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Have type 2 diabetes, taking Gemer and Januvia. Irregular blood sugar level. Walking daily, controlling diet. Help

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General & Family Physician
Practicing since : 2003
Answered : 115 Questions
i am type 2 diabitic i am takin GEMER 1, januvia before bf , volibo .3 with lunch and GEMER 2 +VOLIBA BEFORE dinner . My fasting level is around 145-160 mg/dl and after two hrs it comes to 180-190 again at evening at 8 pm it comes to 140-150 mf/dl.
i want that My fasting to reduce to 90-100 mg/dl.
i am walking 30-40 minutes daily . and have good diet control


Posted Mon, 17 Sep 2012 in Diabetes
Answered by Dr. Mihail Iepure 3 hours later
Thank you for your details, I see your blood glucose level still not under control, you didn’t reach the therapeutic target: fasting 90-130 mg/dl; 2 hrs postprandial 160-180 mg /dl ; bed time 110-150 mg /dl, Hemoglobin A1c <7; You have to review with your Doctor treatment ( doses, frequency) and strictly follow following life style advices : 1.Dietary prescription : Weight loss and maintain ideally body weight; restriction of saturated fat to < 10 % of total calories (replaced them by monounsaturated fats); restriction of cholesterol to < 200 mg/day; restriction of proteins <20 % of total calories; sodium restriction <2.4 gr/day , in case of hypertension sodium restriction <2.0 gr/day, in case of nephropathy protein restriction to <0,8 mg /kg/day or 10 % from total calorie intake. 2.Exercise prescription : combination of aerobic and resistance exercises, avoid extreme heavy lifting, straining, ( may raise blood pressure and aggravate retinopathy ); Intensity: increase heart rate moderately to 55 % of maximal heart rate ( 220 minus age in years); Duration : 30 minutes, preceded by stretching and flexibility exercises for a minimum 10 minutes; Frequency : best result if exercises occurs daily or minimum 3 time /week; if fasting glucose level are around 250 mg/dl, avoid strenuous exercises, if fasting glucose > 300 mg /dl, avoid any type of exercises; Monitor blood glucose level before , during and after exercises; 3.Monitoring; 4.Treatment planning ; 5.Avoid common precipitants: infections( respiratory, urinary, gastroenteritis, sepsis ) inadequate treatment; acute coronary syndromes; alcohol; drugs;
I would recommend you follow all these advises if you want to reach 100 mg/dl fasting level and to avoid main complication: nephropathy, retinopathy and neuropathy.

I wish you good luck and speedy recovery,
Hope this helps and I have answered your query. If you have additional queries don’t hesitate to ask.

Best Regards,


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