Hi XXXXXXX

Thank you for the query.

The medications you are taking are absolutely fine. But you need additional Metformin Tablet for your sugars for full control. Due to HCM's policy I cannot prescribe the doses and frequency to you. So please see a good Diabetologist for this.
For burning sensation of the body stricter sugar control is first thing to do and then taking medications like gabantin or pre-gabalin will give further relief and for this also your Diabetologist's prescription is necessary.
If you cannot control rice intake then make sure you exercise extra on the days you eat rice or you can also take tablet named Voglibose just before that particular heavy meal. Please discuss this matter with your Diabetologist as your clinical assessment will help the Diabetologist to prescribe this medication.
If your BP is under control, then all the anti-hypertensive medications you are on are correct.
Please make sure you do not ignore physical exercise just because you have medications to control your sugar, BP and cholesterol. After a few years, these medications can fail to act properly if you do not take care of your weight, exercise and diet properly.
If your limb is affected due to polio then please learn upper body exercises to keep your metabolism and weight under control.
I hope you got your answer. Please get back for any further query.

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I meant the types of medications are certainly best for a person with this kind of diabetes. But for uncontrolled sugars you always need to add extra dose of tablets or add new types of tablets or insulin in the regime.
Please remember that diabetes is a progressive disease and your insulin reserve in the body keeps on depleting further after the diagnosis. How fast it depletes depends on your genetics, lifestyle and other body conditions. Hence addition of tablet Metformin or Pioglitazone or glimepiride should help reduce your sugars further.
The breakfast you eat is fine. Addition of medication will take care of PP sugars. No need to reduce your diet further when you are not overweight.
Fo your tiredness, please get your hemoglobin level and serum sodium level checked. If both are normal then we will have to further investigate for other reasons.
Please get back with reports. take care.

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The other tests are TSH, FT4, Serum cortisol.

Full day diet has to be divided into 3 major (breakfast, lunch and dinner) and three small meals (snacks).

Eat all sorts of seasonal vegetables and fruits. The vegetables can be consumed in large quantities when cooked in very less oil, no gravies, and less salt. Some vegetables can be eaten raw in salads as per your preference (like tomato, cucumber, carrot, raddish, beetroot, methi leaves).
All fruits have sugar and eventhough mango, sapota (chikoo) have more sugary taste you can eat such fruits also. You will have to match the sugar content like this: 1 orange= 1 mosambi= 3/4th of big apple= 1 big sapota= 1 big banana= 1 small mango= 13 to 14 grapes= 200 gm of edible watermelon portion= 10 to 12 strawberries = half pomogranate etc.
You should eat upto 2 fruits spread into major/ small meals.
The days fresh fruits are not available you can consume upto 3 dry dates or 3 dry figs or 12 to 13 dry grapes with a few nuts.
Milk has to be skimmed and then make tea/ coffee/ curd out of it. About 400 to 500 ml milk has to be distributed over your major and minor meals.
About 8 to 10 portions of rice/ chapati/ rava to be consumed all over the day spread across all the meals. One portion is about 1 chapati (50gm weight)= 100 gm cooked rice= 100 gm cooked upma= 100 gm cooked poha.
I hope you got your answer. for any further query get back. All the best.

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