My fbs 2 weeks ago 323 and 4 days ago 283 hba1c is 12 nearest physician suggested me metformin 500 2 time a day, glimepiride 1 mg 2 times. A day & meconeauron 3 times a day please advice.

Santhosh C AbrahamEndocrinologist17yrs exp

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Hi lybrate-user with such high blood sugars and hba1c along with symptoms I would suggest you to start insulin. It indicates that your insulin production is quite low. Oral medications and tablets alone can't help. Starting insulin will decrease your complications given your age. Lantus will be a good option. It is also important to check your blood pressure, cholesterol and kidney function tests and treat as appropriate. Regards santhosh.  

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Dr. Prabhakar Laxman JatharEndocrinologist50yrs exp

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Mr. lybrate-user kewalramani, thanks for the query. I have seen the details mentioned and understand your concern. You have mentioned only fasting glucose levels & hba1c%. There is no information on after food glucose levels, dietary pattern & extent of daily exercise. Another important aspect is looking at your height & weight with a bmi (body mass index) of 29.35 kgs/sq meter (normal < 23 kgs/sq meter). Your ideal body weight (ibw) should be about 67 kgs, which means there is an excess of 18 kgs. This is a major hindrance in achieving better or desirable glucose control. Overall there is a need to look at your overall treatment which includes drugs, dietary pattern weight control and extent of daily exercise. At 31 years you have a very long life in front of you. So please take care. Ideally at your age fbg should be < 100 mg or closer to 100 mg, pp 150 to 160 mg & hba1c% < 6.5%. So please take necessary steps to upgrade the treatment. Thanks.  

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