How to keep blood sugar level under control?
my mother's sugar level after taking lunch always remains above 250 mg/dl.sugar level for fasting,pp(breakfast) and pp(dinner) r below 200 mg/dl.iam worried that how should i make her sugar level after taking lunch below 250 mg/dl. here r some previous HBA1C readings for better understanding.
12 febuary 2014- 5.5%
15 XXXXXXX 2014- 5.4%
diet plan is very important in diabetes
Dear Sir i can understand your concern.
i am very happy to see your mother's previous Hba1c are in very good control and she is doing very well.
i am having few questions
1.what are medication taken by her for diabetes.
2.what is duration of Diabetes.
3.height and weight
4.any h/o of bleeding like hemorrhoids and peptic ulcer
5.is she facing any low sugars if so how many and when.
Usually lunch will be big meal of the day.By careful adjusting the composition of lunch after food blood sugars can be controlled
pls provide me required information for further analysis.
I am ready for further discussion
Dr XXXXXXX XXXXXXX
-duration=approx 7 to 8 years
-weight= approx 50 kg,height=166 cm
-no bleeding like hemorrhoids and peptic ulcer
-yes there has been situation where she had low sugar after which i gave 2 spoon of sugars.but this is not frequent.what i can recall is for past 6 months low sugar was their for 3 times and generally it used to happen in fasting and pp(breakfast).
one more thing since my mothers hba1c readings r quite good what then what happens to the indivudual readings.should i take hba1c or gulcosemeter reading seriously.
need diet modification....
Thank you for providing info in such a short notice.
At the outset, I am very happy to see her metabolic profile is very good. Further it is heartening to know there are no frequent hypoglycemia's. In this instance, I feel the current list of medicines aer fine. She needs to follow a good diet regimen to lower sugar values further. Try talking to a nutritionist for a diet plan.
Both Hba1c and individual readings are important.
Especially people who are having medical condition like low haemoglobin we can not depend only on HBa1c, as in anaemia the Hba1c is not reliable.
Individual sugar estimation should be done twice weekly on lunch dinner and breakfast in uncontrolled patients and once weekly in well controlled patients.
Once in a month check sugars at early morning 3 am as its the time where patient might have lowest sugar of the day.
Once in 6 months glucometer should be Calibrated.
In short, in my opinion her medical treatment is good. She needs to work on her diet. Discuss with a nutritionist and plan a good dietary regimen.
iron deficency anaemia
Dear sir after careful analysis of your moms reports there are few points which I want to highlight.
haemoglobin levels are borderline low---11.1 along with this there is low mch and mchc which is showing that there might be iron deficiency anaemia.
The TSH is also elevated --14.4
The uncontrolled thyroid might be one of the reason for anaemia.
In uncontrolled thyroid there will be defective iron absorption so in such cases oral iron might not be effective.
Correcting thyroid is very important.
in this kind of scenario we need to depend on individual glucose estimation.
i suggest you to prepare a chart with seven point glucose estimation
the seven points are
2.2 hrs after breakfast
4.2 hrs after lunch
6.2 hrs after dinner
7.At early morning 3 am
This can be done once in a week and treatment can be adjusted basing on this values.
There is latest technology available called CGMS (continuous glucose monitoring system)which will do 600 blood sugar test per day without any pain.This small chip can be used for 7 days and give a good graph of sugar levels.
Dr XXXXXXX XXXXXXX
-which medicine has doctor given for iron deficiency .
-where can i buy cgms and approx cost .i live in XXXXXXX
orofer xt is the medication give for mom to improve iron.
with the recovery of thyroid...anaemia will also recover.
CGMS is marketed by company called meditronics
no need to buy the machine
The device is called ipro-2 device
you need to buy sensor the cost of sensor will be aprox 6000 inr
i suggest you find the medical representative for meditronics and he will come to your home and fix the device to your mother its a very small chip kind of device and absolutely there will be no difficulty in wearing it.
Address of medtronic in XXXXXXX
A-16, Ground Floor XXXXXXX Cooperative Industrial Area XXXXXXX Road
New Delhi-110044 XXXXXXX
Kindly write to me for any further questions in Diabetes.
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