Q: I am 45 years old, weighing 63 kg and 5.3 feet in height. I am a diabetic for the past 5 years. I am taking Dibizide 1 per day before breakfast. Last week the clinical test showed glucose level fasting - 140 and postprandial - 210. I go for walks, atleast one hour daily. Do I have to take the same pill or should I add anything more to this? Is Dibizide-M enough?

A:There is a widespread misconception that adult diabetics have less insulin. While this is true to some extent, most patients also suffer from inability to use insulin. Thus they need an insulin sensitiser. It is not a good clinical practice to administer Fixed-Dose Combinations (FDCs) for the reasons given below. One should take medicines separately. Both your blood sugar levels are high. I suggest you take gliclazide 80 mg twice daily along with metformin 500 mg twice daily. This should settle your blood sugar levels. If not you can increase metformin dose to 850 mg twice daily though this may not be necessary. The aim is to bring fasting level below 110 mg and PP below 160 mg. Readings above 180 mg result in sugar appearing in urine. Fixed-Dose Combinations (FDCs): Medicines are discovered individually and are supposed to be taken separately. A huge number of irrational, illegal combinations of drugs are being sold in India; quite a few without mandatory approval of the Drugs Controller General, India (DCGI). Except in a few cases (such as TB medicines), it is always better to take medicines separately so that dosage can be adjusted and side effects monitored.