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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Diabetes Be Controlled Without Simply Increasing Insulin?

My mother (70) was suffering from diabetes since 3 to 4 years, It was normal after taking the pills glynase before lunch and dinner. Two months ago, she was admitted in the hospital due to low sugar (28) and RHO+MS+MR Severe PSH+TR. During the treatment in the hospital diabetes going to fluctuate from 150 to 450. After discharge from the hospital consulting doctor advise insulin inj.mixtard 6 unit per day, we test the diabetes every 10 days, increase the insulin as advised (i.e.from 6 unit than 8, than 12. The last diabetes report is 217 & after lunch 241, further insulin increse upto 16 units as advised. Now would you guide me, how we control the diabetes, rather we increase the unit day by day. May please advise or mail me ur guidelines at my mail : YYYY@YYYY thanks
Wed, 1 Oct 2014
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Diabetologist,  's  Response
Dear sir I can understand your concern
in my optinion your doctors approach is good and systematic
I would like to give few suggestions
in diabetes control we need to consider diet and exercise as important as medications
but in your case since age is factor advising extensive exercise regimen is not possible
so mild walking is advisable if there is no comorbidites like arthritis.
next comes diet which can be followed by splitting meals to five and avoid refined carbs
regarding medications
1. considering the new medications like DPP4 inhibitors is a very good option since they are not associated with hypoglycemia as glynase
2.stopping glynase is a good option since there is associated cardiac problem.hypoglycemia is not good for heart.
3.regarding insulin it's a good option but considering insulin like levimer or glargin is preferred choice than mix.
mix is associated with more chance of hypo than levimer or glargin
mix will work only for 12 hrs and this glargin and levimer will work for 24 hrs with very less hypoglycemia than mix.
kindly discuss this options with your treating doc
regards
Dr Vamsi
Diabetologist.
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How Can Diabetes Be Controlled Without Simply Increasing Insulin?

Dear sir I can understand your concern in my optinion your doctors approach is good and systematic I would like to give few suggestions in diabetes control we need to consider diet and exercise as important as medications but in your case since age is factor advising extensive exercise regimen is not possible so mild walking is advisable if there is no comorbidites like arthritis. next comes diet which can be followed by splitting meals to five and avoid refined carbs regarding medications 1. considering the new medications like DPP4 inhibitors is a very good option since they are not associated with hypoglycemia as glynase 2.stopping glynase is a good option since there is associated cardiac problem.hypoglycemia is not good for heart. 3.regarding insulin it s a good option but considering insulin like levimer or glargin is preferred choice than mix. mix is associated with more chance of hypo than levimer or glargin mix will work only for 12 hrs and this glargin and levimer will work for 24 hrs with very less hypoglycemia than mix. kindly discuss this options with your treating doc regards Dr Vamsi Diabetologist.