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Blood sugar level high. On insulin, telmicin GD, lipkind. Help?

I am a diabetic patient since 1998. My age is 64 years. I am taking insulin injection from the last five years. My fasting and post prandial blood sugar is 141 and 287 mg/dl. Medicines prescribed is: Insucare M50 30 units bbf and 30 units bd, Insucare R 15 units B/L, Tab Sulphonorm G forte After bf and after dinner one each, Tab Telmicin GD at 9 am, Tab Harnical D 10 am, LipikindP:us 9 pm after dinner. I am a pure vegetarian person. I am going for morning walk at 6 for 50 minutes, morning tiffin 4 idly/3 dosa, at 1030 oats at 1230 wheat ravva as food instead of rice 5-6 hrs 2 idlies at 830 hrs wheat upma. My doctor told me not to eat idly at night. Is it correct. Can you please advice what else can i do to comedown my blood sugar.
Asked On : Mon, 25 Mar 2013
Answers:  3 Views:  126
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Pulmonologist 's  Response
Hello Aswini,

Congratulations on following a very healthy diet.

Also it seems you are taking your drugs very regularly.

Regarding the advice on eating idly at night , it may not affect you blood sugar badly but may cause bloating and reflux in some persons. Please discuss with your doctor regarding the basis for discouraging it.

Your fasting blood sugar is near normal ,but post prandial need to be .reduced.

It can be achieved by increasing the morning insulin dose.

Also tablets that delay absorption of sugar can be tried ( glucosidase inhibitor like voglibose).

Also pioglitazone in low dose can also be tried.

Your doctor who has been treating your diabetes for a long time will be in a better position to make the choice
Answered: Tue, 26 Mar 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
In spite of taking insulin injections,you blood sugar levels are uncontrolled and this requires re adjustment of your insulin doses.Either the current dose of insulin should be increased or a long acting insulin analog like DETEMIR or GLARGINE may be added to take care of basal insulin requirement.
You must consult a diabetologist and get the dose of insulin adjusted.It would take time but eventually it can be controlled.
It is very important to control your sugar levels meticulously to avoid future complications.
As far as eating rice idly in night is concerned,there is no problem taking it.
You can substitute white rice idly with brown rice idly.
Carry on with your morning walk but make sure that it is a brisk walk and not a leisure walk.
Control your blood pressure and lipid levels also meticulously.
Answered: Mon, 25 Mar 2013
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Cardiologist Dr. Anantharamakrishnan's  Response
Hi friend,
Welcome to Health Care Magic

The management is three-pronged - Diet, Exercise & Drugs
When the other 2 are standardised, the change is with the drug

The ideal way for Insulin will be to have a long acting basal preparation + short acting preparation before each meal (3 times). This is the regime we use for juvenile, brittle and pregnant diabetics - and has given excellent control.

Take care
Wishing speedy recovery
God bless
Good luck
Answered: Wed, 27 Mar 2013
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