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How can I control my blood sugar level?

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Internal Medicine Specialist
Practicing since : 1980
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My a1c goes between 8.5 and 9.5 and I can't manage it. the last med, glimiperide 4 mg seems to be working less than the rest. I take insulin at night but sometimes I have to take it 2x a day. I overeat yes, I am 59 and weigh 216 pds but fluctuate in pounds 5-10 only. Yes I would love to lose weight but now I am only concercened about the diabetes. My sister is 65 and is on dialysis because of diabetes and my mother had kidney failure but pre-dialysis as it is today. I am so worried and in order to see normal levels of glucose I HAVE TO EAT AS IF I AM ON A DIET.....sometimes I can but sometimes I can not. Is this a problem I am having because I need to drop 30 pounds (not so easy) as my primary care doctor suggests or can another med or something help me. Re Food. Yes when I have 2 ---- 1/2 cup servings of rice or pasta, my nite numbers are just over 200 like 215-230. But if I haven't eaten much that day so I have 4-5 servings of rice or pasta, my sugar is almost 400. I want to be treated for my diabetes from an endocrinologist now. I am so upset and nervous every day when I hear my glucose monitor ring.
Posted Sat, 8 Feb 2014 in Diabetes
Answered by Dr. Rakesh Karanwal 2 hours later
Brief Answer: You need Insulin therapy to control blood sugar Detailed Answer: Hi Ma'am, Thanks for your query. 1. Firstly, You have apparently developed secondary failure of oral anti-diabetic drugs. That is, the oral drugs, which were fully effective earlier, are no longer effective. HENCE, YOU NEED TO CONSULT AN ENDOCRINOLOGIST at the earliest, so that he puts you on Insulin therapy only. INSULIN THERAPY IS THE ONLY OPTION FOR CONTROLLING YOUR SUGAR. 2. Then, there is another complication : obesity leads to insulin resistance. That is, the effect of a particular dose of Insulin would be much less than anticipated. Therefore, weight-loss will play a major role in control of diabetes. 3. As the saying goes "Nothing comes free of cost". It is also applicable to diabetic control. You will have to give a boost to your determination and maintain a strict self-control and routine, so as to bring blood sugars down to ideal/near-ideal levels. 4. In continuation with the previous paragraph, you need to rigidly follow the following principles :- * WEIGHT MANAGEMENT :- Burn more Calories than you take. The shortfall in energy would be made good by burning body fat. The greater the shortfall, the better. * DIET :- You should switch over to a LOW CALORIE, RESTRICTED CARBOHYDRATES, LOW FAT and High Protein diet. Consult a dietician, who will tailor a dietary chart, which should be rigidly adhered to. * Instead of three main meals, take 5-6 small meals (Breakfast, lunch, evening tea with some snacks, dinner and at bedtime). Have a plateful of green salads, 15 minutes before main meals. * Regular physical exercise, such as, workup in gym, cycling, jogging, brisk walk, aerobics will burn body fat and thereby contribute to diabetic control. * Avoid foods rich in carbohydrates, such as, refined sugar, alcohol, rice, fruits, confectionary, junk food, fast food. etc... * Control of thyroid problem. I can assure you that the measures, penned above, will control your blood sugar to the desired levels. So, consult an Endocrinologist and apprise him of my opinion. I am certain that he will agree with me and replace oral anti-diabetic drugs with Insulin. Also consult a dietician for making a diet chart depending on your body requirement. Lastly, your undue concern about grossly elevated blood sugar levels and weight problem, goes on to prove that you have a high degree of will power, determination and motivation to go an extra mile in order to bring your medical problems under total control. I therefore, have no doubt whatsoever, that you WILL be completely successful in controlling your diabetes and weight. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
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