Diabetes India
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Fluctuation in Sugar levels

I am 61 years old I am Diabetic since 2002.My problem is my sugar fluctuate so often.Yesterday Post lunch sugar was 180 at 2pm and 4.30pm it is 64.I have tried taking tablets upto 2013.From 2013 I started Insulin per Doctor suggestion.Presently my insulin dosages are @20 units

Morning as well as Night.In addition to that I take 2 tablets of violex trio 2mg at morng & eveningand Aztolet 20mg one tablet at Bed time .I also take 3 tablets of Gudmar.But sugar levels are not controlled.Please suggest me what type of diet I have to take.

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Thanks for reply.Right now I am in USA hence I will not be able to give you reports however my last HB1C is 8.2.My breakfast oats with Milk and walnuts.Lunch one chapathi along with more vegetable evng 4pm any fruit, night chapathi or broken wheat mix veg kichidi or some mix vegSoup either at lunch or dinner, take brown rice weekly 2 times. Thanks once again.

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Yes my insulin is a type of fast & long dual acting .Volix trio combination of gimpiride & vogibose

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Sugar levels do fluctuate but such a sharp drop is not acceptable.Firstly,there maybe a need for reviewing the medicine doses.The doctors generally prescribe the dosage based on HbA1c test.To my understanding,your dosages are pretty high.If you are on insulin,oral medications are generally given at minimum levels.Request your doctor to review your medicines.Regarding diet,general principle is to cut down on high glycemic value foods like sugar,rice,wheat,potato.beets etc. and have more of lower glycemic foods like greens,vegetables,legumes,mixed boiled sprouts,eggs,cheese etc.You can plan your diet based on this basic principle according to your tastes.Also cut down on portion sizes to a moderate level.You have to constantly experiment with trial and error method.Next time,please mention your HbA1c reading so that the forum can have a better understanding.

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Increase your carb in lunch immediately. And consult your doctor for drug doses adjustment .

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Violex trio 2 mg consists of Glimepiride (2mg), Metformin (500mg), Voglibose (0.2mg)

Glimepiride is used along with diet and exercise, and sometimes with other medications, 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). Glimepiride lowers blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body) and helping the body use insulin efficiently. This medication will only help lower blood sugar in people whose bodies produce insulin naturally.

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.

Voglibose is an alpha-glucosidase inhibitor used for lowering post-prandial blood glucose levels in people with diabetes mellitus.

Aztolet 20 mg Tablet contains the following active ingredients: Atorvastatin 20 mg and Clopidogrel 75 mg.

Atorvastatin is used together with diet, weight loss, and exercise to reduce the risk of heart attack and stroke and to decrease the chance that heart surgery will be needed in people who have heart disease or who are at risk of developing heart disease. Atorvastatin is also used to decrease the amount of fatty substances such as low-density lipoprotein (LDL) cholesterol ('bad cholesterol') and triglycerides in the blood and to increase the amount of high-density lipoprotein (HDL) cholesterol ('good cholesterol') in the blood. Atorvastatin may also be used to decrease the amount of cholesterol and other fatty substances in the blood in children and teenagers 10 to 17 years of age who have familial heterozygous hypercholesterolemia (an inherited condition in which cholesterol cannot be removed from the body normally). Atorvastatin is in a class of medications called HMG-CoA reductase inhibitors (statins). It works by slowing the production of cholesterol in the body to decrease the amount of cholesterol that may build up on the walls of the arteries and block blood flow to the heart, brain, and other parts of the body.

Clopidogrel is used alone or with aspirin to prevent serious or life-threatening problems with the heart and blood vessels in people who have had a stroke, heart attack, or severe chest pain. This includes people who have percutaneous coronary intervention (PCI; angioplasty; a type of heart surgery) that may involve inserting coronary stents (metal tubes surgically placed in clogged blood vessels to improve blood flow) or who have coronary artery bypass grafting (CABG; a type of heart surgery). Clopidogrel is also used to prevent serious or life-threatening problems with the heart and blood vessels in people who have peripheral arterial disease (poor circulation in the blood vessels that supply blood to the legs). Clopidogrel is in a class of medications called antiplatelet medications. It works by preventing platelets (a type of blood cell) from collecting and forming clots that may cause a heart attack or stroke.

