Symptoms & When to Seek Care

Common signs include excessive thirst, frequent urination (especially at night), unexplained weight loss, fatigue, blurry vision, slow-healing wounds, and recurrent infections. If you have a family history, obesity, high blood pressure, high cholesterol, PCOS, or had diabetes during pregnancy, you’re at higher risk and should get screened.

Tests & Diagnosis We Commonly Recommend

• Fasting & post-meal sugars, HbA1c (3-month average), and random sugars as needed
• Lipid profile, kidney function (serum creatinine, eGFR), urine microalbumin/creatinine ratio
• Liver function tests (before/while on certain medications)
• Thyroid profile when indicated, vitamin B12 if on specific drugs
• Retinal (eye) screening and foot examination (vibration/monofilament)

We individualise the work-up so you’re not over-tested, but nothing important is missed.

Personalised HbA1c & Glucose Targets

Targets are individualised based on age, duration of diabetes, work routine, and other health issues:

• ~7.0% (53 mmol/mol) for most adults
• 6.5–6.9% for newly diagnosed/younger adults if safe
• 7.5–8.0% for elderly, recurrent hypoglycaemia, or multiple comorbidities

Typical fasting target is 80–130 mg/dL and 2-hour post-meal target is often <180 mg/dL unless we decide otherwise for safety.

Type 1 vs Type 2 — How Care Differs

• Type 1: Lifelong insulin, carbohydrate counting, ketone education, and school/work support plans.
• Type 2: Lifestyle + oral meds first; add/transition to insulin when needed. We also discuss SGLT2 inhibitors/GLP-1 based options when suitable.
• Prediabetes: Diet, activity, weight optimisation and risk-based medication to prevent progression.

When Do We Start Insulin?

• Very high sugars, HbA1c > 10%, ketones, or symptoms (polyuria, polydipsia, weight loss)
• Oral medicines insufficient to meet agreed targets
• Special situations: infections, surgery, pregnancy, steroid use

We typically begin with basal insulin and titrate to reach fasting targets. If post-meal values remain high, we add mealtime (bolus) insulin or adjust the regimen. Technique, storage, and hypo-prevention education are standard for every patient.

Monitoring: Glucometer or CGM?

Self-monitoring helps you see patterns and prevents highs/lows. Many patients benefit from short-term or ongoing CGM to fine-tune meals and medicines. We’ll recommend a plan based on your therapy and daily routine.

• Sample SMBG schedule: Fasting most days; add pre-/post-meal checks when adjusting treatment or if readings are unstable.
• Bring logs: Note meals, activity, symptoms with sugar values — it speeds up dose adjustments.

Diet & Lifestyle You Can Actually Follow

We emphasise a sustainable Indian diet pattern: more protein & fibre, fewer refined carbs, healthy fats, and smart portion control. You’ll receive sample plates, weekly goals, and shopping checklists. Activity targets combine walking + resistance training, plus sleep and stress routines.

• Indian plate idea: 1 serving dal/paneer/egg/chicken, 1–2 small rotis or ½ plate rice (preferably brown), large salad/sabzi, curd/buttermilk.
• Swap sugar-sweetened beverages for water, lemon water, or unsweetened tea/coffee.
• Target 150+ minutes/week of moderate activity plus 2–3 strength sessions if your doctor says it’s safe.

Foot Care & Sick-Day Rules

• Inspect feet daily; keep skin moisturised; never walk barefoot outdoors.
• During illness, check sugars more frequently, hydrate well, and contact us if sugars/ketones are high or you can’t keep food/fluids down.
• Learn signs of low sugar (shakiness, sweating, confusion); keep glucose tablets or sweet juice handy.

Follow-up Cadence

• Newly diagnosed/changes: review in 2–4 weeks
• Stable: every 3 months with HbA1c as advised
• Annual: retinal exam, kidney tests, foot assessment and lipid review

Vaccinations for People with Diabetes

We discuss and recommend appropriate vaccines (e.g., influenza, pneumococcal) based on age and risk, and coordinate scheduling, especially before travel or seasonal outbreaks.

Special Situations We Help With

• Pregnancy planning and gestational diabetes
• Fasting for religious occasions — safe adjustments
• Surgery/infections: temporary dose changes and monitoring plans
• Work/travel routines: meal timing, snacks, and hypoglycaemia prevention

Why Choose Dr. Manuj Sondhi?

• 14+ years’ experience; MRCP (UK); ethical, minimalistic prescriptions
• Clear goals, structured follow-ups and patient education
• Integrated clinic with onsite psychiatry support for stress/sleep issues when relevant

At Nirvana Clinic, you receive practical, personalised diabetes treatment in Greater Noida—not one-size-fits-all advice.