by Ganesh
I am having diabetis past 10 years with good control.
At present, I am taking 1 tblt of Onglyza 5mg daily after lunch and my sugar level 2hrs after lunch always below 140.
But my fasting sugar is always from 130-150range after medium dinner. Also sugar level is 190-200, 2hours after dinner.
Daily, I am going for brisk walk from 8pm to 8.45pm.
What medicine I have to add to control my fasting sugar as well as 2 hrs after dinner reading?
Thanks,
Ganesh
Ganesh, fasting readings of 130–150 mg/dL are at or above the upper end of the usual target for many adults with diabetes. Two-hour after-dinner readings of 190–200 mg/dL are above the commonly used post-meal target of less than 180 mg/dL.
Do not increase Onglyza or add another medicine yourself. Saxagliptin 5 mg is already the higher usual once-daily dose. The correct treatment depends on your HbA1c, kidney function, weight, other medicines, and heart and kidney history.
Answer by Dr. Albana Greca, MD, MMedSc
Hello Ganesh,
I understand your concern. Your glucose is controlled after lunch but rises more after dinner and remains higher overnight. This pattern deserves a medical review, but it does not identify one specific medicine that is safe for you.
For many nonpregnant adults with diabetes, general targets are 80–130 mg/dL before meals and less than 180 mg/dL one to two hours after the beginning of a meal. Your personal targets may differ because of age, diabetes duration, low-glucose risk, and other health conditions.
Measure the after-dinner reading about two hours after the start of dinner. These guides explain blood sugar after eating and fasting blood sugar from 127–200 mg/dL.
No—not on your own. Onglyza is saxagliptin, a DPP-4 inhibitor. It is taken once daily with or without food, so taking it after lunch is acceptable if prescribed that way.
The approved doses are 2.5 mg or 5 mg once daily. A 5 mg dose should not be increased. If eGFR is below 45 mL/min/1.73 m², or with certain interacting medicines, the recommended dose is generally 2.5 mg. Kidney function should be checked before treatment is changed.
I cannot prescribe an additional medicine from these readings alone. After checking your HbA1c, kidney function and medical history, your clinician may discuss:
Type 2 diabetes treatment often needs adjustment over time. This is common and does not mean that you have failed.
No. Your 45-minute brisk walk is useful moderate exercise. Running is not automatically safer or better, particularly with heart disease, neuropathy, foot problems, retinopathy, joint disease, or little previous vigorous exercise.
Continue brisk walking if it is safe. A short walk after dinner may help some people reduce the meal-related rise. Increase exercise intensity gradually and obtain medical advice before strenuous exercise if you have chest discomfort, breathlessness, dizziness, foot problems, or known cardiovascular disease.
I personally advise my patients to balance the intake of cinnamon, bitter melon, or gymnema to help manage your current blood sugar levels. However, I do not recommend to use herbal supplements to replace effective diabetes treatment. They can vary in strength, and we need to protect you from possible side effects, and interaction with medicines. See our diabetic herbs evidence and safety guide.
Contact your clinician if readings repeatedly remain above your personal target or frequently reach 200 mg/dL or higher. Seek urgent care if high glucose occurs with vomiting, severe abdominal pain, confusion, marked weakness, dehydration, difficult breathing, fruity-smelling breath, or moderate-to-large ketones.
While taking saxagliptin, promptly report new shortness of breath, swelling of the feet or legs, or rapid unexplained weight gain because these may be heart-failure symptoms. Severe persistent abdominal pain, especially with vomiting, also needs urgent evaluation.
What I want you to remember: these readings are not usually an emergency by themselves, but the repeated pattern should not be ignored. The safe next step is a structured glucose record and clinician review—not a higher Onglyza dose, forced running, or unproven herbs.
Educational safety note: This answer provides general education and cannot diagnose a condition or prescribe an individual medicine. Do not start, stop, or change diabetes medication without your prescribing clinician.
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