My brother-in-law (age 32) was diagnosed with diabetes-2 recently (HbA1C-10 and RBS 500 at the time of diagnosis. Doctor immediately gave insulin and kept him on metformin 850 mg (BDPC) and sitagliptin 100 mg ODPC. He has changed his diet (taking cereals and millets instead of white rice. Now his sugar levels are in control and the doctor advised to continue the dosage for 3 months. Then after the tests he will adjust the dosage accordingly. Since he is taking proper diet, my sister is worried with side effects of medicine and high dosages. Is this dosage too high and dangerous?

Dr. Jagruti ParikhEndocrinologist27yrs exp

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Most of the patients whose HB1c is more than 10% with blood sugar in range of 500 mg I always initiate with insulin therapy and continue insulin for 3 months till Hb1c is less than 7% and continue control of sugars with the help of suitable oral tablets. Only in some group of patients where there is chronic infections, hormonal imbalance - kidney or liver malfunction than some times it is safer and better to continue insulin injections for long term .As the awareness regarding proper diet and regular exercise increases and patient tries to incorporate in his daily routine may result in to gradual reduction of insulin and tablet dosages over time.  

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