Sugar 18-20 mmol-l are very high sugars. Sugar above 13 mmol / l is glucose toxicity —toxication of the body with high sugar, which is why we must reduce sugar below 13 mmol / l. Ideally, to reduce sugar below 10 mmol / l (target sugar levels for most patients with diabetes are 5-10 mmol / l), namely, with sugars below 10 mmol / l (these are sugars both before and after meals) the low risk of developing diabetes complications. With sugars above 13 mmol / l, the risk of developing complications is very high.
Blood sugar must be reduced. First, you yourself can begin to follow a strict diet (remove all fast carbohydrates, eat slow carbohydrates often and gradually, preferring non-starch vegetables (cucumber, tomato, cabbage, zucchini, eggplant) and low-fat squirrel (fish, chicken, beef, mushrooms, a little - legumes, nuts).
In addition to the normalization of the diet, sugar can be reduced by increasing physical activity (most importantly, remember: you can give yourself loads of sugar up to 13 mmol / l, when the sugars are higher, the body suffers from glucose toxicity, the loads will overload the body).
You should also read the literature on the treatment of diabetes (a lot of information about the treatment of diabetes, the selection of insulin therapy you can find on this site and on my website - // olgapavlova.rf), you should also go through a school of diabetes to begin to orient in glucose-lowering therapy and insulin therapy .
And now the most important thing: you need to find yourself an endocrinologist who has enough time, knowledge and desire to find you adequate sugar-lowering therapy, which will be useful for the body and effective in terms of controlling blood sugar. Insulin can be prescribed by a therapist, and only a competent endocrinologist will be able to select a modern, safe therapy. Very often in the clinics too early and by no means always, according to indications, give insulin for T2DM, which leads to sad consequences: an increase in insulin resistance, as a result of which insulin starts, and the sugars grow; weight gain, unstable sugars, hypoglycemia and deterioration of health. Insulins in diabetes mellitus is a therapy when all other options are ineffective or when a person has terminal renal / hepatic insufficiency (that is, rare situations). But even in such situations, with properly selected insulin therapy and diet, you can maintain ideal sugars, well-being and body weight.
Therefore, your main task at the moment is to search for a competent endocrinologist, to be examined and to select an effective and safe therapy.
Doctor endocrinologist Olga Pavlova