Diabetes in smoker

46 year old diabetic who has had an average HbA1C between 11 and 14 for the past 3 years under a physicians follow up. He is a chronic smoker as he is a long distance lorry driver. He was previous on s/ c insulin mixtard 20 IU at night janumet 50/ 1000mg bd and diamicron 160mg daily.

Stopped the janumet as he was having serious GERD issues despite being very thin. Stopped the insulin.

Added a SGLT2 inhibitor and kept with the diamicron. Added imusil 1 bd and dorza 20 drops bd and akkermansia 10 drops bd. The sugar levels have been gradually coming down and after 5 months for the first time hba1c is 6.4 and post prandial glucose is less than 8.

We also added cal phos and bryonia bd as he was constantly thirsty and had bad bone pain. All his symptoms has resolved including his insomnia. He smokes lesser these days and feels more alert.

He is also on a mix of alpha lipoc acid with vit b12.

Note : add alumina for smokers – they tend to have aluminium overload, considering the low calcium aluminium toxicity will be high.