### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello Sir, My mothers age is 51 & she is having diabetic from past 15-20 yrs & she is taking medicine from doctors on regular basis but the sugar level is not decreasing.Recent report 392(before breakfast) & 450(after breakfast).She had taken insulin as well for some time but now she left.Suggest me regarding the same.Regards,Prabal0000

### output:

Hell, When a person gets diabetes, it is observed that almost 50% of his or her Insulin producing cells of pancreas (Beta cells) tend to be non-functional.  Further, if blood glucose is not rapidly controlled, then genotoxicity due to hyperglycemia (high glucose in blood) further damages beta cells. Therefore, after few years suffering with diabetes almost every single patient has to start taking insulin as most of the cells are non-functional. There is no insulin in the system. It has to be given on daily basis for controlling blood glucose, that too for lifetime. Looking at the blood glucose levels mentioned, your mother has to be on Insulin injections along with oral anti-diabetic Chat Doctor.  There is no other option. If the glucose level is not controlled effectively, the long term serious consequences of diabetes will start manifesting like retinal problems, peripheral neuropathy, affection of blood supply to the lower limbs, cardiovascular diseases and kidney disease. Ideally if one has to achieve good control then fasting glucose should be closer to 100 mg, PP 160 to 170 mg & HbA1c%Along with Insulin and other 