Q: I am a 46 years old male. My job requires less physical work but is high on stress. I suffer from asthma and hypertension. I am taking Sartel 80 one tablet in the morning for hypertension and homeopathic treatment for asthma. I was earlier taking Amedepin (5 mg). The asthma is under control now but I am required to take Seroflow 250 inhaler / puff sometimes. I had developed diabetes a few years back. My family doctor started with Semidaonil four years back. . My fasting blood sugar is 125 mg/dl and PP around 145 /150 mg/dl. I have, however put on weight (reaching 89 kg from an initial weight of 70-73 kg). My cardiologist asked me to discontinue Semidaolil and prescribed Glyciphage SR 1gm. I have also started cycling an hour daily. I have now lost weight and am 78 kg now. But my sugar levels have been very erratic. What should I do?

A:It appears you are now taking medications for hypertension, diabetes and asthma. It also appears that you are making lifestyle modifications with exercise and are losing weight. This is excellent and I would congratulate you on doing this. It would be advisable to continue doing this and work on getting to your ideal body weight. That will in itself help your hypertension and diabetes. The glucose however does not seem to be in control and you should meet with your family doctor or a diabetologist as soon as possible to make sure you do not need a dose change , an additional medication or dietary changes to help with the fluctuating glucose. Also, you must make sure you have have your kidney function evaluated, urine tested for microalbuminuria, ensure your glycosylated hemoglobin (HbA1c) is ideally around 6-7 or lower and you are getting regular eye checkups.

Your blood pressure should also be well controlled because the diabetes increases your risk of coronary heart disease- check with your doctor if you should start taking an aspirin and how your cholesterol and other lipid levels are doing. The inhaler you mention for asthma is supposed to be taken on a regular basis to decrease inflammation in the lung airways and an additional inhaler like albuterol is used to decrease wheezing when you have an attack. Please make sure your doctor knows how you are managing the asthma. You should also monitor your peak flow with a peak flow meter. Please do all you can to manage stress since it can be a killer in more ways than one. Also avoid smoke exposure, smoking and limit alcohol intake.