Q: Dear Sir, My mother is aged 58 years and is a known diabetic for last 18 years. Now she is taking Glynase and human insulin ( Mixtard 30 units in the morning and 15 units at night). Her blood pressure is always normal (125/80). Recently she had a heart attack and the angiogram revealed 2 blocks of 90% and 60% both in the right artery and are close to one another. The left portion of her heart is completely free from blocks and is clear. She has been advised medical management and we were advised that angioplasty is not a answer for her condition. She is now on Betaloc, Ecosprin, Clobitab, Nitrofix, Avas. Kindly advise whether she should continue these medicines for better management and whether there are any medicines by which these blocks can be dissolved. Also kindly explain about insulin resistance and its effects on diabetic patients. I would be gratrful for your early and detailed reply. K.S.Harish, Bangalore

A:The decision regarding the course of management by Angioplasty for your mother can only be taken after reviewing her complete data including the angio film. Regarding her management, she is being treated appropriately and if she is having no symptoms it is good. Insulin resistance means that the efficacy of insulin gets blunted and there are ways to manage this problem by adding drugs which increase the efficacy of insulin under medical supervision.