Diabetes India
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Glycemic control medications

I'm from Dhaka. I've had type 2 diabetes since 2011.

My reports are as follows:

FBS-6.6,2HABF-10.9 ,HbA1c-7.0

Current medications:

Sitagliptin 50 mg(1-0-0),Metformin XR 500 mg(0-0-1),Regular about 1 hour of walking.

Requesting for either new or changed medications.

39 Replies
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You need to discuss medication changes with a doctor.

Eating less of what you usually do, and eating some natural fat such as coconut, nuts, full-fat paneer and ghee wll lower blood glucose. Click on this link phcuk.org/wp-content/upload...

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Do you think that my medications r enough ?if not then you may kindly be requested to help in this regard.

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I can't help you in that regard, only to reiterate what I've written above.

Your blood glucose is still high.

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Weight will increase with full fat food.

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Even if you don't eat too many calories? That's a myth.

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Thanks

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Welcome to the group, Purono. Please note that members of this group can not give advice/prescription for medicines or change in current medicines. You have to consult your Doctor for such things. We can, however, suggest some dietary and lifestyle changes based on our experience/knowledge which are are likely to improve the conditions.

Your numbers are slightly on higher side. It should be possible to bring it down through dietary changes . It appears to me that you have been taking carb-rich breakfast which raises your blood sugar high ( 10.9 ). If you reduce the carbohydrate your number will come down. Please let me know what do you normally take in your breakfast/lunch/dinner. Also, tell us your age, height and weight.It is good that you are walking regularly for one hour. You just need to follow a sensible diet plan in order to fix the problem. You may even get rid of medications or reduce the dosage if your diet plan works.

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"HbA1c is just on the border". Would you please elaborate? A1c with a total of 7 is really high.

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Thanks for your courteous reply.but so far i know it should be 6 or at least 6.5 for sexual behaviour. Though i m on tough walking schedule which can't reduce sugar levels that's why i m telling about medications changing or new.

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Everyone isn't the same. One thing may help a person, but may not be right for the other people. A doctor has to help with a plan for a person to lower the A1c in a safe and reasonable way so no one gets sick or have severe lows.

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Frankly, you are on the wrong dosage schedule. Metformin is to be taken at least twice daily for sr preparations. But your doctor can guide you better.

Good luck.

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Thanks for extending your hand.Sir,What about my on going sitagliptin and metformin XR ?would you please explain?

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I'm of the opinion that type 2 diabetics should try to be medication free asap. The medications used for Diabetes is not only unscientific and harmful, but also illogical. Sitagliptin is a beta cell whipping medication. We are not insulin deficient, but hyperinsulinemic because of ir. The best solution is lchf/keto range diet. But take care if you adopt that diet. Medications might cause severe hypos. with the keto diet. Consult your doctor and if the doctor doesn't comply, you may choose one who understands and believes in lchf /diet therapy for Diabetes.

Good luck.

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From the side effects concern can i take Glibenclamide 5mg before breakfast and dinner as well as metformin 500 mg after breakfast and dinner for a short period of time ?

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Please read my messages carefully. We should try to control Diabetes by idm. Glibenclamide has once a day dosage. But, your doctor is the best person to advise you regarding the medication doseages.

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I did not mean to say that 7% is acceptable value for A1c. That is why I am suggesting dietary changes to bring the number down. ADA guidelines suggest target HbA1c of less than 7% for a diabetic person. My only intention was not lose sleep over 7%. It should be possible to bring it down.

For the sake of clarity, I have deleted the confusing statement from my reply.

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😃😃. It's alright. Everyone should have a1c values between 4.2 & 5.6. That's the range for nonDiabetic people and we should intend to achieve that range. 7 is pretty high. Ada always sets confusing targets. Logically we also should have 5.6 or less values.

Have nice time.

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Before we to and fro with this, 7% is above the threshold for diabetes, which is technically defined as hyperglycaemia, so it must be high by definition.

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Yes, Anup is very learned on this subject, and my aim was to prevent unnecessary argument. The actual threshold for diabetes is accepted as 6.5%

6% is the boundary for prediabetes, so that too would indicate hyperglycaemia, though not full blown diabetes. Below that I think Anup would acknowledge there is still debate as to what is optimal.

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As a side-note, Anup used to make me smile with his contempt for the term prediabetes; he would say it's like being a little bit pregnant. What he meant by this is that it lulled people into a false sense that their condition is less serious than it really is.

