Brief Answer:
Please repeat HbA1c again and if required then do FBS and PPBS blood sugar

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. HbA1c is taken as gold standard for evaluating diabetes control in patients.

2. If the HbA1c level is 6.5 or below then the diabetes control is good. Your HbA1c done 3 months back was 6.1 and that is good for a diabetes patient. HbA1c is a test that is to be repeated every 3 months and to clear the doubt, I suggest you get another HbA1c done this week to know if your average blood glucose level has gone up in last 3 months.

3. The medicines Diamicron XR 60 mg and RIOMET 1000 mg are recommended and good for blood glucose control in diabetes. Any change in medicine is only if your sugar is not under adequate control. These medicines control the sugar level slowly through out the day.

4. The blood glucose not decreasing 4 hours after meals depends on the food which you eat. Some foods cause rapid decline in blood sugar levels after 2 - 4 hours while after eating few others, the blood sugar level might continue to show high.

5. Please get a proper fasting blood sugar, post prandial blood sugar done in a standardized laboratory at your place. Please do the post prandial 2 hours after taking 75 grams of glucose. This will give an accurate value. If the HbA1c, fasting blood sugar and post prandial blood sugar are in normal range then there is no need to change medicines.

6. Your eyes also require to be checked once a year because diabetes affects the retina.

7. Kidney function tests and neurological examination is also to be done regularly because of diabetes.

Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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Brief Answer:
Your diet is well planned

Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.

1. Your diet is well planned and you might continue having the same diet. Below is a sample diet for you and you might like to make changes to suit your needs.

2. A sample daily diet chart is as follows

Early Morning

A cup of tea/ milk with 2 biscuits of your choice

Breakfast

2 parathas with curd or 2 plain rotis with paneer or 2 idlis with chutney/sambhar or 1 bowl of upma or oats

Mid morning

Soup or a whole fruit (apple or guava)

Lunch

Salad with rotis (2 to 3) or rice (1 bowl) with dal/ sambhar and a cup of vegetable. Occasionally you can add some light fries in lunch. You can add two vegetables every day.

Afternoon

Tea/ juice with 2 biscuits

Dinner

Same as in lunch with slight variation. Dinner should be lighter than lunch
Milk after dinner

3. Please do HbA1c once every 3 months.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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