I'm a 56 year old woman and was diagnosed with Type 2 Diabetes. The doctor has asked me to monitor my blood glucose level frequently. Why should a person with Diabetes keep on checking their blood glucose level? Isn't it enough to check the level once every year or so..The level of glucose in the blood is a variable marker and fluctuates during the day. Blood glucose levels depend on the food pattern, exercise, stress and medications which the patient is consuming. To keep a track of blood glucose levels and to keep them in the target range it is advisable to check blood glucose levels frequently.To prevent complications due to Diabetes, it is advisable for a patient with Diabetes to keep blood glucose levels within the target range, which depends on the age of the patient and life expectancy. For young patients the targets are lower and for geriatric patients they are a little higher. By and large fasting or pre-meal blood glucose levels around 100 mg/dL are advised and2- hour post meal around 150 mg/dL is required. We also advise HbA1c (average blood glucose test for last 2-3 months) which should be kept around 7 per cent.If the blood glucose levels are not tested regularly, we won't be able to judge whether they are higher than the target or lower than the normal levels. As low blood glucose levels (hypoglycaemia) might also prove harmful. So it is advisable for a patient with Diabetes to check blood glucose levels frequently as advised by their doctor.Dr Vedavati PurandareConsultant Diabetologist I am a 60 year old man with Type 2 Diabetes for the past 22 years. Last month when my post prandial test reading was 220mg/DL, I was on Galvasmet 50/500 (1-0-1), Glimy 2mg (1-0-1), Glyciphage 500mg (0-1-0) and Olmezest 40 mg (1-0-0). Seeing my blood test result, my doctor prescribed novomix 50/50 of 6 units once in the morning (6-0-0) along with the above medicines. I went in for a second opinion and the other doctor asked me not go in for Insulin and prescribed Volibo 0.3 mg (1-0-0). I am told that oral tablets affect various organs in the body such as kidney etc. Is this true? Do you advise taking insulin? Are premixes better than conventional insulin?Don't change your medications based on single elevated blood glucose reading.Please do an HbA1c which will give you a fair idea about glycaemic control over past 3 months. If you are worried about “220” figure then for time being you cantake tab volibo 0.3 with breakfast. The other option is to split your breakfast into two portions one portion at your regular time and the other after few hours like at brunch time.As you have Diabetes for long duration, insulin is always a better choice if your HbA1c is suggestive of poor Diabetes control. All medications have some or the other side effect but in Diabetes the main culprit for complications is your uncontrolled Diabetes. The medications which you are taking right now have side effect like abdominal upset (from metformin) and hypoglycaemia (from glimepiride). But if you eat food on proper time and with proper quantity then you can avoid hypoglycaemia.We avoid use of metformin or glimepiride or Vildagliptin in patients with elevated kidney function profile. Insulin is better than oral medication. Despite taking all best available oral medications if you still have poor glycaemic control then it's always good to start insulin. All insulin is good and has a good effect. If you are using convectional insulin then you have to keep gap of approximate 15 minutes between insulin administration and your food which you can avoid if you use insulin analogue. For older patients, I prescribe an insulin analogue. Premix insulin is a combination of two insulin - a short acting and an intermediate acting insulin.Dr Manish BothaleConsultant Diabetologist
I'm a 56 year old woman and was diagnosed with Type 2 Diabetes. The doctor has asked me to monitor my blood glucose level frequently. Why should a person with Diabetes keep on checking their blood glucose level? Isn't it enough to check the level once every year or so..The level of glucose in the blood is a variable marker and fluctuates during the day. Blood glucose levels depend on the food pattern, exercise, stress and medications which the patient is consuming. To keep a track of blood glucose levels and to keep them in the target range it is advisable to check blood glucose levels frequently.To prevent complications due to Diabetes, it is advisable for a patient with Diabetes to keep blood glucose levels within the target range, which depends on the age of the patient and life expectancy. For young patients the targets are lower and for geriatric patients they are a little higher. By and large fasting or pre-meal blood glucose levels around 100 mg/dL are advised and2- hour post meal around 150 mg/dL is required. We also advise HbA1c (average blood glucose test for last 2-3 months) which should be kept around 7 per cent.If the blood glucose levels are not tested regularly, we won't be able to judge whether they are higher than the target or lower than the normal levels. As low blood glucose levels (hypoglycaemia) might also prove harmful. So it is advisable for a patient with Diabetes to check blood glucose levels frequently as advised by their doctor.Dr Vedavati PurandareConsultant Diabetologist I am a 60 year old man with Type 2 Diabetes for the past 22 years. Last month when my post prandial test reading was 220mg/DL, I was on Galvasmet 50/500 (1-0-1), Glimy 2mg (1-0-1), Glyciphage 500mg (0-1-0) and Olmezest 40 mg (1-0-0). Seeing my blood test result, my doctor prescribed novomix 50/50 of 6 units once in the morning (6-0-0) along with the above medicines. I went in for a second opinion and the other doctor asked me not go in for Insulin and prescribed Volibo 0.3 mg (1-0-0). I am told that oral tablets affect various organs in the body such as kidney etc. Is this true? Do you advise taking insulin? Are premixes better than conventional insulin?Don't change your medications based on single elevated blood glucose reading.Please do an HbA1c which will give you a fair idea about glycaemic control over past 3 months. If you are worried about “220” figure then for time being you cantake tab volibo 0.3 with breakfast. The other option is to split your breakfast into two portions one portion at your regular time and the other after few hours like at brunch time.As you have Diabetes for long duration, insulin is always a better choice if your HbA1c is suggestive of poor Diabetes control. All medications have some or the other side effect but in Diabetes the main culprit for complications is your uncontrolled Diabetes. The medications which you are taking right now have side effect like abdominal upset (from metformin) and hypoglycaemia (from glimepiride). But if you eat food on proper time and with proper quantity then you can avoid hypoglycaemia.We avoid use of metformin or glimepiride or Vildagliptin in patients with elevated kidney function profile. Insulin is better than oral medication. Despite taking all best available oral medications if you still have poor glycaemic control then it's always good to start insulin. All insulin is good and has a good effect. If you are using convectional insulin then you have to keep gap of approximate 15 minutes between insulin administration and your food which you can avoid if you use insulin analogue. For older patients, I prescribe an insulin analogue. Premix insulin is a combination of two insulin - a short acting and an intermediate acting insulin.Dr Manish BothaleConsultant Diabetologist