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How should diabetes be monitored?

Q: I have been going through a mild diabetic condition for the past 12 years. My fasting sugar varies between 110 and 130 mg/dl and the sugar 2 hours after food is below 180 mg/dl. I am on a diet control. My question is two-fold:

  1. I have not taken any medicine to control the sugar. I do it through diet control. I am a vegetarian and do not drink or smoke. Is a medicine necessary for my condition ?
  2. I would like to put on some weight. I am 62 years old and weigh 48 Kg.

A:You have not mentioned how often these blood glucose levels are done, nor what your glycosylated haemoglobin level is. The glycosylated Hb gives an idea of the average blood glucose over the preceding 8-12 weeks and should be done 2-4 times a year. A post-prandial sugar hovering around 180 mg/dl certainly indicates your blood glucose control has scope for improvement. The low weight probably also indicates poor control. I would suggest you:

  1. Exercise regularly, e.g. go for regular walks: this will improve your blood glucose and help you gain weight.
  2. Ensure your diet is adequate and balanced: many people end up starving themselves in trying to control diabetes.
  3. Monitor the fasting and post-prandial (PP) blood glucose at least every month, and the glycosylated Hb at least every 6 months.
Whether the diabetes is mild or not, you are at higher risk for chronic complications. I hope you have the following bare minimum checks on a regular basis:
  1. Blood cholesterol and triglyceride levels: annually
  2. Retinal examination: annually
  3. Urine protein in 24 hour collection: annually
  4. Blood creatinine: every 2-3 years
  5. ECG: annually

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