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Is this hit and trial approach the right way to control my high blood sugar?

Dr Karthiyayini

Dr Karthiyayini Mahadevan  |1146 Answers  |Ask -

General Physician - Answered on Jun 26, 2024

Dr Karthiyayini Mahadevan has been practising for 30 years.
She specialises in general medicine, child development and senior citizen care.
A graduate from Madurai Medical College, she has DNB training in paediatrics and a postgraduate degree in developmental neurology.
She has trained in Tai chi, eurythmy, Bothmer gymnastics, spacial dynamics and yoga.
She works with children with development difficulties at Sparrc Institute and is the head of wellness for senior citizens at Columbia Pacific Communities.... more
Asked by Anonymous - May 09, 2024Hindi
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I am 54 years M ,having Diabetes and High BP (HTN) since the past 13 years. At times it has been in poor control also like in May 2021 the HbA1c was 10.10 which gradually went down to 7.70 and then remained constant between 7.90 and 8.10 with the medications and 'not so strict' diet regime. Plus the body weight was also increasing and i gained around 10 kgs (101.2 Kgs) in a span of around 06 months. Recently in March 2024, the test reports indicated it as 8.70 causing me some concern and in April 2024 the reports showed a value of 9.20, which made me think about the reliablity of Lab report as well as made me change the doctor. My medicines were changed from Glimepiride (2 mg),Metformin (500 mg) Pioglitazone (15 mg) and METFORMIN-500MG + VILDAGLIPTIN-50MG twice daily ( taking for about 20 months) to GLIMEPIRIDE-2MG + METFORMIN-500MG + VOGLIBOSE-0.2MG and Dapagliflozin 5 mg+Metformin 500 mg twice daily recently in Mid April 2024. I was asked by the doctor to report after a month with Fasting and PP readings. However after few days,I started realising that my blood sugar was approaching higher and then I experienced needle like sensations in feet and hands plus sticky urine with a heavy head and hot face. I again went for a checkup three days back and the randomn sugar was 291 mg/dl. The medications have again been changed to Dapagliflozin (10mg) + Metformin (500mg) + Sitagliptin (100mg) + Saroglitazar (4mg) in the morning and METFORMIN-500MG + VILDAGLIPTIN-50MG since yesterday (08.05.2024) and I have been asked to take daily readings and report after 10 days. All this has lead to a panicky feeling in me, resulting in increased HTN. I am worried that how this hit and trial or permutations and combinations will help me in achieving a perfect set of medicines to lower my blood sugar to normal levels. Kindly advice. I shall be highly obliged.

Ans: Medicines alone cannot work in these Lifestyle diseases.
Lifestyle modification plays a vital role
So start with your dietary discipline. Strict no to Sugars and refined carbohydrates.
Have less portion of Carbohydrate in a complex form
Timely meals with early dinner before 7 pm
DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.
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Hello Doctor, I am 44. I was suffering from gastric issues Somewhere in Oct 2021, i started feeling anxious and all negative thoughts. As a nature, i take good care of self. But due to this anxiouness, i was unable to sleep well or even concentrate well. I thought to consult a MD and he took my BP reading, which was in range of 142/90. He avoided started any medications and advised for lifestyle changes to alter this situation, to which i stared with certain life-style changes like, - sun-bath in morning. - walking - morning & evening - meditation - in evening. i continued this till Dec 2021 and again revisited the MD in Jan 2022, to which he advised to continued with the same routine. By March 2022, i was feeling better. Again, the same story repeated in Sep2022 and this time, with lot of gastric issues, sleep troubel and feeling of fear and anxiety and again i visited him in Nov 2022, was getting more anxious. Looking at my condition he started with beta-blocker. The condition was not very much improving and i took the blood tests on my own in Nov 2022 end, to which, Lipid profile was bit out of range, HaB1c - in pre-diabetic zone and in liver tests - SGPT was 62. I visited to the MD with report and he advised me to continue with beta- blocker and to start with the statins daily 10 mg, after dinner. I continued this for Dec 2022 with life style change with yoga and meditation routines along with walks. In Jan 2023, the tests were repeated and it was all NORMAL. The doctor advised to stop the medicines wef Jan 2023 and again advised to repeated tests in Feb 2023. In Feb 2023, all parametere were normal , but Lipid profile was again out of range. The MD again started with the same medicines from March 2023 onwards ie 1 beta - blocker in morning after break-fast and 10 mg statin after dinner. I repeated the tests in April 2023 and it was again all NORMAL. Now, the MD reduced the statin drug to 5 mg from 10 mg and continued with beta - blocker. I am leading a healthy life with yoga, meditation, diets with more fibres and less oily or say no oil deits to the extent possible. I have stopped eating any outside food and fully on home made food only now. benefits till now, - Sleep paterrn improved - Gastric issues has gone - IBS gone, - better mood My questions to you sir, - The MD is again planning to stop the medications in next visit, since all reports are normal and i feel normal. is that okay? - Again, i may develop the symptoms? - I am following a better life style - yoga, meditation, walkings, proper diets, are there chances that i would remain off medicine always? - What are the benefits and disadvantages of station and beta -blockers, if at all, i have to take it? thanks.
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Ideally statins need to be taken for long because the lipid levels are bound to go up once you stop the statin. We need to decide however whether you really need a statin at your age. Do you have a family history of premature heart disease. If you do not have a family history of premature heart disease, you can probably stop statins for a few years . Can consider doing a CT Coronary calcium score

