medical advice. We are available from 9AM to 9PM IST everyday.
Doctor :   hi
User :   hi
Doctor :   go ahead with ur medical query
User :   my father is a diabetic
Doctor :   ok
Doctor :   For Administrative and health purposes, Please provide these details -Age: Gender: Occupation: Location: Marital Status: Dependants: Yes/No
User :   59/m/retired lecturer/giddalur
User :   no dependant
Doctor :   since when he is diabetic
User :   undegone cabg with severe lv dysfunction
User :   from past 10years
Doctor :   ok
User :   his sugar levels from the past 2weeks are 360/290/210/170/182
Doctor :   is it fasting or PP
User :   all these are fasting levels
Doctor :   ok
Doctor :   did u get urine tests done
Doctor :   urine sugar?
User :   he is using HUMAN MIXTARD 50/50
User :   ya
Doctor :   what was the report
User :   one week urine sugar levels are 290 when blood levels are 360
User :   when it was 210 urine sugar is tracable
User :   when it is 170 urine level is -ve
Doctor :   then u need to consult physician
User :   ya
User :   cnsulted
Doctor :   his sugars are high
Doctor :   how much insulin he is taking now
User :   they suggested to use mixtard 50/50 45 units in the morning and evening
Doctor :   ok
User :   in the afternoon he is using 10 units of actropid
Doctor :   ok
Doctor :   how much is the sugar level now
User :   do u suggest any tablets along this insulin
User :   reclide some thing
Doctor :   no
User :   last friday that is 182
Doctor :   ok
Doctor :   whats the level this morning
Doctor :   u needs strict diet control
Doctor :   and exercise
User :   today we didnt check
Doctor :   does he have any infection
Doctor :   he is running with fever?
Doctor :   please check
User :   excercise he is a cardiac patient with severe lv dysfunction
User :   no
Doctor :   he can walk
User :   no infection
Doctor :   ok
User :   he is walking
Doctor :   he is able to walk
Doctor :   good
User :   slowly
Doctor :   u needs to have strict diet control
User :   ok
Doctor :   to bring down the sugar levels
Doctor :   dont give him too much food at a time
User :   ok
Doctor :   but give in divided doses
Doctor :   4 times a day
Doctor :   in small quantity
User :   ok
Doctor :   stirctly avoid giving any sweets
Doctor :   very less rice
User :   ok
Doctor :   more of chappati or ragi with vegetables and greens
User :   other than rice what shall he take?
Doctor :   wheat or ragi
User :   e?
User :   okk
Doctor :   I would recommend you to take the advice of a nutritionist who can help you with the menu you require based on your diet patterns. For all weight problems, please visit and register at, you can also call them alternatively at 0000

Doctor :   if the sugar level remains high
User :   they told to have oats
User :   thanx
Doctor :   u need to consult a physician and get repeat sugar levels and urine sugar tests done
Doctor :   ur welcome
Doctor :   thats fine
Doctor :   he can have that
Doctor :   Please fill this form I send, While I type the necessary information, and do inform me when done.
User :   any docotr in hyderabad so that we can consult?
Doctor :   we are operational in bangalore as of now
Doctor :   we will be coming to hyd shortly
Doctor :   we dont have data base for hyd
Doctor :   as of now
User :   any references in hyd if u have any
Doctor :   u can follow up with endocrinologist
Doctor :   near by
Doctor :   we dont have database with us for hyderabad
User :   here we are finding so many physicians who specify that they are diabetic specialists
User :   okk
Doctor :   consult a endocrinologist or diabetologist
Doctor :   keep regular follow up with same doctor
Doctor :   he will knowing the history better
Doctor :   he will be knowing the medical history better
User :   ok
User :   i wanted to know one more thing
Doctor :   sure
User :   if sugar levels are high then proprtionately creatinine leveles will be high?
Doctor :   yes
Doctor :   it will affect kidney function
Doctor :   as well
Doctor :   so creatinine will go up
Doctor :   any doubts
Doctor :   did i clear all ur doubts?
User :   bcoz 2weeks back creatinine was 2.1
User :   last week it was 1.7
Doctor :   what is the value now
Doctor :   it is above normal
Doctor :   normally it should be around 1.2
User :   as sugar values are coming down it is coming down
User :   ya
Doctor :   in longstanding diabetes
User :   my father is using DYTOR , METENIX for cardiac
Doctor :   there will kidney damage
Doctor :   ok
Doctor :   so it is essential to prevent kidney damage
Doctor :   with good diabetic control
Doctor :   and delay the process
User :   if we reduce these dosages it is coming to lower levels
User :   hb is 9.8
Doctor :   dont lower the dose
Doctor :   let the physician decide
Doctor :   go by his advise
Doctor :   when was this done
User :   cardialogist only suggested to reduce the dosage
Doctor :   thats fine
User :   hb was done 2weeks back
Doctor :   need to keep watch on this creatinine levels
User :   nephrologist said when HB is around 8.3 to 8.8 creatinine levels would be around 3
User :   is it so?
User :   3months back HB is 8.3 at that time creatinine is 1.8
User :   2weeks back it is 9.8 and creatinine is 2.1 and later it is 1.7
Doctor :   ok
User :   HB 9.8 is also less than normal range na?
Doctor :   there is no documented medical evidence
User :   okk
Doctor :   to show relationship between hB levels
Doctor :   and creatinine
Doctor :   hb drops due to lack of iron
User :   we cannt compare HB levels and creatinine
User :   ya
Doctor :   thats what medical abstracts say
User :   spot protein and creatinine ratio was 0.06
Doctor :   ok
User :   any problem with this ration?
Doctor :   but
Doctor :   there is kimmelstien glomeroloscelrosis
Doctor :   this is a change seen in diabetic nephropathy
Doctor :   wherein the glomerulus decrease the capacity to filter
Doctor :   in each nephron increasing the creatinine levels
Doctor :   r u there
Doctor :   r u able to follow
Doctor :   ok

User :   ya
Doctor :   when was the test done
User :   with what test can we find out this ?
User :   which test?
Doctor :   BUN/S.creatinine ratio
Doctor :   protein-to-creatinine ratio is an efficient predictor of protein excretion in patients with diabetic nephropathy;
User :   bun/creatinine ration we didnt do
Doctor :   ok
User :   protein/creatinine was done 2weeks back
Doctor :   follow up with the endocrinologist for this sugar levels
Doctor :   ok
User :   bun was 82.7 at that time creatinine was 2.1
User :   ok
Doctor :   ok
User :   bun is different from blood urea?
Doctor :   Blood urea nitrogen
User :   what is the major difference?
User :   between the two?
Doctor :   blood urea and blood urea nitrogen are both same
Doctor :   anything else u want to know
User :   at the diagnostic center they told that both are different
User :   2 more mins plz
Doctor :   ok
User :   the reference ranges for bun they told 6-20 for blood urea they told upto 40 some thing
Doctor :   ok
Doctor :   Yes, as I am chatting with some patients simultaneously. Please bear with us for a reply
User :   ur specialist in which area if u can let me know?

User :   okk
User :   its not a problem
Doctor :   ok
User :   ur specialist in which area?
Doctor :   I am a General Practitioner, I believe I can help you within my expertise and If required I shall recommend a specialist
User :   ok
User :   it was wonderful experience chatting with you
Doctor :   there will variation
Doctor :   in different lab
User :   okk
User :   for creatinine they used XLkit they told
Doctor :   ok
Doctor :   Thanks for consulting Health care magic. Bye for now. Please refer your friends to our service
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