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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment To Control Blood Sugar

Respected sir, my wife is 32 years old & suffering from diabetes for last 2 years. Her reading of sugar level is very abnormal, Instead of she is walking regularly and maintaining diet chart given by dietician. e.g.- first doctor given-AMARYL M1 1 tab bid + GLYCOMET SR 500 1 tab at bed time, after one month sugar level come down from 295 fasting to 147 fasting and hba1c from 8.4 to 7.1 . After that doctor given JANUMET 50/1000 1 TAB OD + GLYCOMET SR 500 1 TAB AT BED TIME. Significantly blood sugar arises after one month and it was in between 170 to 185 fasting and after 3 month HBA1C WAS 8.1. Again we went to doctor and doctor given her AMARYL M2 1 TAB OD, + GLYCOMENT SR 500 1 TAB AT BED TIME and 16 units of LANTUS SOLOSTER. BUT ALL THE EFFORT ARE IN VEIN. NOW she is under treatment of another consultant, he prescribe AMARYL M2 1 TAB BD + GLYCOMET SR 500 1 TAB AT BEDTIME, sugar level was in between 150 to 160 fasting. After he prescribed AMARYL M2 1 TAB BD + GLYCOMET SR 1000 1 tab at bed time, but instead of it low down sugar level it become hike and now it is 225 fasting, again we consulted with the doctor and he want to add 10 units of LANTUS SOLOSTER AT BEDTIME,........ But sir both we are becoming frustrated and need your kind help, WE NEED ANY KIND HELP TO LOWER DOWN THE HYPERGLYCEMIA, AFTER 3 YRS OF OUR MARRIED LIFE WE ARE NOT ABALE TO TAKE ANY ISSUE, IS IT POSSIBLE WITH THIS READIG LEVEL OF SUGAR. KINDLY HELP SIR, WE WANT A BABY. I AM HELPLESS. SIR I AM WAITING FOR YOUR REPLY VERY EAGERLY. SIR PLEASE HELP ME. THANKING YOU SIR WITH REGARDS, ATIN MUKHERJEE CONTAI WEST BENGAL -721401 PH- 0000
Mon, 20 Oct 2014
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Dietitian & Nutritionist 's  Response
Hello! My name is Richa Saxena. I am a diabetes educator and I would be glad to help you.

I can understand your problem and the amount of stress that you both must be having while trying to manage diabetes. Is she taking only lantus or short-acting insulin also? Lantus is a long acting insulin which helps to stabilise blood glucose over a period of 24 hours, that is it works slowly within the body to keep blood sugar stable throughout the day. Blood sugar rises after a meal, so a short acting insulin is given to patients to cover that blood glucose spike which happens after a meal.
First of all, I would like to know whether she is monitoring her blood glucose at home or not? If she is, then record the blood glucose readings pre and post meals say pre lunch and post lunch to see if her meal plan for lunch needs modification. Also it is best to have meals at a fixed time everyday and activity levels when maintained regularly will help you to manage blood glucose effectively. So having meals at fixed time and walking for a fixed duration at a particular given time will prevent fluctuations in blood glucose that your wife is having. If there is any change in activity or diet, then insulin dose needs to be adjusted accordingly. You need to learn how to balance food, activity and insulin by working closely with a diabetes educator. Sometimes certain medications also interact with insulin leading to low or high blood sugar. You must consult a competent diabetologist in your area. Ask questions about side effects of medications you are using. The more informed you are ,the better you will be able to control diabetes.

If you need more guidance you can always contact me.
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Suggest Treatment To Control Blood Sugar

Hello! My name is Richa Saxena. I am a diabetes educator and I would be glad to help you. I can understand your problem and the amount of stress that you both must be having while trying to manage diabetes. Is she taking only lantus or short-acting insulin also? Lantus is a long acting insulin which helps to stabilise blood glucose over a period of 24 hours, that is it works slowly within the body to keep blood sugar stable throughout the day. Blood sugar rises after a meal, so a short acting insulin is given to patients to cover that blood glucose spike which happens after a meal. First of all, I would like to know whether she is monitoring her blood glucose at home or not? If she is, then record the blood glucose readings pre and post meals say pre lunch and post lunch to see if her meal plan for lunch needs modification. Also it is best to have meals at a fixed time everyday and activity levels when maintained regularly will help you to manage blood glucose effectively. So having meals at fixed time and walking for a fixed duration at a particular given time will prevent fluctuations in blood glucose that your wife is having. If there is any change in activity or diet, then insulin dose needs to be adjusted accordingly. You need to learn how to balance food, activity and insulin by working closely with a diabetes educator. Sometimes certain medications also interact with insulin leading to low or high blood sugar. You must consult a competent diabetologist in your area. Ask questions about side effects of medications you are using. The more informed you are ,the better you will be able to control diabetes. If you need more guidance you can always contact me.