Q: I am 69 years old and diabetic, but managing my sugar levels with medication. I take 1 tablet of Glynase, Glyciphage and Stamlo 10 mg. I control my diet and exercise by and taking 7 green leaves/flowers of "Sada Bhaar" flower. My fasting sugar is around 102-106 and PP is around 150, but HbA1c varies from 5.02 - 4.2 on a scale of 4.2 - 6.2. However, it was a cause of concern today when the blood creatinine was found to be 1.49 (limit 0.7-1.4). For the past 2 months the readings are1.00, 1.20, 1.28, 1.29, 1.25, 1.26, 1.22, 1.25, 1.03, 1.3 and today it was 1.49. My weight since retirement has comedown from 70 kg to 62 kg. Uric acid levels are within normal limits. What are the steps to keep this under control? What should I avoid?

A:Diabetes is the commonest cause of kidney disease worldwide. Your s. creatinine has been progressively going up suggesting deterioration of kidney function. The damage is usually irreversible. To slow down further deterioration - your blood sugar needs to have impeccable control (HbA1c < 7 %) and yours seems to be good. However Glyciphage is not a good drug for diabetes with kidney disease. You should stop it in consultation with your diabetologist. Your blood pressure should be controlled to levels of 120/75 mmHg. You need to get your urine test for 24 hrs urinary albumin excretion and if high you should start ACE inhibitor of ARBs again in consultation with your physician. These drugs are very good to slow down deterioration of kidney function in a diabetic. Avoid routine pain killers like Nimulid, Brofen, Combiflam etc. No self medication and no drugs with unknown effects. Do not take too much salt (> 4-5 gms/day) and protein 0.6-0.8 gms/day. Your physician along with a dietician can advise you regarding diet in detail.