Tighter sugar control prevents diabetes complications: Dr. Gadge

Dr. Pradeep Gadge is an expert at handling diabetes and its complications.

He has practiced as Clinical Assistant at Lilavati Hospital, S. L. Raheja Hospital and the All India Institute Of Diabetes.

He is a teaching faculty for postgraduate Diabetology students at the College of Physicians & Surgeons.

Dr. Gadge’s special interest lies in diabetes in pregnancy.

The expert took time off his busy schedule to answer Sify readers questions on diabetes. Read the chat transcript here.

hello sir.i am a type-1 diabetic patient from past 18 years.i am using insulin pump to control my sugar.i am a gym enthusiast.so i just wanted to ask u that can i use supplements like whey protein,creatine,glutamine etc.
Depends on your Kidney function tests & other complications you have, if any.

hi doctor, im in second trimester. since my mom is diabetic, can i know what precautions to take to prevent gestational diabetes
Keep a watch on your diet. Exercise as per your gynec’s advise.

what is the right quantity of calories for breakfast for a person with fasting sugar 107?
Depends on patients gender, height, weight, etc

my mom diab since 2002. she is getting swollen ankle since august last yr. is this arthritic or due to diabetes
Can be due to DIABETIC KIDNEY DISEASE OR HYPOTHYROIDISM OR CERTAIN DRUGS LIKE PIOGLITAZONE/ INSULIN/ PREGABALIN OR some other cause. This requires detailed examination of the patient & investigations. Sometimes inspite of all this, the cause may remain obscure. Such patients have to be treated symptomatically.

what diet can diabetics follow to lose weight
High fibre, Low fat, Low salt containing diet

I AM A TYPE 2 DABETIC PATIENT.WHAT ALL THINGS TO DO. I AM TAKING MEDICINE.

A textbook can be written on this. To explain in short what to be done by a DIABETIC, besides taking medicines, I would say: PROPER DIET, EXERCISE, STRESS MANAGEMENT.

I am 40 years old , Earlier I was taking amaryl 1 mg tab in india, but in dubai, doctor recommended to take januvia .. but januvia did not help and now doc prescrbed Onglyza (saxagliptin) 5mg. is this the good medicine or can I go back to Amaryl?

If JANUVIA didn’t help, probably ONGLYZA also won’t. Treating Diabetes is not just selecting a drug randomly, but it has to be in a systematic fashion. See a specialist preferably.

If we come to know that anybody have diabetes, then can we cure it completely or we can just maintain it???
Cure is usually less likely. However with tighter sugar control you can prevent most complications.

my husband 34 years old weight 72 kg height 5-3″ is diabetic for last 4 years . his sugar level is under control but he complains of leg pain continuously . pls suggest
Leg pain can happen due to multiple reasons, besides diabetes. Ask you doctor to do a thorough physical examination & probably the reason may be evident. It could be anything from Vitamin D deficiency to electrolyte imbalance to nutritional deficiencies. Sometimes smoking can also be the cause.

WILL IT LEAD TO ANY PROBLEM IF I TAKE HEAVY FOOD AND ADJUST DOSE OF MEDICINE TO KEEP BLOOD SUGAR CONTROL?
Yes

I am a diab & the levels are within limit. I was taking PIOZ15 and recently stopped due to newsitem on this well as on internet that it has the side effects creating bladder cancer. My Doctor says it has not been banned by the IMA. ur opn pl
I dont think PIOGLITAZONE is that bad. Probably its blown out of proportion. However these are my individual views.

Does diabetes is easily tracked ? or do i need any special tests to under go ??
For screening if you have diabetes, the best test would be ORAL GLUCOSE TOLERANCE TEST with 100 gms of glucose (in non pregnant patients) & 75 gms (in pregnant patients)

diab last 10 yr. taking inj last 2yrs 20 ml morn, night. pain while passing urine, drink water and coconut water. take uripas tablet at times. suggestions for pain relief. PP 195-205 fasting 160

You may have Urinary Tract Infection. It would be better to go through atleast URINE ROUTINE test & then decide the further treatment.

