Experts answer your Diabetes related queries. Send your questions to editorial@test.diabeteshealth.co.in
I understand through social media that the blood glucose level is being fixed by foreign medical panels and followed worldwide. They say that these are suggested at lower levels than what should be to cover maximum people and motivate them to start using medicines. This is done in order to help vested commercial interests. That is to help the pharma industry to reap fruits. I would like to know how far it is true and what is the most authentic and proved range of blood glucose levels and range for Diabetes determination.
The diagnostic blood glucose level being fixed by foreign medical panels for some
vested interest is certainly not true. The guidelines are strictly scientific with lot of evidence. It is proved beyond evidence that the disease process of Diabetes begins even before its diagnosis. The earlier the disease is diagnosed and treated, the better are the long-term outcomes and the dreaded complications can be prevented.
Please always consult your doctor before following medical advice posted on social media. If the blood glucose levels are not tested regularly, your doctor 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.
Nikita Sarkar
Consultant Diabetes Educator
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 insulin 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 tablet 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 can take tab volibo
0.3 mg 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 may 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 intake of your food. 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 Sudeep Jain
Consultant Diabetologist
