Diabetes India
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Insulin or no Insulin

I am 60 years old male, diabetic for 18 years, hba1c 7.4, also take insulin for last 5 years (30+30) two times and take amaryl 3 & pioz 15 at lunch. Can I leave insulin and go on with medicine only? Also can lchf diet do something better for me?

22 Replies
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It is advisable to consult the doctor who had prescribed the insulin and drugs earlier before any change

The hbaic of 7.4 is high and needs to brought down to acceptable level

Regarding diet you can try as low carb diet may help bring down hbaic along with above medication presently prescribed by doctor

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Thanks

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Yes, LCHF diet will surely help and bring down your dependency on drugs and insulin. When you do changes in diet, please measure blood sugar frequently to avoid hypo.

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Thanks

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consult your doctor no self medication in diabatis its dangerous

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Thanks

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First of all, please don't be panic about diabetic mellitus. It is not a disease, it is a deformity. At your younger age, say 25 you can able to jump at least 5 feet easily, But at this age of 60, you can't. Why? Similarly the insulin which generated in your body is either not enough or ineffective. Thats why doctors prescribe insulin. It is good. But once you control your diabetics level within 150-200, on the advice of the consulting doctor, the insulin intake may be changed. To reduce your diabetic levels, do medium brisk walk for 40 minutes, simple aerobatic exercises for 20 mins per day is enough. Before going to walking, take lukewarm water one or two glasses with fresh lemon juice with a pinch of salt will hold good for your health at empty stomach. Try this, you will get good result, as I did. Avoid sugar, sweet etc. Take less quantity of food with regular intervals. Enjoy life, be happy.

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Thanks for your advise, I walk regularly and drink water in that form but a lesser quantity. I will increase

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150-200 is too high, imho that suits perfectly the HbA1c of 7.4, to achieve HbA1c of 6.5 the target bs must be in the range of 120-160

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I think 7.4 is little bit high.If it comes 7 or bit lesser it's fine. 18 years diabetes is also a factor.medicine and insulin is ok .

Don't decrease or lesser than this. Focus on HBA1C.

Good luck 😉

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Thanks, I will definitely try to lower hba1c.

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Insulin therapy should be continued as it has no side effects.

Check your fasting blood sugar daily and postprandial blood sugar occasionally.

You should control your high blood sugar by low carbohydrate diet and aerobic exercises.

Glimepiride (generic name) Amaryl (brand name) 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.

Pioglitazone (generic name) Pioz (brand name) is used with a diet and exercise program 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). Pioglitazone is in a class of medications called thiazolidinediones. It works by increasing the body's sensitivity to insulin, a natural substance that helps control blood sugar levels.

Pioglitazone has been found to be associated with bladder tumors. It has been withdrawn in some countries.

Sources:--

en.wikipedia.org/wiki/Low-c...

en.wikipedia.org/wiki/Aerob...

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

medlineplus.gov/druginfo/me...

en.wikipedia.org/wiki/Piogl...

medlineplus.gov/druginfo/me...

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Thanks, I will definitely talk to my doc. regarding pioz.

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You continue with Inj Insulin (Mixtard 50:50) in consultation with Physician nearby besides regular investigation in regard to Hb A 1C..

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Thanks

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You should continue insulin, need to check for serum creatinine,if it is normal,it is better to add Metformin and stop pioz,lchf diet is advisable with some restrictions only after checking kidney status

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Thanks. My creatinine is 0.83. Previously I used to have metformin, had some digestion problem regularly, doctor changed metformin. Will be thankful if suggest lchf diet in details.

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Pioglitazone should be avoided in elderly as there is documentary evidence of bladder cancer and also it causes water retention,but it is safe to add dapagliflogin 10mg(Tb oxra).

About lchf diet:should minimise carbs to <30 g per meal and using saturated fats in cooking and moderate protein intake can reduce insulin requirement

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Are you a doctor or a fellow diabetic .

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I am a Diabetologist

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Glad to know that. Hope to interact with you more in future. Thanks again.

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What do you mean by (30+30) two times? What kind of insulin do you take? Do you mean 30 in the morning and 30 in the evening? Or 30 basal (long acting) + 30 prandial/bolus (rapid/fast acting) either way it is too much imho, more over you still has amaryl 3 (mg?) and pioz, FYI I take only 18 units (long acting) once a day, my fbs was 297 and 2hr ppbs 546 HbA1c 12.7 when i was diagnosed a year ago, they went down to fbs 113 and 2hr ppbs 117 in just 5 days, my HbA1c is 6.5 now, sometimes i take Amaryl (Glimepiride) 0.5 mg when i get high for i can get low (hypo) with amaryl 1 mg, i don't have any strict diet, still enjoy coffee with 2 tsp of white sugar, even chocolate bar and pudding

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