Madhunashini – Gudmar (Gymnema sylvestre), is a herb popularly known for its anti- diabetic action and is mentioned in Ayurvedic treatment of diabetes, renal calculi, cough, snake poison and jaundice.

You should pay more attention to diet and exercise. Consult a dietitian.

Please seek a second medical opinion.

Sources:--

en.wikipedia.org/wiki/Glime...

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Metfo...

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Vogli...

en.wikipedia.org/wiki/Atorv...

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Clopi...

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Gymne...

medlineplus.gov/druginfo/na...

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Thanks for Ur reply.I have changed 3 doctors for the last 6 years.All are diabotologists due to address change I have changed doctors.I consulted the same who has reduced dose of insulin.i also started walking daily more than 10000 steps per day from the last 1.5 months.I also have hypo thyroid for which taking Thyroup one tablets early in the morning.Right now I am in USA I will be in India after 13th December. My height is 4.10, weight is 56kg. My all other readings are ok. Thanks again.

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Your Body Mass Index is 25.8 and you have overweight.

A weight-control strategy might include:--

* Choosing low-fat, low-calorie foods

* Eating smaller portions

* Drinking water instead of sugary drinks

* Being physically active

Sources:--

medlineplus.gov/ency/articl...

en.wikipedia.org/wiki/Body_...

medlineplus.gov/weightcontr...

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I am using only 0.5 ltr per month rice bran oil.Ghee below 100gr per month.Take only coffee without sugar no cool drinks or artificial sweetner .I have no other problems.

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Hello PD Rani are you T1 or T2 ? I presume T2. T1 your pancreas does not work (auto immune) T2 it could work 70% or 3o%. If I where T2 I would keep right off carbs & high sugar. Keep going for regular walks & be active as much as possible. Good luck & keep hydrated

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Thanks for reply. Doctor recommended test for T3 &T4 &TSH tests which are quite normal.I am not taking high Carbohydrant and high sugar foods.I drink one cup of coffee without sugar.

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Hi

with my understanding a bit of experience please change the following and check for few days how the sugar levels controlled: (I am copying for what you wrote before andwith my suggestions for each:-

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1. my last HB1C is 8.2 : This is not that bad. But your medicine dosage seems high with all types of combinations.

2. My breakfast oats with Milk and walnuts. : say you are taking 50g Oats + 100ml (whole milk)+20g Walnuts. Your getting (389+62+185=636 cal as breakfast of which only 243 Calories coming from Fat content of this food items and the rest 392 calories coming from Carbohydrates. i.e. 38% from Fat and 62% from Fats. This is NOT GOOD. forget about Low Glysemic or not for the time being. the percentage should be just opposite at least. But ideally i think it should be 70% from fat and 30% from carbs if we call it Low Carb High Fat (LCHF) diet.) This is only my estimation but actually i do not know how much each quantity you are taking.

3. Lunch one chapathi along with more vegetable: let me not consider the vegetables now as i do not know how much and what veg you take. but even if you take just one roti (multigrain) its 140 calories and the breakup is 70% from carbs and only 19% fats. even if it is LOW Glysemic the ratio is NOT GOOD.

4. evng 4pm any fruit, Not sure which fruit you take. suggest to take only Citru fruits with all possible fiber. Say mandarin you taking after removing the peal you comsume the pieces as it is do not make juice and leave the pulp. Hope you consuming whole pieces.

5. night chapathi or broken wheat mix veg kichidi or some mix vegSoup either at lunch or dinner, take brown rice weekly 2 times. Except the Veg soup rest all again Carbohydrate based even the wheat with kichdi.

So all in all, if i have very clear quantity and the item wise then the calculation and assessment will be more clear. Any how, in my view your diet is the culprit for the sugar levels you have and the fluctuations are due to medicine dosages.

You try to follow 70% fat (good fat) and only 30% carb if possible make it only 20% carb and rest from good fat items.

then see the results regularly in testing Fasting (12 hours fasting is better representative), PP sugar (exactly at 2 hours after Lunch). and see if any improvement. and mind you I cannot suggest any dosage of medicine, as i am not Doctor :) , even if you follow the change in diet i suggested.

post me the findings and observations.

Regards

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Further i just seen you are taking Coffee. STOPPPPP IT.

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I am keeping my fingers X ed for you good luck.

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