Diabetes 2 from last 3 yrs. pl suggest Proper Diet & precaution measures to keep Sugar in Control. im working in pvt. com & i do my maximum work by sitting on table ; hence no more physical exercise is being done by me
Exercise is as important as medicines & diet. Try to be active.

I m t1D frm age 25. Now I m 33. I take huminsuline N & R. My q is y I feel sometime very fit and a low blood sugar level and sometime it get reversed with the same doze. If I increase a unit in the doze then my sugar level drop to 50 at night.
You should be seen by a specialist. Consult someone in your vicinity.

What is the right food & exercise for Sugar 140 with fasting?
When only Fasting sugar is HIGH, you may need medicines to bring it down. DIET & EXERCISE alone may not help. However the approach has to be individualised, as per patient.

My fasting value is 90 and post prandial value is 151 and what precaution i should take?
DIET & EXERCISE. Keep repeating your GLUCOSE TOLERANCE TEST at regular intervals

I am a type-1 diabetic. Often, Test report is reverse i.e a lower side in PP like 91, 104 and Fasting is between110 to 139. Taking Amaryl M1 OD before B/F. Also, day by day beoming lean. I am doing Morning walk on daily basis.
Probably you need to shift from a long acting drug to short acting & the dose adjusted in such a way that more aggressive dosing at night than the day dosing will do the trick.

Blood sugar 6.4 after having the bottle of glucose (OTG test) an hour later test is 13.5 . What is your recommendation to bring this into control without medicine. I take only wheat bread for bfast and dinner. Chapathi for lunch.
DIET & EXERCISE will be the key

I am a type 2 diabetic for the past 2 years and take 850 mg Glucophage tables twice daily. I take a couple of drinks once a week and would like to know if I can take my medicines after having a drink?
Yes

OTHER THAN THE CONTROL OF BLOOD SUGAR ARE THERE ANY OTHER BENIFITS OF INSULIN?
Insulin is thought to have anti-inflammatory properties. It is an anabolic hormone, so it helps in building muscles & fats stores in those who are in catabolic stage e.g: Tuberculosis.

WHAT IN YOUR OPENION (GUESS) IS THE REASON FOR ONSET OF DIABETES?
Genetics, Sedentary life style, Faulty diet, stress, probably certains chemicals in the diet (Endocrine disruptors), etc

IS IT THE HIGH AVERAGE BLOOD SUGAR OR SPIKES (LOW AND HIGH) IN BLOOD SUGAR THAT IS HARMFUL?
Low & high are more harmful. But even persistent high sugars are..

WHAT IS THE MAXIMUM DOSAGE OF METFORMIN PER DAY?
In Indians, usually doses above 1750 mg/day do not show any extra benefits. The effect plateaus after that dose. Side effects only increase with increasing dose after 1750

WHAT IS THE MAXIMUM DOSAGE OF GLIMPIRIDE FOR DAY?
8 mg/day. Try not to exceed that.

WHAT IS THE BEST METHOD OF INSULIN ADMINISTRATION?
Actually into the portal system. However at present, we inject it into the subcutaneous tissue.

ARE THERE ANY FOODS WHOSE CALORIFIC VALUE IS NEGATIVE i.e. MORE CALORIES ARE SPENT IN DIGESTING THE FOOD THAN THE FOOD GIVES US?
NO

WHAT ARE THE ADVANTAGES AND DISADVANTAGES OF USING INSULIN THROUGH INHALER?
Inhaled insulin is not available at present!!!

WHAT IS THE APPROPRIATE STAGE TO USE INSULIN?
The best Judge to decide this is the doctor who is seeing you.

