Hello Doc,

First of all congrats on helping the patient reduce his 76 IU of Insulin in such a short interval. Post tapering the sugar levels do fluctuate.

Now you have two options.

1. Either continue Prameha diet kit and control the sugar levels for one more month without Insulin injectables. After this month, start the step 2.
2. Manage the patient on 800 Calorie diet chart. Ask the patient to refrain from Wheat and wheat related foods like Maida and Suji. Rice and rice related should be avoided for more 60 days post prameha. Milk and milk derived bakery products should be on hold for 90 days post Prameha. No sugar or Jaggery related sugar free products also. If possible, ask the patient to consume only 2 meals a day keeping a gap of about 8 to 10 hours in between these two meals. If hungry, ask the patients to consume salads or vegetables. I am sure, post Prameha, the hunger must have reduced for the patients.

I would strictly advise not to restart the insulin injectables again if the compliance from the patient is intact.

Involve the relatives for this task and congratulate the patient and his relatives for what has been achieved and put them on the next goal of further reversal process.