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Have Diabetes. Heart Profile And Urine Report Normal. Should I Take Insulin Or Oral Medicine?
Question: 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
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
Hi XXXXXXX,
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
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
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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