Diabetes India
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How to control weight ? Diabetic since 15 years ,65 yr. Female, 5' ht. wt.65 Kg. Take insulin Mixtard 20 u morning & 18 u night F 120 PP 200

Thanks for information on Diabetes. I am 65 yrs Housewife 5' ht.wt.76 Kg. My wt. has gone up and Dr. advised to take Janumet 50mg & Glimy-1 instead of Gluconorm -PG1 . I take insulin Mixtard 20 units morning & 18 units night. My sugar level is - fasting 110/130 & PP 180/200 .Also take tablet Hopace2.5 in morning. The Janumet is imported & expensive whereas the content is same as Gluconorm PG1. Need advice from our colleagues in this regard. Also ,tried food supplement from Dr. G Wellness but not much benefits. Diabetes since 15 years & insulin since 5 years.

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Your body mass index is 27.9 and you have overweight. Your normal weight should have been in between 97–127 pounds (44--58 kg). The generally recommended treatment for being overweight is a modified or controlled diet in conjunction with increased physical exercise.

A weight-control strategy might include:--

* Choosing low-fat, low-calorie foods

* Eating smaller portions

* Drinking water instead of sugary drinks

* Being physically active

Your fasting blood sugar level should be less than 100 mg/dL and post-prandial blood sugar level: less than 140 mg/dL.

Check your post-prandial blood sugar and blood pressure daily and make a record of the same.

Lifestyle changes can help you control and prevent high blood pressure — even if you're taking blood pressure medication.

Here's what you can do:--

* Eat healthy foods.

* Decrease the salt in your diet.

* Maintain a healthy weight.

* Increase physical activity.

* Limit alcohol.

* Don't smoke.

* Manage stress.

* Monitor your blood pressure at home.

* Practice relaxation or slow, deep breathing.

Adopt DASH diet (Mediterranean diet). Eat a low-cholesterol, low-fat diet, which includes cottage cheese, fat-free milk, fish, 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.

Sitagliptin/metformin (trade name Janumet) is an anti-diabetic drug, being a combination drug of sitagliptin (a dipeptidyl peptidase-4 inhibitor) and metformin.

Sitagliptin is used along with diet and exercise and sometimes with other medications to lower blood sugar levels in patients with type 2 diabetes (condition in which blood sugar is too high because the body does not produce or use insulin normally). Sitagliptin is in a class of medications called dipeptidyl peptidase-4 (DPP-4) inhibitors. It works by increasing the amounts of certain natural substances that lower blood sugar when it is high.

The most common side effects of sitagliptin are upper respiratory tract infection and headache. Sitagliptin also is associated with abdominal pain, nausea and diarrhea. There have been reports of fatal and non-fatal pancreatitis following use of sitagliptin. Acute kidney failure and severe hypersensitivity reactions have also been reported during treatment with sitagliptin.

Metformin is used alone or with other medications, including insulin, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Metformin is in a class of drugs called biguanides. Metformin helps to control the amount of glucose (sugar) in your blood. It decreases the amount of glucose you absorb from your food and the amount of glucose made by your liver. Metformin also increases your body's response to insulin, a natural substance that controls the amount of glucose in the blood.

The most common side effects with metformin are nausea, vomiting, gas, bloating, diarrhea and loss of appetite. These symptoms occur in one out of every three patients. These side effects may be severe enough to cause therapy to be discontinued in one out of every 20 patients. These side effects are related to the dose of the medication and may decrease if the dose is reduced.

A serious but rare side effect of metformin is lactic acidosis. Lactic acidosis occurs in one out of every 30,000 patients and is fatal in 50% of cases. The symptoms of lactic acidosis are weakness, trouble breathing, abnormal heartbeats, unusual muscle pain, stomach discomfort, light-headedness and feeling cold. Patients at risk for lactic acidosis include those with reduced function of the kidneys or liver, congestive heart failure, severe acute illnesses, and dehydration.

Ramipril (generic name) Hopace (brand name) is used alone or in combination with other medications to treat high blood pressure. It is also used to reduce the risk of heart attack and stroke in patients at risk for these problems and to improve survival in patients with heart failure after a heart attack. Ramipril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

Ramipril generally is well-tolerated, and side effects usually are mild and transient. A dry, persistent cough has been reported with the use of ramipril and other ACE inhibitors. Coughing resolves after discontinuing the drug. Other side effects include abdominal pain, constipation, diarrhea, rash, dizziness, fatigue, headache, loss of taste, loss of appetite, nausea, vomiting, fainting and numbness or tingling in the hands or feet.

Ramipril and other ACE inhibitors also may cause kidney failure and increased levels of potassium in the blood. Individuals with bilateral renal artery stenosis (narrowing of the arteries going to the both kidneys) should not take ramipril or other ACE inhibitors because they may develop kidney failure. The most serious but, fortunately, very rare side effects are liver failure and angioedema (swelling of lips and throat that can obstruct breathing).

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