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How should I go about managing diabetes?

Q: I was diagnosed with diabetes 13 years back. I was controlling it with diet restriction only. I was operated for a uterine fibroid and hysterectomy was done six years ago. Pre operatively I was given insulin injection for two days and after that I was given Daonil 5mg. From the past 6-7 months I am on Daonil 5mg and Glufit 15mg. My fasting blood sugar is 140-170 mg and PP sugar is 190-200 mg. Please advise me about my diet and medication.

A:At present your diabetes is not well controlled, from the sugars you have mentioned, and you are quite obese. For good control of diabetes, as well as the knee pain (osteoarthritis) you will need to lose weight and take action on several fronts, not just get random sugars done. 1. Make sure you are exercising (e.g. walking) regularly. Regular exercise is essential for everyone, but more so for diabetics. 2. Talk to a good dietician to make sure your diet is balanced and appropriate for weight loss: preferably in the form of a 3-meal-3 snack regimen, with low fat in cooking, low fat milk, plenty of fiber (fruits, salads, whole daals), moderate protein and fat, moderate salt and sugar, plenty of water. 3. Maintain your BP as close to normal as possible. 4. Get glycosylated haemoglobin tested every 4-5 months: this is what gives an idea of overall diabetes control. 5. Test blood sugars (fasting and post breakfast) systematically, at least 1-2 a month, and keep track of the values. Everyones blood sugars fluctuate very frequently, and random sugars may miss higher levels which would then cause sugar to spill in the urine. 6. Make sure your blood lipid levels are tested at least once a year, and maintained in the normal range. 7. Make sure your retina, kidney function, ECG and peripheral nerves are tested at least once a year. 8. Do not seek to manage with short cuts like getting medicine doses adjusted on the internet: stay under regular follow up with a good diabetologist/ physician.

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