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Dr. Andrew Rynne

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What precautions should be taken while changing from Insulin injection to tablets?

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Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 805 Questions

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Posted on Fri, 30 Oct 2015 in Diabetes
Question: I am 55 years old male patient and for the past 4 years have Type II Diabetes. I am advised to take Insulin 20 units in the evening and Metformin 1gm each in the morning and in the night. When I am in tour I am not able to regularly take the insulin injection. I consulted the doctor last month and he suggested to take insulin regularly for one month and Metformin also and come after one month with Blood Sugar test(FBG and Post Lunch BG) and Serun Creatinin. After one month my FBG is 125 and my Post Lunch BG is 145. Serum Creatinine is 1.0.
Now my doctor has put me on two tablets namely Glador M1 Forte before breakfast and Istamet 50 mg/500 mg.
I am to add that I am hypertension patient. I am advised to take Repace 50 mg, Ecospirin 150 mg, Lipicure 10 mg and Pentacid 40mg.
From tomorrow onwards I plan to take these tablets for Sugar control instead of Insulin injection in the evening.
Is this OK? Any precaution to be taken when I change from injection to tablets?
Please advise.

XXXX
doctor
Answered by Dr. Abhay A Mali 1 hour later
Brief Answer:
You are on right tract for Diabetes treatment.

Detailed Answer:
Hi,

Thanks for your question.

Noted your concern.

When blood glucose levels are too high, usually it is preferable to start insulin along with oral antidiabetic medicines in the initial stage for better blood glucose control by giving rest to pancreas, as in your case.

After one month of insulin and Metformin treatment your blood glucose levels are very well controlled and hence you have been started on more oral antidiabetic medicines and stopping insulin.

While shifting from insulin treatment to oral medicines there may be fluctuations in blood glucose levels which needs to be corrected by regular monitoring of blood glucose levels.

So it is advisable to recheck your Fasting & Postprandial blood Glucose levels after 3 to 4 weeks and accordingly appropriate changes in antidiabetic medicines can be done.

You should also aware of Hypoglycemia (low blood sugar levels) it's symptoms, it's prevention and measures to be taken during episode of hypoglycemia.

Along with all above it is advisable -
- To follow calories and fat restricted diet.
- Regular exercise.
- Maintain healthy weight.
- Regular monitoring of
* blood pressure,
* Lipid Profile at least once in a year or more frequent depending upon base line Lipid Profile.
* Fundoscopy by ophthalmologist to know any changes of diabetic retinopathy.
* Screening for diabetic nephropathy, neuropathy.

Hope this helps you.

Regards,
Dr Abhay Mali.
Diabetologist.




Above answer was peer-reviewed by : Dr. Vaishalee Punj
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