Dear Doctor, Please help me to control my diabetes. I am a dibetic patient about 17 years and under insulin for the past 5 years.Before five years I underwent CABG surgery. My need for consultation is for Diabetes. Now i take Metformin 500 SR/Diapride 2mg and 30/70 fast acting Insulin 18 in the morning and night time I take diapride 2mg and Insulin 8 points only. My HbA1c is 7.9 and always PP is above 200 to 240 Today fasting is 121 and PP is 234.Please advice.

Hi,

Since you are a known diabetic,few changes which have to be brought in are lifestyle modifications. If you have already not changed them or if you are not serious about them because they are the only steps which would help you the most. Drugs just bring down sugar for a few hours and then would raise back again and your body can become slowly resistant to the same drug dose so first you will have to bring lifestyle modification(changes) in yourself.

1)Eat a low-cholesterol, low-fat diet, which includes cottage cheese, fat-free milk,vegetables, poultry, and egg whites. Use monounsaturated oils such as olive, peanut, and canola oils or polyunsaturated oils such as corn, safflower, soy, sunflower, cottonseed, and soybean oils. Avoid foods with excess fat in them such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter, shortening, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips, coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.smoking should be stopped,all direct sugars should be reduced

2)Alcohol can be beneficial in small amounts to raise hdl but only in small amounts,you can have green tea,have plenty of fruits vegetables(high fiber diet),plenty of water

3)You should have a work out plan for your daily routine this will also help you raise your hdl ,reduce stress,reduce weight if you are overweight(this is very important)

4)Have a high fiber diet(fresh fruits and vegetables),plenty of water should be consumed

5)Smoking should be absolutely stopped

6)Loose weight if you are overweight

If you have high cholesterol,then even statin( a class of drugs to reduce cholesterol) can be precribed to you.

For now you can add a combination of( Voglibose .3mg and Metformin 500mg,as per your history if you are taking just metformin 500 once daily in morning,only then this drug can be added for twice daily with lunch and dinner(but remember to change lifestyle cause if this does not work then you may have to increase insulin dose which will further increase your risk for heart and kidney diseases).

•  insulin
•  diabetes
•  metformin
•  hba1c
•  fasting
•  sugar