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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Type 2 Diabetes

Hi Dr., Greetings.
I am a Chronic Calcific Pancreatitis (opts) 2001, now I am suffering with Diabetic type 2, FBS-212, PPBS-393. I am taking regular medicine, but it is not under control. Please advice me.

Thanks & Warm Regards

Jay Prakash
Bangalore
Fri, 10 Apr 2015
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Diabetologist 's  Response
Hi, Mr. Jay Prakash,

As you have mentioned you have chronic calcific pancreatitis which was diagnosed in 2001.

And you have mentioned that you have Type 2 Diabetes which is not under control despite of regular medicine.

In your case I want know on what basis you have been labeled as Type 2 Diabetes.
We need to differentiate between Type 2 Diabetes from pancreatic Diabetes (which is more likely in your case).
Treatment of two is different, Type 2 Diabetes usually be controlled with oral medication.
In pancreatic Diabetes insulin is only treatment for controlling blood sugar level.

In your case I want to know
1) Your age.
2) How many years back you have been diagnosed as having Diabetes.
3) Family history of diabetes.
4) Your height and weight, (usually type 2 diabetic patients are obese, Pancreatic diabetic patient usually lean, thin, weight below average)
5) Signs of malnutrition, low hemoglobin, significant weight loss.
6) Current medicines for diabetes.

I will advise you to do following test
1) Stool Examination for fat, elastase.
2) Complete blood count,
3) Serum level of Vitamin D (fat soluble vitamin), calcium.

On the basis of your history, clinic Examination, investigation we can confirm your type of Diabetes, and accordingly need to modify your treatment.
Till that time you can start insulin according to your treating Consultant.

I think this much information is enough for you, you are free to write your queries to me.

Regards,
Dr Abhay Mali

I find this answer helpful
General & Family Physician Dr. Michelle Gibson James's  Response
HI, thanks for using healthcare magic

The goals for premeal and fasting blood sugars is 70 to 130, 2 hour post meal goal is less than 180.

If your current medication is not controlling your blood sugars then it needs to be adjusted. The dose needs to be increased or additional medication added.
You need to speak to your doctor so this can occur.

In addition , you would need to monitor your. If you use a diet high in carbohydrates, it would also contribute to high blood sugar readings.

I hope this helps
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Suggest Treatment For Type 2 Diabetes

Hi, Mr. Jay Prakash, As you have mentioned you have chronic calcific pancreatitis which was diagnosed in 2001. And you have mentioned that you have Type 2 Diabetes which is not under control despite of regular medicine. In your case I want know on what basis you have been labeled as Type 2 Diabetes. We need to differentiate between Type 2 Diabetes from pancreatic Diabetes (which is more likely in your case). Treatment of two is different, Type 2 Diabetes usually be controlled with oral medication. In pancreatic Diabetes insulin is only treatment for controlling blood sugar level. In your case I want to know 1) Your age. 2) How many years back you have been diagnosed as having Diabetes. 3) Family history of diabetes. 4) Your height and weight, (usually type 2 diabetic patients are obese, Pancreatic diabetic patient usually lean, thin, weight below average) 5) Signs of malnutrition, low hemoglobin, significant weight loss. 6) Current medicines for diabetes. I will advise you to do following test 1) Stool Examination for fat, elastase. 2) Complete blood count, 3) Serum level of Vitamin D (fat soluble vitamin), calcium. On the basis of your history, clinic Examination, investigation we can confirm your type of Diabetes, and accordingly need to modify your treatment. Till that time you can start insulin according to your treating Consultant. I think this much information is enough for you, you are free to write your queries to me. Regards, Dr Abhay Mali