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Hi My Mother Is Diabetic For Last 17 Years. Following
Question: Hi
My mother is diabetic for last 17 years. Following are her parameters
1. Fasting Sugar is 100 to 110 , PP Sugar is 140-150
2. HbA1c is 7.7 in Oct 2018, Sep 2017 is 7.2
3. Taking Medicines for last 17years.
4. Last 3 months prescription is below
a. Diamicron XR-60 1 Tab Before breakfast
b. Januvia 50 - 1 after breakfast and 1 after dinner
c. Metformin SR 500 - 1 after breakfast and 1 after dinner
d. Losartin 25 - 1 after breakfast
e. Rosuvastatuin - 10 1 Tab after dinner
f. Volix - 0.3Mg 1 tab with lunch
Questions
1. Should she shift to insulin at this stage or stil continue with medication
2. If she should move to insulin what is the best way to move so that her blood sugar doesnt go up and down
3. Can she take insulin belt or she has to take it manually ?
My mother is diabetic for last 17 years. Following are her parameters
1. Fasting Sugar is 100 to 110 , PP Sugar is 140-150
2. HbA1c is 7.7 in Oct 2018, Sep 2017 is 7.2
3. Taking Medicines for last 17years.
4. Last 3 months prescription is below
a. Diamicron XR-60 1 Tab Before breakfast
b. Januvia 50 - 1 after breakfast and 1 after dinner
c. Metformin SR 500 - 1 after breakfast and 1 after dinner
d. Losartin 25 - 1 after breakfast
e. Rosuvastatuin - 10 1 Tab after dinner
f. Volix - 0.3Mg 1 tab with lunch
Questions
1. Should she shift to insulin at this stage or stil continue with medication
2. If she should move to insulin what is the best way to move so that her blood sugar doesnt go up and down
3. Can she take insulin belt or she has to take it manually ?
Brief Answer:
Agree with "starting insulin therapy"
Detailed Answer:
Hello
I have gone through your query and understood your concern.
Your mother take four classes of anti diabetic drugs and HbA1C is 7,7%.(the goal is <7%).
Considering that she take her Diabetes medicines for 17 years,i can say that it is time to start insulin therapy to have better blood sugar results.
I will suggest to start two injections of premixed insulin morning and evening.This is the most appropriate insulin regymen in my opinion,to stabilise her blood sugar results,considering her actual blood sugar results and HbA1C result.
If she was my patient,i will suggest to inject insulin rather than insulin belt insulin pump.
I recommend to check her blood sugar result before every injection of insulin.The insulin pump can stop working or inject the same dosis of insulin every moment and this can be a problem.
Checking blood glucose is important because it will warn the diabetic if his/her pump stops working right, or his/her infusion set stops working. This can cause high blood glucose levels and the diabetc can go into diabetes ketoacidosis, which is very serious and dangerous.
So, to resume in my opinion your mother needs insulin injections to treat her Diabetes.
Hope i have answered to all your questions.
Let me know if i can assist you further.
Take care.
Agree with "starting insulin therapy"
Detailed Answer:
Hello
I have gone through your query and understood your concern.
Your mother take four classes of anti diabetic drugs and HbA1C is 7,7%.(the goal is <7%).
Considering that she take her Diabetes medicines for 17 years,i can say that it is time to start insulin therapy to have better blood sugar results.
I will suggest to start two injections of premixed insulin morning and evening.This is the most appropriate insulin regymen in my opinion,to stabilise her blood sugar results,considering her actual blood sugar results and HbA1C result.
If she was my patient,i will suggest to inject insulin rather than insulin belt insulin pump.
I recommend to check her blood sugar result before every injection of insulin.The insulin pump can stop working or inject the same dosis of insulin every moment and this can be a problem.
Checking blood glucose is important because it will warn the diabetic if his/her pump stops working right, or his/her infusion set stops working. This can cause high blood glucose levels and the diabetc can go into diabetes ketoacidosis, which is very serious and dangerous.
So, to resume in my opinion your mother needs insulin injections to treat her Diabetes.
Hope i have answered to all your questions.
Let me know if i can assist you further.
Take care.
Above answer was peer-reviewed by :
Dr. Yogesh D
thanks doctor. Can you pls suggest the brand and name of insulin
Brief Answer:
NovoMix
Detailed Answer:
Hi again
If your mother"s was my patient ,i will suggest to start Ins.NovoMix 12UI morning and 8 UI evening,injected 10 min before meals.
Check your mother's blood sugar before insulin injections and 2h after the meals.
Let me know the results and i will be happy to guide you further.
NovoMix
Detailed Answer:
Hi again
If your mother"s was my patient ,i will suggest to start Ins.NovoMix 12UI morning and 8 UI evening,injected 10 min before meals.
Check your mother's blood sugar before insulin injections and 2h after the meals.
Let me know the results and i will be happy to guide you further.
Above answer was peer-reviewed by :
Dr. Yogesh D
OK Thanks Maam. HOw long the testing has to continue. Before and after meals.
Dear Maam,
Kindly describe as steps for the entire process.
Like
Step 1 - Test Blood Sugar before 2 hours.
Step 2 Take Insulin
Step 3 Eat Food
Step 4 Test Again after 2 hours
How long should the testing continue ??
Kindly describe as steps for the entire process.
Like
Step 1 - Test Blood Sugar before 2 hours.
Step 2 Take Insulin
Step 3 Eat Food
Step 4 Test Again after 2 hours
How long should the testing continue ??
Also maam , after she takes insulin , should she continue with cholestrol medications that she takes as preventive now. ??
She takes presently
TONACT EZ 10mg (Ezetimibe 10mg & Atorvastatin 10mg)
She takes presently
TONACT EZ 10mg (Ezetimibe 10mg & Atorvastatin 10mg)
Brief Answer:
2-3 days.
Detailed Answer:
Hello again,
I recommend to follow these steps:
Step 1 - Test Blood Sugar before the insulin injection.
Step 2: Insulin injection
Step 3: Meal
Step 4: Test Again two hours after you have eaten.
Testing your blood glucose both before and after a meal allows you to see how that meal affects your blood glucose levels and helps you to understand which meals may be best for your blood glucose control.
Blood glucose testing is one part of managing your diabetes successfully.
Write the date, time, and result of the test in your blood sugar record. This testing may continue for 2-3 days after starting insulin therapy.
Let me know the results and I can assist you further.
Regarding preventive therapy with cholesterol medication, it will not change.
Hope this helps.
Take care.
2-3 days.
Detailed Answer:
Hello again,
I recommend to follow these steps:
Step 1 - Test Blood Sugar before the insulin injection.
Step 2: Insulin injection
Step 3: Meal
Step 4: Test Again two hours after you have eaten.
Testing your blood glucose both before and after a meal allows you to see how that meal affects your blood glucose levels and helps you to understand which meals may be best for your blood glucose control.
Blood glucose testing is one part of managing your diabetes successfully.
Write the date, time, and result of the test in your blood sugar record. This testing may continue for 2-3 days after starting insulin therapy.
Let me know the results and I can assist you further.
Regarding preventive therapy with cholesterol medication, it will not change.
Hope this helps.
Take care.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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