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Please consult with your doctor before going off or changing doses/medication. This is to be on the safe side of things and keep you, or another person from getting very sick-- or worse.

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Yes. Absolutely. About medications. I'd recommend one hour ppbs. Blood sugars should never go beyond 140. That's recommended for good Diabetes control.

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Wish you guys would stop with all the ppbs, aim at 120 @ 110 min and GP!!!! I'm new to diabetes and would appreciate the real meaning of what your saying!!! Hard enough finding information but cant get any with abbreviations!!! Thank you much:)

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Get microalbuminuria lab report done to assess kidney damage.

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Thanks for your courteous and well briefed reply.For your kind information my menus are as follows :

Breakfast : 2 thin piece of roti with vegetables.

At 11am :Muri with Raw tea.

Lunch :1 Roti with vegetables.

Evening :Toast Biscuit with Milk tea.

Dinner :2 cup rice with vegetables,fish and dal.

In house used to have milk tea. I have gone through this community about 15 days where i m seeing comments regarding medications as because in course of a diabetic patient grows some insights.

Age :48,Height :5'-5'',weight :69 lbs.

Eagerly waiting for your reply.

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Thank you Purono for the information. As I suspected, you have been following a carb-rich meal which is not good for a diabetic. What I am going to suggest you will be little difficult for you to follow because like me and many others you are used to eating carb-rich meal for so many years. I will still request you to follow the revised meal plan at least for a week and see if you get the improvement in blood sugar numbers.

1. Breakfast: An Omelette with two large or three medium size whole eggs cooked in coconut oil/ghee/butter. Use oil generously. Generous portion of green vegetable salad. You may add some cheese if above is not enough. Eat to satisfy yourself fully but do not indulge in overeating. Tea/Coffee as required without added sugar.

2. 11 am: With the above breakfast you will not feel hungry. Have some tea only.

3. Lunch: Depends how hungry you feel. You can have some grilled chicken with green veg salad.or a small piece of fish and green vegetable. Other option is full cream yoghurt e.g. greek yoghurt and some nuts. Tea/Coffee as required.

4. Evening: You can have a cup of tea and plan for an early dinner may be around 6 pm or so.

5. Dinner: Limit rice to minimum quantity and increase the amount of meat. Choose fatty cut of the meat. Eat green vegetable generously. It will be better If you can avoid rice altogether but I know it is little difficult. Reduce the quantity.

Drink plenty of water throughout the day. Add some flax seed/chia seeds in your diet. That will provide fibre and Omega - 3 fatty acid.

Keep self-monitoring your blood sugar and reduce the medicine dosage if blood sugar goes too low in consultation with your Doctor.

Please see the posting below:

healthunlocked.com/diabetes...

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Weight- 69 lbs or kgs?

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Sorry 69 kg.thanks.

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Remove bakery items & rice and add some nuts like almonds, walnuts etc. Rest seems to be fine.

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Start measuring your blood sugar 2 hrs after each meal. If blood sugar is more than your target range, replace high carbohydrate food with low carbohydrate food or good fats till you achieve good blood sugar reading. Target one meal at a time to make dietary changes. Hope it helps.

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Dear all learned group members,today lunch i have taken only a roti with vegetables;2 hrs after reading is 10.7.

So in this backdrop,I m seeking some less harmful medications from this innovative group members.

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Thanks for your valuable suggestion.if you don't mind then you can tell something about my medications.

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I am not COMPETENT to advice like so many other qualified Pundits in this forum.

However, most of the new comers to this forum ( I believe ) had your numbers (or around that) when they came in.

PREVENTION is better than CURE.

Therefore, reduce the INPUTs (mainly CARBs)and let the BS level come down.

Then you will feel it physically light and comfortable.

That will be our slogan for sure in this forum.

As far the numbers, I would say <6 will be ideal.

From my experience:

And when we shooot for that number, we may end up in 6.2 etc and trust me that range will stop the CRAVE for sugar.

I don't consume sugar in any form. However few other intakes (for example milk used in coffee etc do have carbs in them - the list is endless).

We need to be watchful, count the numbers, consume and see the result.

Then you will reach the stage of 'whether or not you need to give up the medications etc'. All these are steps followed based on inputs from this forum.

I am OK now.

But I am not a qualified guy to advice like others, who strictly follow the so called unwritten rules.

I tend to go out of BOUNDs, now and then, and rein in the numbers lateron.