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We two brothers have inherited a property on 200 sq yard by registered will of our father in 2020. The property was purchased by our father in 1970 and redeveloped in 1990 into three story building. Ground floor is with my brother and first floor. Third floor without roof rights was sold by our father at the time of redevelopment . Me and my brother have terrace rights as per registered will of our father ( each has 50% roof/ terrace rights). My brother is US citizen and want to sell his share for four crores. The expected rental income from the ground floor will be Rupees 60 thousand per month. The circle rate of the property is Rupees 7 lakh per yard. My interest in the ground floor of the property is mainly to live peacefully without any interference by unknown new buyer. I am 65 and my question is from financial point should I purchase from my brother by paying Rs. 4 crore or keep the amount in bank as fixed deposit/ RBI bonds at around 8 percent per year. Second question is if he sell it to other buyer how he will sell terrace as the terrace is undivided and we both have inherited it by registered will. Thirdly there are many builders who want to redevelop the property into four floor with basement and stilt parking. What will be the right option . I have only son .
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If you’re considering whether to purchase your brother’s share of the inherited property for ?4 crore, weigh peace of mind against financial returns. Buying his share gives you full control, eliminates potential disputes with a third-party buyer, and ensures no interference in your peaceful living. However, the rental yield of ?60,000/month (~1.8% annual return) is significantly lower than the ~8% return you could get by investing ?4 crore in fixed deposits or bonds, which would generate ~?2.67 lakh/month.

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Hi sir/mam, I'm 32 years old working in a private firm as Manager. I own 9 lacs in FDs, accumulated 17 lacs in Mutual funds through SIP of around 23k pm (currently XIRR at 15-16% in with 75% in equity). I also have 2.5 lacs in PPF and 1.2 lacs in NPS. For tax savings I do yearly investments in PPF and NPS of about 1 lacs and rest I cover with ELSS (part of my SIPs). I want to retire at the age of 50, my current salary is 1.2 lac per month in hand, and receive few incentives of 1.5 lac a yr. I live in Mumbai with my wife and plan to buy a house of 60 lacs (out of which 20 L I'm borrowing from family, and rest of it will be loan with about 35k EMI). I also have a flat in NCR worth 80 L (purchased at 35 lacs), for which I have an EMI of 11k per month which is covered by rent I receive from there. I don't have kids yet, but I plan to have two of them. What should be my plan of investing that I can retire by max between 50 and 55 yrs of age with an upper middle class lifestyle in either Mumbai or NCR. How much should my corpus be? My current expenses are around 60k including rent in Mumbai, and my parents are independent. I have both health and life insurance of 1 cr+ cover.
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Asked by Anonymous - Jan 20, 2025Hindi
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Hello sir, I am 35yo with 2 (4yo, 1yo) children. Can I retire now, with following corpus: mutual fund and stocks : 3.5 crore, lands: 50 lakh, PF&PPF: 80 lakh, FD: 25 lakh, SGB &Gold:50 lakh. Currently doesn't own any house. Monthly expense is around 1 lakh.
Ans: Your corpus and monthly expenses show a solid foundation. Retirement at 35, however, requires careful assessment. Let’s analyse your situation step by step.

