How to Control Blood Sugar With or Without Medicines
A patient who has been controlling his blood sugar very well with medicines recently asked me this question-“Doctor, can we control blood sugar without taking medicines?”
My answer-“Yes. But it depends on the stage of your diabetes.” “Meaning? How?” he asked again. I then went to explain to him ‘How’.
Now let me elaborate on this ‘How’. For explaining this ‘How’, I will tell you my experiences with some of my patients.
For whom I have written this article-
Any patient having difficulty controlling his/ her blood sugar should read this article. The examples of patients narrated are real life patients undergoing treatment in my clinic.
Now, let’s begin-
Case Study no.1:-The patient with Very High Blood Sugar
About 2 years ago, a 62 years old father of a priest in our community temple visited me at 12.30 p.m. with the following symptoms-
- Feeling very tired and fatigued.
- A sudden increase in the frequency of urination-about 7 to 8 times in the night for more than a week.
- Dry mouth and intense thirst.
- Sudden loss of weight– about 10 kg in a span of 15 days.
He later went on to say that he was traveling to his native place Mangalore and he had already reserved a seat on the train. The train was to depart at 3.45 p.m. I was in a fix now, because I had an inkling of what has happened to him.
On an impulse, I told him that I am getting his blood sugar done. I keep a Glucometer in my clinic, just for times like this.
Upon checking his blood sugar, the glucometer gave this report- Not Recordable. I was shell shocked. Now what? I asked him-” Since when are you suffering like this?” “One week”, he replied. “Then why the hell did you wait for so long?” I asked him in an annoyed tone.
What did I do next?
I immediately referred him to a pathology lab to get his random blood sugar and urine done urgently. After half an hour, my Pathologist colleague rang me up and he reported these results-
- Random blood sugar-725mg/dl
- Urine Sugar- 4+
- Ketones in urine-+ve
Now, look at the HbA1c value- it is way above the normal range of 5 to 6%. For your ready reference, I am including a table below which shows how much the mean blood sugar value should be for every 1 percentage rise in HbA1c-
What did I advise this patient?
Firstly, I advised the patient to cancel his journey and get admitted to the hospital. I also told him that he was suffering from severe diabetes with a condition called Diabetic Ketoacidosis. And, that if he chose to travel, he may not reach his destination alive.
This patient was admitted to the hospital for about a week where he was treated with intravenous[IV] Insulin to bring his sugar before other complications set in. Later on, after his blood sugar reached normal levels, he was put on Oral Anti-Diabetic Drugs which maintained his blood sugar very well.
He was also advised to go for regular walks and have a properly balanced diet sans sweets and starchy food. I also advised him a high protein diet to build up his muscle mass as he had lost plenty of it during his ordeal.
This patient will need medicines to keep his diabetes in check throughout his life. Along with medication, I also advised him to have a proper 3 meal diet containing all the essential nutrients with lots of fibers in it.
Now, let’s jump to the next patient-
Case Study no.2:-A patient with Pre-Diabetes having a marginally raised blood sugar-
A young male person aged 26 years visited my clinic with complaints of-
- Repeated urination
- Increased weight- his BMI was 28kg/sq.mtr.
- Excessive thirst
- Increased hunger
As usual, I checked his random blood sugar. It was 166 mg/dl. This made me suspect pre-diabetes in this patient. I suggested the following investigations for this patient-
- Blood sugar[BS] fasting and post-lunch[PP]
- Urine sugar
His reports came in as follows-
- BS- Fasting-118, Post-lunch[PP]- 175;
- Urine Sugar- Fasting-Negative, Post-lunch-1+
If you have noticed the above reports, they are slightly above the normal values. This condition is called Impaired glucose tolerance (IGT) or Pre-diabetes.
These patients can be successfully treated without medicines. Here is a good article on Pre-diabetes that i suggest you should read-link
What did I advise this patient?
This patient was advised-
- Regular exercise- preferably walking or jogging. This helped him reduce his BMI to acceptable values- about 24kg/ sq.mtrs- in 6 months time
- Eat a low carbohydrate diet- avoid sweets, rice and potatoes as far as possible.
- Add more fibers to the diet in the form of fruits and vegetables. This helped him overcome the urge for sweets as well as bringing down his weight by 10 kg.
This patient was advised to keep up this routine throughout life to maintain his sugar levels and avoid becoming a diabetic.
Case Study no.3:-A patient with poorly controlled Diabetes
A middle-aged man visited my clinic with complaints of a painful urination. On examination of his genitals, I came across this picture-
- The foreskin of his penis was swollen-he could not retract it. It appeared like this-
- There was whitish discharge around the foreskin-this a candidial[yeast] infection in diabetes.
- The urination was very painful suggesting urethritis .
- Blood sugar random came out to be 215gm/ dl.
I suggested him the following investigations-
- Urine routine and microscopic- there were lot of bacteria, yeast as well as pus cells in his urine.
- Blood and urine sugar- both fasting and post-lunch. Both were very high- BS( F)-175, BS(PL)-255; Urine Sugar- Fasting +2, Post Lunch- +4
This patient was already on these medications-
- Glycomet GP1- a combination of metformin in and glimepride-two times a day.
- Dichrome( Chromium picolinate)- once a day. It helps insulin to work properly.
What this patient was not doing-
- No exercise- he was sedentary and rarely went for walk or did any physical work. During this visit his weight was 82 kg for a height of 162 cms- way above the ideal body weight requirement of 61kg. His BMI was-31.25kg/ sq.mtrs.- way above requirements of 18- 25.
- Not following the diet regimen I had suggested- he was binging on sweets. He liked sweets.
- Skipping medications off and on.
My updated suggestions-
1.Added 2 more medicine- 💊-
- Tenegylptin(Zilenta) 20 mg 1 before lunch
- Voglibose 0.2 mg(Vogli) 1 before lunch and 1 before dinner.
- Tab. Flucanozole 150 mg once daily for 5 days to control the candidial ( yeast) infection.
- Anti- inflammatory drugs to control swelling and pain in the urethra
- Candid cream( clotrimazole) to apply locally on the infection.
2. Strict diet control- no sugar or starchy food ( rice, potatoes).
3. Regular walks and exercise to bring down his weight to acceptable levels of 61 to 65 kg.
After 3 months-
The following changes were observed as the patient followed my instructions strictly-
- Weight reduced to 75kg. BMI down to 28.58 kg/ sq.mtrs.
- Blood sugar – Fasting-118; Post-lunch- 156; HbA1c-6.5%.
As you can see, I have narrated 3 different instances of varied signs and symptoms of diabetes with increased blood sugar and its management.
I hope you have understood the implications of having a high blood sugar level. And I also hope this article helps you managing your diabetes very well, if you are under treatment for same.
To know more about how you can manage blood sugar without medicine, you can read this Article>Link