High blood sugar: 50-year-old diabetic man seeks insulin advice

Ans: Managing type 2 diabetes can be challenging, but it’s great that you’re actively working on it with medication, diet, and exercise. Maintaining a balanced diet and regular physical activity is crucial. Since you’ve been doing yoga, you might also consider incorporating other forms of exercise like walking or strengthening exercises and aim at losing fat mass. Many people with type 2 diabetes use insulin to achieve better control. However, it’s important to work closely with your doctor to determine if this is the ideal treatment for your condition.

Ans: Given your current HbA1c level of 9.4% and blood sugar readings, it seems that your diabetes is not fully controlled with your current medication regimen. For dietary modifications, focus on a balanced diet with low glycemic index foods, plenty of vegetables, lean proteins, and whole grains. Avoid processed , sugary foods and drinks. Regular physical activity can help improve insulin sensitivity and lower blood sugar levels. It’s crucial to consult with your family physician before making any changes to your medication or starting new treatments. They can provide personalized advice based on your overall health and specific needs.

Ans: You are on maximum doses of 4 antidiabetic drugs and with that your HbA1c is in the range which is higher than acceptable range of 7%.
Then, considering you are 45 year only and have a long life expectancy ahead, a better and stricter control is needed. This essentially mean we should aim for reducing oral medications and starting on basal insulin is a good idea.

There are many myths in the mind of people about insulin.
You need antidiabetic medications and it should be focused on reducing blood sugar levels. I agree that starting on insulin is a good idea and we can reduce some oral medications.

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

Ans: I think you should be congratulated for the efforts you have made.

The blood sugar levels are still in range of pre-diabetic. Therefore, it is advisable that while you continue the lifestyle modifications, it will be useful if you take atleast metformin, which works as insulin sensitiser. Once your HbA1c is below 6 and fasting sugar below 100, you can discuss with a physician and stop medications.

However, one of the key factor to determine blood sugar levels is going to be your age. So, if you are younger than 60, remission is a good target.


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