Good evening sir, My brother is 37 yrs old, 174 cm tall, weighs 67 kg and his random blood sugar reading is above 225. But he is otherwise alright though I feel he has become thinner over the time. What would be your advise to him sir?
Persistent high sugars lead to weight loss. In his case, this must be the reason. Ask him to take appropriate treatment

I 55 years old male and married with 2 daughters, am suffering from diabetes since last 33 years and now taking insulin 2 times a day. How to control?
See a diabetologist

I am a male of 47 years age (HT: 5ft 7inch and WT: 77 KGS). Diabetic since 6 months. Taking Zoryl M1 before lunch and Glycomet 250 before dinner. Recent FP 86 and PP 110. Should I continue to be on the medicine or chances of cutting down in future?
Probably the dose of GLIMEPIRIDE can be decreased..& probably later stopped. However atleast continue METFORMIN

I am diabetic since 2004. Suggest steps to control sugar level so as to be healthy.
As earlier, DIET, EXERCISE & Lifestyle modification

my father is 67 yrs old and paralyzed by brain stroke since 04 yrs. He is also diabetic . and his sugar varied from 90 to 360 in fasting.
Needs immediate attention by a Diabetologist

diabetic for 20 yrs . taking insulin inj since 3 yrs. have switched over to “onglyza” tablet with Glyciphage as advised by my physician. sugar levels have gone down ,PLBS is 108. have lost weight. would like to know whether Onglyza is safe?
Onglyza is quite safe, if used judiciously..

I am diabetic from the age 43.I am 49 now.How to control diabetese as my increases so that I can be healthy.Give us the steps to be taken.
Diet, Exercise & proper treatment

I am diabetic neuropathy patient. I am 8o years old and diabetic since `979 and my sugar level throught out is under control. Now it has taken serious turn. I am neither able stand or walk. I am taking food supplements. What us the remedy.
Drugs should be cautiously given at this age. Its best to see your diabetologist/ neurologist

My Dad and Mom are diabetic patients…Father is also have undergone by pass surgery..what is the best possible ways one should follow to control diabetic
Diet, Exercise, Medicines

some times fasting it iscoming 146 and some times 100 .
I need further information. This is inadequate..

51 yrs,72 KG blood sugar last 4 yrs +Thyroid & Rehu. arth. taking GLIM. 2 / 5oo MF TWICE Eltroxin 100 tab , Crocin SOS, bloOd sugar fasting last week 160 & PP 201. LFT NORMAL . leg muscle some times stiff leg muscle some times become stiff
I have answered a similar query earlier

With fasting my sugar is 140 even after taking medicine regularly. can you comment
Change of medicine needed

my HBA1c rwading is 7.2 – do I need to take medications now
Probably YES, if this is inspite of DIET & EXERCISE

i am 72 old female my fasting sugar is 155 & 250pp pl advice medicine
Medicines should not be advised without seeing the patient!!!

My father died by suffering from diabetes. how much risk factor for me but no one is suffering by this disease in my both paternal or maternal relatives.
Still you have significant risk..so be watchful

My fasting blood sugar ranges between 110 to 150 and PP between 140 to 180 since last 6 yrs despite my controlled diet, regular walk and medication (1 tablet a day). Whether these levels are risky. Please advise option for improvements.
See an expert

I am 36 years old. I have diabetics for last 3 years. I have 6 years old boy and he is doing good. Now can i have another one child. And is the child any possibilities to have diabetics or any problem.
Yes you can have a child

My fasting reading is 119 and pp is 125, I use Gluconorm Forte 1000mg before breadk fast and Cytaprin 500mg and Pioz 15mg before dinner. what is your advice.
Continue same

i have been taking glimaday 2mg as advised by my physician. is it safe? some times i get hypoglycemia after taking this tablet.

It is quite safe. Hypoglycemia can happen if you do not eat as advised & if you do not eat on time

Sir, What are type 1 and type 2 diabetes?
This needs too much of explanation. Kindly GOOGLE this. In simple words, Type 1 is someone who just cannot live without insulin..they will go into ketoacidosis & die. However Type 2 are those who usually respond to tablets in early stage & may progress to require insulin later in life

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