Q: I am a 60 years old male diabetic. My blood glucose level depends on what food I take. In case it is protein like fish or meat with vegetables then my fasting glucose in the morning ranges from 100-120mg/dl and the 2 hrs post-prandial level is around 130mg/dl. When I eat carbohydrates like rice, macaroni, beans etc then the fasting glucose will be 160mg/dl and the 2hrs value around 180mg/dl. My medication consists of 1/2 Daonil before breakfast plus 1/2 Glucophage after breakfast and 1 Daonil before dinner plus 1/2 Glucophage after dinner. My height is 1.76m and my weight 80 kgs. I do heavy exercise at least 5 days per week for more than 1 hour per day. Please let me know what is the recommended medication in my case?

A:It is well known that the rate of rise of glucose after a meal depends on the type of food eaten. Foods with a low glycemic index i.e. those with a reduced rate of rise of glucose after digestion are always to be preferred. For example, whole wheat bread has a lower glycemic index compared to white bread and is to be preferred. If you contact a professional dietician, or go to a website such as that of the American Diabetes Association, you can get more information on foods with low glycemic index. Medicine doses need to be tailored taking into account food intake, work done, glycemic control (hemoglobin A1c, glucose levels), hypoglycemia etc. It would really be best to contact a local endocrinologist for this purpose.