37 Year Old Male Experiences Breathing Shortness and Chest Pain, Seeks Advice

Ans: Jaisa ki mene previous question ke jawab mein likha hai, UTI kuch medicine ka side effect hai.

Medicine ke alawa, aapko sutained lifestyle mein badlav karne honge tabhi uric acid and TG control mein aayenge.

Ek acche physician is consult kijiye and you can have good control of your health.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: Please let me know your weight and BMI as well.
It seems that you are developing insulin deficiency and resistance both.
After certain period, the oral medications become less effective. In such situations, it might beneficial and important to get started on Insulin.

The sudden spikes in sugar levels could also be due to stress or altered sleep pattern or change in dietary factors. However, that would not explain such as spike for long.

Please consult your physician and get on steps needed for effective sugar control.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: It seems that you are on Gliflozins (SGLT-2 inhibitors such as Dapa, Empa ). These are effective anti-diabetic medications but carries the risk of infections in genitalia.
So, it is important to maintain good genital hygiene, stop medications for short period when you have such infection. Also, stop medications in any acute illness.

Please consult a physician and get it treated.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: Based upon information provided by you, it is possible to reverse your diabetes status. However, in the beginning, the lifestyle modifications alone may not be enough.
There is a concept called 'Legacy effect' after UKPDS study, which indicate that if we control our sugar early, it is likely to have long term benefit and may reverse/ remission of diabetes.
The ideal candidate for remission/reversal are following:
1. Diabetes identified in last 5 years,
2. Blood sugar levels/ HbA1c less than 8% and on less than two anti-diabetic medications
3. Self motivated

Congratulations to you as you appear very motivated.
I would suggest stop alcohol completely and get started on one oral anti diabetic medicine.

It is possible that your blood sugar levels would come under control in next 6 months.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: Hello;

It is nice to know that you have good health care cover for yourself and family.

But you must also have adequate term life insurance atleast till the age of 60.

Life is full of uncertainties and hence to ensure financial security for your dependents, in case of any unforeseen event, life insurance is highly desirable.

Cheapest life insurance in India is the one offered by Indian Post Deptt. Also known as Postal Life Insurance.

Ofcourse it's not available for all and max cover is 50 L, but you may check eligibility by visiting nearest post office.

If you are eligible then you may supplement it with another term life cover of 1.5 Cr.

I have live example in front of me where a hale and hearty young person(32 years) postponed buying life insurance and suddenly he expired in a freak swimming accident.

Now his young son and wife are literally on the road.

Don't look at premium as a cost rather an investment to protect your family in unfortunate circumstances.

Best wishes;

Ans: Not sure why you are being advised pp after 90 min.
The timing of pp is two hours after the first bite of breakfast.

A good control mean, PP in range of 70 to 180 mg%. However, more around 100 to 140 mg%. The HbA1c should be below 7% Specially those whoa re above 65 years of age and preferably below 6.5% for a tighter control if person is younger than 65 years.

These days, more individualised approach is followed for these parameters for effective control.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: If your Hba1c even after three or more medicines is more than 8.5, it would be a good idea to consult a physician and get started on Insulin.

Insulin is safe and effective and can help in reducing sugar levels quickly. It should be done with lifestyle modifications including weight reduction, physical activity and dietary modifications.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: The blood sugar levels and how tight control should be done is also influenced by age.
Her fasting blood sugar levels are acceptable. Post meal (2 hrs after the meal) can be in range of 70 to 180 mg%. Therefore, she is doing largely fine on that also. You can reduce post meal sugar level by some dietary modifications and cutting down on sugary and carbohydrate meals. Also, adding salads and fibers would also help.
It would be helpful to get to know her HbA1c levels so, I would get a sense of her overall sugar control.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
New Delhi

Ans: The medicines you are referring to are in group of Gliflozins (SGLT-2 inhibitors). These medicines are very effective and pass the sugar through urine. Anyone on these medicines should drink a lot of water. Yes, you can drink a lot of water in the night or any time.

Not the less water. If you are feeling thirsty, drink water. anytime.
Urine test once in a year is okay.