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How can my mother's glucose level be controlled?

Q: My 60 years old mother is suffering from diabetes for about three years. Although her blood glucose levels have been fluctuating, they have always been below 270 mm/dl. However, for the past four months, they have been fluctuating between 190 to 350 mm/dl. She maintains a very strict diet, goes for regular brisk walk for about an hour and is very active. There is no change in her daily routine or stress levels. Is there a way to bring the glucose levels to normal? She has a lot of mental stress due to family problems and keeps awake the whole night. Our general physician has recommended a sleeping pill along with the diabetes tablets. How can her glucose level be brought down to normal?

A:Blood glucose in range of 190-350 mg/dl and such a wide fluctuation is suggestive of poor control. From your query it seems that she is not on medications. If so, then there are very good chances that she can achieve control with medications. She can be started on Glimepride 1 mg before breakfast daily and followed up for titration of doses. I would also suggest getting HbA1c to know last three months blood sugar control. Also get lipid profile, kidney tests and eye examination to know the complication status. She should also take aspirin 75 mg daily and based upon lipid profile might need a cholesterol lowering medicine. It is very true that persons who are under stress suffer from poor control and fluctuations, as with stress there is release of cortisol, which can increase blood glucose. Having a good night sleep will help her in controlling glucose levels.

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