Sir, i am male 59 years height 5.11, weight 84 kgs diabetics for that last 10 yrs, having oral medicine like vida 50 and metformin 1000 once a day and telma 40, for last 2 years on insulin earlier it was 18 morning and 20 nyt bue to high blood sugar I was advised to take 230 morning 32 nyt before meals and also above medicines, my reading through glocometer is fasting more than 150 to 180 and pp 250 to 290. Im moderate drinker average 90 ml 4 times in week I also go for walk for 30 mts in morning 5 days a week, my diet is v normarmal like roti, dal/veg and curd in all 3 meals. Thanx for liver through getting the opinion. Imretd def. Officer and nw working as manager my job is bit hectic with stress. Im very emotional and sent. I hope I hv given you complete history past and present. Please please advise me to manage my sugar and and diet plan. On my id. Avinash. hoping a complete advise. Regards.

Dr. Prabhakar Laxman JatharEndocrinologist47yrs exp

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Mr. lybrate-user, Thanks for the query. I have gone through the details given. As I can see that present treatment is not helping in controlling glucose levels. So there has to be a closer look at the total treatment, diet and extent of daily exercise. By diet I mean a look at the exact caloric intake per day and composition of it. Plus exercise of only 30 minutes a day is not enough, it needs to be increased so that there is better glucose utilisation. In this communication we are supposed to give only general guidelines. No drug prescriptions can be given. So if you are looking for online help, please come in a private conversation (paid consultation), with following details (in addition to already given)- HbA1c%, lipid profile, serum creatinine, urea values, (to calculate eGFR) and BP reading. Then I will be able to give specific guidance and required prescription. Or else please consult your local diabetologist and so as to achieve better control. Ideally fasting glucose should be < 100 mg, PP 150 to 170 mg and HbA1c% < 6.8. Right now your glucose levels are too high. This can accelerate incidence of long term complications of diabetes. Thanks. 

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