For example, I had good meal (with deserts, kheer etc) for Ram Navami.

The way I compensated was "Fast the next morning- skip the breakfast - Go straight for lunch" Yes. thats what I did.

Would it be right to say that "I have the cake and eat it also". May be. Does it change my HbA1C.

Hell, No.

Please take the right ones and discard any thing in-appropriate from my inputs.

The reason I mentioned, little more briefly, was to let you have an idea that you can bring every thing in control by INTAKEs and also relax, enjoy, avoid medications once you are in control and also eat Kheer now and then.

Kudos to all the Pundits of this forum

Rgds,

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Thanks for your very insightful and inspirational wisely remark. This is my earnest request you upto control stage i require some less harmful medications then life will take it's own course. Sorry for requesting.

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Ask your doctor, but I'm of the view that metformin and pioglitazones are two medications which don't whip beta cells, but accelerate glucose metabolism. But, you must follow the advice of your doctor.

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Would you be pleased enough to help me regarding the dosing pattern of metformin and pioglitazone?

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Dear friend. I'd love to help you, but i can't. Your doctor is the right person.

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Well.

As rightly pointed out by several others, this forum does not promote / recommend any medications.

So, RULE # 1 would be "LOW CARB HIGH FAT".

(High fat is to compensate for the energy lost in the process of going in the route of 'LOW CARB")

Unless you have money in the bank (savings account), you cannot issue a cheque.

If you have,say, 5000, you cannot spend more than that unless you have a large OD facility( with the exception of guys like Nirav Modi, choksi etc - I dont want to get into any digressed subject).

The inference is, if you dont INPUT any sugar into the system, there is NO sugar (except a minor % generated by the Liver - quote our Pundits).

So, the rule is take more nuts, butter, non-starchy stuff, greens, vegetable etc. I am a pure vegetarian all my life and just stay with that.

Then test your BS at home regularly. It will show some significant improvements over time. (that's what I did).

Also, pls note that no one in this forum is suggesting you to stop the current medications (until you get your numbers in good shape)

However, my personal opinion is Ayurvedic medications are little /less harmful (depends on the body constitution).

So, I take a Pathanjali medication titled "MadhuNaashini Vati ( I dont claim that its doing wonders, because I dont know how it is helping - no proof). Psychologically, I used to think it has a bearing on my system to some extent.

Also, do a search in Google for Homeo and Ayurvedic preparations for Type2.

You will get good recommendations.

one of my friend ( he was into Homeopathy - just to spend his leisure- for more than 45 years) prescribed a medication called 'Syzygum Jam" tincture and bought some bottles for me few years ago.

There are claims and counterclaims.

Better to go with recommendations of a physician before embarking on any thing.

Please use your discretion. Its more of management , I feel and heard the folks in this forum mention.

Good Luck to you.

You are NOT bad for your numbers yet, but dont let it DICTATE going forward.

One last word,

The stress level we go through has significant bearing on the BS level.

My humble request to pundits of this forum may be (if they can),

It is worth while to come up with some topics on How to manage stress level (that are some times inherent in our routine / versus some we invite etc etc). You may already have some threads on this in this forum.

For example,

I noticed that guys with following tasks/ chores tend (list is inclusive / not exhaustive) to stay on edge and end up with Type 2 rather quickly. Moment they realize and overcome these things, they tend to get better,

-- Always facing deadlines / targets at work

-- Bumper to Bumper traffic involving more than 30 minutes of drive to work (You add another 10 minutes to your commute and dont care about others on the road -to avoid this stress)

-- Watching the serious TV serials (most of them start with quarrel and never end the quarrel sequences - and pointing fingers swearing etc.

-- Not earmarking good amount of time of the week to go out (to a park or beach) to constructively spend the time

-- Always going after Un-achievable targets (or setting such targets)

-- Not watching some good TV shows. There were some really good with more light and no stress. I remember a TV show in early 80s titled "Yeh Jo Hai Zindagi". Not sure if there is any matching that show now. That was really a stress reliever with good laugh. There are several good ones like

Lawrel and Hardy, Jerry Lewis, I love Lucy, Full house etc that are posible.

Etc etc etc..........

Again ignore the In-appropriate ones.

Good luck. again you are just on the border for your age. Not bad yet, my personal opinion.

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Purono

I hope you do know now what to do with your high blood sugar after receiving so many advice. I was diagnosed with Type 2 in 2011 which I only control my BSL purely with diet and exercise. So can you if you want to.

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