Reader's Corner

I am a 54-year-old man. I have been suffering from Type II diabetes mellitus for the last 8 years. Previously I had been on an oral hypoglycemic drug. Euglucon (1 ½ daily). I almost never got my blood-sugar checked properly. For the past one year, I am suffering from yet another problem – heart disease. It started with an acute attack of breathlessness last winter. I was taken to Jaslok Hospital, Mumbai, where they diagnosed my condition as Diabetic Cardiomyopathy with left ventricular ejection flow = 15 per cent only.

My problem is that I have poor control over diabetes. Previously I was on Human Mixtard Insulin (30-70, twice a day) and 3 Walaphage tablets a day. But the blood sugar hardly ever goes below 200 mg (fasting). Even with the present drugs my blood sugar level remains around 206 mg (fasting).

With the cardiac drugs I am just about okay – I go to the office daily, take a morning walk for 1 hour, and can drive also. But sometimes I do feel weakness and pain in the chest for 5-10 minutes.

Please advise some treatment for diabetes. Also, please enlighten me about my cardiac health and whether taking too many drugs will have long term side-effects.

Eight years of neglected diabetes could lead to the occlusion of the small arteries in the heart, kidney, eyes, nerves and brain. This causes death of tissue in these organs, which leads to impaired functioning. The basis of your cardiomyopathy could be the gradual occlusion of arteries. Currently, there is no known cure for this condition and all you can do is maintain a healthy diet, take your medications regularly, follow up with your physician periodically and keep your diabetes well regulated. I am afraid I cannot modify your medications as they can be modified only after a clinical evaluation. I may suggest that you consult your physician and omit Walaphage as it is not the best medication in your clinical situation.

If you regulate your diet judiciously your diabetes can be controlled with less insulin which would be safer for your heart condition. I can offer the following general guidelines for your treatment:

Your cardiac medications are a must at the present moment, and though they do have side effects they will have to be endured as there are no other safe options.