I am 47 year old men and weight is 105 kg. Diabetic since 2000 and today my fasting was 181 and pp is 220. Hba1c is 7.6. I am taking estmet 50/500, volibo.3 mg and gemer 2 morning and evening daily for last one year. Kindly suggest my medicines are or any change. please suggest.

Dr. Sajeev KumarGeneral Physician32yrs exp

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You have to take Insulin for better control. Diabetes affects all organs in the body ? Eyes, kidneys, nerves, reproductive system all are affected, In fact, from toe to hair. For diabetic control, patient and doctor should be in constant touch for regular follow up and advice. The common symptoms are :-Both types of diabetes have some of the same tell-tale warning signs. Hunger and fatigue. Your body converts the food you eat into glucose that your cells use for energy. But your cells need insulin to bring the glucose in. If your body doesn't make enough or any insulin, or if your cells resist the insulin your body makes, the glucose can't get into them and you have no energy. This can make you more hungry and tired than usual. Urinating more often and being thirstier. The average person usually has to pee between four and seven times in 24 hours, but people with diabetes may go a lot more. Dry mouth and itchy skin. Because your body is using fluids to make pee, there's less moisture for other things. You could get dehydrated, and your mouth may feel dry. Dry skin can make you itchy. Blurred vision. Changing fluid levels in your body could make the lenses in your eyes swell up. They change shape and lose their ability to focus. Diabetes, often referred to by doctors as diabetes mellitus, describes a group of metabolic diseases in which the person has high blood glucose (blood sugar), either because insulin production is inadequate, or because the body's cells do not respond properly to insulin, or both. It is a difficult task to control blood sugar in the desired normal range. Whatever we eat is metabolised to sugar in the body to provide energy for our daily activities. For the absolute control, one has to monitor his / her blood sugar at regular intervals (Self-Monitoring of Blood glucose ? SMBG). Though difficult, this can be done by a glucometer and keep a record. Get an idea of Fasting sugar (FBS) and 2 hours after food (PPBS), & HbA1C (inform me) and check before dinner and after every major food. The basic idea is to reduce the food intake to 1/3 of what you take now. The dictum of sugar control is diet, exercise, diet + medicine and at later stage medicine+ Insulin will be needed. There are different diet plans of varying calories for each person depending on his activity & life style. For diabetes, hypertension (high BP) and many long-term illness control there is the need for regular advice and follow up. Just one time consultation or advice is not enough to guide a diabetic in scientifically & medically correct manner. For giving you regular follow up you ask me with all details like your daily eating pattern and medicines you take. I assure you a proper guidance. If you keep in touch personally. 

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