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How to manage diabetes?

Dr Anju Virmani
Consultant Endocrinologist,
Sunder Lal Jain Hospital,
New Delhi

Q: My mother is diabetic since 7 years and her blood sugar is 135 (F) & 275 (PP). Currently she is taking Glycomet 850 & Glycigon 80 mg. Now she has been advised to take insulin for some time till the sugar gets reduced. I am not very sure about it because then she will be totally dependent on external insulin. Please suggest any medicines or advise if she should go for insulin injections .

A:Before you consider starting insulin, please make sure that:1. Your mother is getting enough exercise. The best way is to walk about40-50 minutes per day. This can be in one stretch, or divided into 2-5 partsof 10-20 min each, depending on her general health, weight, knee conditionetc.2. She is not taking too much fat in her diet, in the form of oily vegetablecooking, parathas, ghee on chapatis, fried snacks eg pakoras, nankeens,mixture, murk, etc.3. She is taking plenty of vegetables and fruits.4. She is taking Glycigon 30 minutes before meals.5. Her blood sugar tests are done every month and are consistently high.6. Her glycosylated haemoglobin test (which gives the average blood sugarover the previous 2-3 months) is high: this is a must.Once this has been done, if her sugars still remain high, she can be put oninsulin. It may not need to be started permanently: sometimes insulin can bestopped once control improves significantly. However, she will continue toneed to be careful about her diet and exercise, as I have said above.