Hello Dr. My mother 82 years old taking diabetes medicine since 12 yrs. Till last year she was on gluconorm g1 twice n was very fine hba1c was never more than 6.5 last year may her levels spiked n was put on janumet 50/500 twice. Which was ineffective then gluconorm g1 was added. She responded well. This year again in july it spiked 200 approx fasting n 300 approx is p.p Dr. gave janumet 50/500 + gluconorm g2 which slowly started working for few days but again the levels spike at present she is on azulix mv 2/0.3 breakfast dinner janumet 50/500 lunch n dinner it?s hardly making any effective change kindly suggest treatment. I have seen glimepiride is effective on her. As gluconorm worked for long time she has controlled bp copd n was hospitalized for severe uti.

Dr. Prabhakar Laxman JatharEndocrinologist51yrs exp

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Hello, thanks for the query. I have seen the details given. There are few factors to be considered while treating a person with that age. Glimiperide is a very strong insulin secretion stimulating drug. But it is also acting for a long time, hence in old age (particularly over 70 years) needs to be used very carefully as it can cause severe hypoglycemia. In patients with long standing diabetes insulin secreting cells of pancreas (beta cells) go down in number as well as loose capability to produce insulin. In such situation any additional dosage of drugs like glimiperide is not going to be beneficial. Plus high plasma glucose also affects beta cells. Hence such patients are better of with a long acting basal analog insulin like glargine 6 to 10 units once at night with oral drug like janumet. It is also necessary to look at patients kidney function so we need to know serum creatinine, urea and egfr.(estimated glomerular filtration rate). Last but not the least at 82 years there is no need to try and bring hba1c% too low. Even 7 to 7.5% is fine. If you have any questions please do come back. It is also necessary to know patients weight, height, dietary pattern and extent of physical activity. Thanks. 

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Dr. Col V C GoyalGeneral Physician46yrs exp

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1.no alcohol 2. Reduce body wt 3. No smoking/ tobacco/drugs/ avoid pollution 4. Diet - no ghee/ butter, have mix of vegetable oils - mustard, til, ground nut, olive oil, have more green vegetables and fruits, have whole grain atta, no fried. Fast. Spicy / processed/ junk food. No sugar, potato, rice 5. 30 mts brisk walk daily as far as possible 6. Deep breathing exercise for 10 mts daily 7. Meditation daily for 10 mts. 6-8 hrs of sleep at night 8. Expose your body to sun for 15-20 mts daily after some oil massage to get vit d. 9. Take more water medicine can not be advised for open question ,for medicine and further advise contact on private consults. Good luck.  

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Hello .. I have query..I suggest you to take Homeopathic Medicine along with above Medicines to control Diabetes and slowly cut off allopathic medicines .. Diet- Have Fatty�fish�like Salmon, sardines, herring, anchovies and mackerel, cinnamon, leafy green vegetables, chia seeds, turmeric ,garlic ,strawberries etc. Avoid- reduce sugar intake, rice , oily , spicy food, junk food, pickle, meat ,sweetened Beverages,White Bread, Pasta ,Flavored Yogurt,Sweetened Breakfast ,Cereals Flavored Coffee Drinks,Honey, Agave Nectar and Maple Syrup,Dried Fruit. homeopathic medicines maintain sugar levels to normal .. you can consult me online for treatment.  

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