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Do I need to change my medicine for better diabetes control?

Q: I am 31 years old, weight 80 kgs, and a diabetic for the past 5 years now. I am taking 1/2 Euglucon tablet in the morning and one half at night. My sugar levels are under control. Last month my HbA1c value was 7.8. From the past few days, my PP sugar levels are not under control and it is > 250 mg whereas the fasting is <130. I heard that if we use the same tablet for a long time, it becomes useless. Is this true? If so, please suggest what should I do?

A:You have developed Type 2 diabetes at rather young age since you are now 31 and have been a diabetic for the past 5 years. I do hope that you are also following non-drug methods such as brisk walk of at least 45 minutes daily to cover no less than 4.5 km, avoidance of sugar in all its forms (such as fizzy drinks containing sugar, mangoes, sugar cane etc.). It is also true that diabetes is a slowly progressive disorder and as time passes more and more medicines are required in larger and larger doses. Since you are now taking the minimal dose, the first thing to do is to increase the dose of glibenclamide (sold as Euglucon, Daonil etc.) to initially one tablet (5 mg) in the morning and one tablet at night. Hopefully your blood sugar will get controlled. If not, you can increase it to three tablets i.e. with breakfast, lunch and dinner. If it is still out of control, then you will need to add metformin 500 mg (Glyciphage) with lunch and dinner. Maximum dose allowed is 850 mg three times daily. There are two aspects of diabetes: less production of insulin and even more importantly less use by the body. Metformin increases the utilisation of insulin. I am sure your problem will get sorted out with above measures.

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