How can I better manage my worsening type 2 diabetes?

Question

Hello doctor,

I have been managing type 2 diabetes for the past 10 years, but recently my condition seems to be worsening. My latest HbA1c test result was 8.2 percent, and my fasting blood sugar levels have been consistently above 150 mg/dL. Additionally, I have a history of hypertension, high cholesterol, and a previous heart attack.

Despite taking Metformin and Insulin, my blood sugar levels remain uncontrolled. I am also experiencing frequent episodes of hypoglycemia. I lead a sedentary lifestyle due to my desk job, and my diet includes a lot of processed foods and sugary snacks. I try to exercise occasionally, but it is challenging to maintain a routine. Could you please advise on any additional tests or changes in my treatment plan to better manage my diabetes and overall health?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Given your situation, it is crucial to reassess your diabetes management strategy, considering your history of hypertension (high blood pressure), high cholesterol, and a previous heart attack. Your HbA1c of 8.2 percent and consistently high fasting blood sugar levels indicate that your current regimen may need adjustment.

Plan for:

LFT (liver function test).
RFT (renal function test).
TFT (thyroid function test).
Complete urine analysis.
C-peptide test, which can guide treatment decisions.

You can also try continuous glucose monitoring (CGM), a device that can help track glucose levels throughout the day and night, providing a better understanding of your blood sugar patterns, particularly the episodes of hypoglycemia. Also, plan for consultation with a cardiologist once every six months. As your blood sugar levels are high, we can review your treatment and make needed adjustments. For this, share details about your insulin dose and type, and Metformin dose.

Regarding lifestyle modifications:

Reduce your intake of processed foods and sugary snacks. Consider consulting a dietitian for a personalized meal plan focusing on whole foods, lean proteins, fiber-rich vegetables, and healthy fats.
Incorporate regular physical activity into your routine, aiming for at least 150 minutes of moderate-intensity exercise per week. Even short, frequent walks can significantly improve insulin sensitivity and cardiovascular health.
Chronic stress can worsen blood sugar control, so incorporating stress-reduction techniques like meditation, deep breathing, or yoga could be beneficial.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.