Q: I am 52 years old. My blood sugar level is 186 mg/dl fasting and 200 mg/dl PP. My medicines were changed form Dianorm to Amaryl, Metadoze IPR and Ebiza. After a month I did a test and the readings were as follows: fasting - 148 mg/dl and PP - 253 mg/dl with 4 pluses in urine. I visited an endocrinologist again and I have been advised to monitor my sugar levels on the glucometer before breakfast and before dinner and advised that if it is above 150 mg then I need to take Huminsulin (30/70) 5 units before breakfast and dinner in addition to the tablets. Please tell me with all these injections and tablets will my sugar levels not go below the stipulated levels? Is it necessary to go for insulin? How long should one keep taking insulin injections? And does these strong doses of Amaryl (6 mg per day) have any effect on the kidneys?

A:The aim of treating diabetes is to control blood sugar at any cost, if oral drugs fail then insulin must be taken. The dose of insulin is to be increased to a level so that blood sugar is controlled, dose is not important but blood sugar control is a must. Insulin is a good thing and should be taken life long. Amaryl 6 mg is a good maximum dose, it does not affect the kidneys but if the kidneys are affected and the serum creatinine is more than 2.5 mg, then it should be used carefully as it is retained in the body for much longer time. In addition to blood sugar, BP and Cholesterol should also be controlled well so that complications can be prevented/delayed.