Diabetes,Mysthenai Gravis & Prednisolon

[mhkhatri]

I am 66 years old male and have diabetes from last 19 years.So far on the oral medicine.
From last one year I am having Myesthenia Gravis as I started with slurred speech ... [More] . 8 months was on Myestin 60 tablets and was OK .Again from last three months MG was worsen and had chewing,left eyelid drooped,double vision etc.Doctor advised for Azoran tablets along with Prednisolon 10mg. Azoran 1-0-1 and Prednisolon 10mg 2-2-2 along with Myestin 60 1-1-1-1.My diabetes doctor put me on Nova Rapid insulinn 15 unit after B.fast,Lunch & Dinner.along with Nova Lantus 30 units with B.Fat. I ]He also put me on Gliclazide 80, 1-1-1 before food and Vildagliptin 50 mg 1-0-1.This started from 16th March. Now my Prednisolon tablets taper down to 30 mg instead of 60 mg.every 12 th days  5 mg Prednisolon is taper down.I gained  my weight by 5 kgs and sodium liquid retention in face and on tummy.My MG is 100% in the controlled.My sugar level is fasting 70 to 160 and PP 170 to 250.Some times it goes to 340 also.I am now suffering from cough .I was regular smoker but since last 8 days I quite absolutely.I have been advised to take Amoxycilin & Potassium Clavulanate tablets with lactic Acid Bacillus (625 ) 3 times a day for 5 days and one capsule of Duova rotacaps for inhalation and Levocetzine 5 mg once.It is 70 % better.I just wish to know that with MG and its other medicine,Amoxicillin medicine can be used? I will get my all X-rays,P.Lung test,other blood test tomorrow.I am now very much lethargic and can not do my routine work with ease.I used only little Law salt only.What care should be taken to make my side effect comfortable.I drink lots of water.Please advise.
Regards.

[Zoelula]

It is good that you take your Nova Rapid 15 minutes before eating. You should definitely talk to your doctor about an Insulin:Carb ratio instead of a set dose.

As far as losing weight, there are a number of ways to do that. Just lowering your carb intake will help you both to lose weight and better control your blood sugar. Things like rice which may be a regular part of your diet, may just not work for you as a diabetic. But since you have some other health problems you might want to work with your doctor to establish a weight loss diet. I'm sending you a website by private message where you can talk with many more diabetics and there is a whole thread on diet and weight loss for type 2's.

[mhkhatri]

Hi Zoe.Thanks for making my error correct.It is by mistake I write after food.My Nova Rapid Fast 15 Units Insulin is to be taken 15 minutes before each three meals.My CBC and S.Creatinin report  will be ready by the evening.I noted to maintain my blood sugar level and will consult my Diabetes doctor on Monday.My total Pulmonary function test report will be ready by Wednesday.I will write you with results.Please suggest for my weight gain as my face and whole stomach is change and more round and solid and make me discomfort as I am suppose to be very active in my working life and now absolutely LETHARGIC.How can I manage my salt diet? Thanks GBU,

[Zoelula]

I'm sorry, I just sorted through your post and noticed that you are on insulin. But your description is odd. You say you take 15 units AFTER breakfast, lunch and dinner?? This is not the correct way to take bolus (fast-acting mealtime) insulin. You should be taking it BEFORE your meal, usually around 15 minutes. If you take it after, and especially if you eat a lot of carbs, it will not have a chance to act before the carbs are digested. Also, a set dose of 15 units does not take into account what you are eating. You need to develop an insulin:carb ratio where you know how much insulin you need for whatever carbs you are eating. A way to figure this is to start with 1 unit of insulin for 15 carbs and then work up or down depending on whether you are in target 2 hours after eating (under 140). I recommend Using Insulin by John Walsh as not all doctors know how to do insulin carb ratios. Set doses are not very effective, as shown by your blood sugar.

[Zoelula]

There are no doctors on this board, mhkhatri; only other people with diabetes. Your medical questions are very specific and I would direct them to your doctors. The only thing I can comment on is that your blood sugar levels are too high. You want your fasting to be under 120, preferably under 100 and your pp under 140. You are at risk for complications at the level you are maintaining. I would suggest a change in medication, or talking to your doctor about beginning insulin.