I can taper all the medicines of low BMI patients but get difficulty in achieving gtt negative stage..instead of normal Hba1c,following diet doing strength training .. please guide how to achieve it
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Hello Dr. Archana,
First of all I will like to congratulate you for your confidence in tapering medications of a Low BMI DM patient keeping his sugar levels in control. Helping such a patient to maintain his HbA1C levels in control without Insulin and OHA is a great task.
I would like to clarify one point here that GTT is not the target for such patients. You should consider Hba1C as the parameter of reversal in such patients.
As you rightly said, to grow the muscle mass you have advised your patient for strength training and you should be aware that growing muscle bulk is a time consuming process.
According to me, you should conduct his GTT after a year of maintaining his HbA1C under 6 and growing his muscle bulk considerably so that the consumed sugars can be well utilized by his muscles.