Current Financial Assets and Allocations

Mutual Funds and Stocks: Rs 3.5 crore

This is a significant part of your corpus. Equity investments offer high growth potential.

Lands: Rs 50 lakh

Real estate investments are illiquid. Consider them only for long-term growth or inheritance.

PF and PPF: Rs 80 lakh

These provide stability and assured returns. These are good for meeting long-term goals.

Fixed Deposit: Rs 25 lakh

FDs are low-risk and ensure liquidity. This is beneficial for emergencies.

SGB and Gold: Rs 50 lakh

Gold is a strong hedge against inflation. It also offers diversification.

Monthly Expense Analysis

Your monthly expense of Rs 1 lakh equates to Rs 12 lakh annually.

Accounting for inflation, this expense will grow over time. Planning for this is crucial.

Core Observations

Your total corpus is Rs 5.55 crore. This is substantial for your age.

Inflation and rising expenses over time will impact your corpus.

Without a house, rent becomes a recurring expense. Factor this into your calculations.

You have no guaranteed income sources post-retirement.

Key Areas of Improvement

Housing

Consider buying a house if feasible. Owning a house ensures stability and reduces rent.

Do not invest excessively in real estate as it is illiquid.

Corpus Utilisation

Avoid over-reliance on equity investments for withdrawals. Equity is volatile in the short term.

Use a mix of debt and equity for regular withdrawals.

Children’s Education and Marriage

Both are major financial goals. Plan dedicated investments for these.

Use long-term instruments for education and marriage funds.

Emergency Fund

Maintain an emergency fund of at least 12 months of expenses.

Keep it in liquid funds or high-yield savings accounts.

Recommended Financial Strategies

Asset Allocation

Diversify your portfolio across equity, debt, and gold.

Maintain 60% equity, 30% debt, and 10% gold as a starting point. Adjust as needed.

Mutual Fund Investments

Continue with actively managed funds. These can outperform index funds in emerging markets like India.

Avoid direct funds if you lack time or expertise. Regular funds offer advisor support and insights.

Debt Investments

Increase debt allocation for stability. Consider high-quality debt mutual funds.

Ensure these align with your withdrawal needs.

Tax Planning

Monitor tax implications of mutual fund withdrawals.

LTCG from equity funds above Rs 1.25 lakh is taxed at 12.5%.

Plan withdrawals to minimise tax liabilities.

Insurance Needs

Ensure adequate health insurance for your family. Cover at least Rs 25 lakh for each member.

Check if you have term insurance. Secure Rs 2-3 crore coverage for your family’s financial safety.

Inflation and Lifestyle Adjustments

Inflation can erode your purchasing power. Plan investments to counter inflation.

Avoid lifestyle inflation. Stick to essential expenses wherever possible.

Income Generation Options

Systematic Withdrawal Plans (SWP)

Use SWP from mutual funds for regular income.

Choose hybrid funds for better stability and returns.

Rental Income

Invest part of your corpus in commercial properties.

Ensure this aligns with your liquidity needs and risk profile.

Freelance or Part-Time Work

Consider light work for additional income. It can extend your corpus.

Use your skills to generate flexible income streams.

Monitoring and Review

Review your portfolio annually. Adjust allocations as goals evolve.

Work with a Certified Financial Planner for periodic checks.

Final Insights

Retirement at 35 is ambitious but achievable with meticulous planning. Your current corpus is strong, but consider the following:

Plan for inflation, children’s needs, and healthcare costs.

Diversify investments and secure guaranteed income sources.

Avoid premature decisions. Evaluate thoroughly before retiring.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

https://www.youtube.com/@HolisticInvestment

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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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