by Jangra
Question: Dear Sir,
It is understood that after quitting smoking, blood sugar normally increases, and this has happened in my case. What preventive measures should I take to control diabetes?
I usually walk for 50 minutes to one hour, but after a sudden fall I have pain in my right knee and can now walk only 30–35 minutes.
How many times can two pieces of bitter melon be taken in a day? I take it regularly, but is it advisable during hot weather? I also take one teaspoon of an Ayurvedic medicine called Madhunashini churan.
I would be grateful for a detailed reply.
—Rajiv Sharma
Quitting smoking is one of the best steps you can take for diabetes, heart, circulation, kidney and eye health. Blood glucose does not inevitably rise after quitting. Some people experience temporary changes because nicotine exposure changes, appetite or weight increases, stress and sleep are disrupted, or diabetes treatment needs adjustment. Monitor your readings more often for several weeks and discuss persistent changes with your clinician—do not restart smoking.
There is no medically established dose of bitter melon for diabetes, and Madhunashini churan has not been proven to replace prescribed treatment. Using several glucose-lowering products together may cause low blood sugar or other adverse effects. Knee pain after a fall should be assessed if it persists, swells or limits walking.
Nicotine can raise glucose and make insulin work less effectively. After smoking cessation, glucose may eventually become easier to manage, but the transition differs between individuals. Withdrawal stress, increased snacking, reduced activity because of knee pain, weight gain, illness, poor sleep and nicotine-replacement products may all influence readings.
Nicotine gum, patches and lozenges are evidence-based quitting aids. The important issue is not simply whether gum contains sugar; nicotine itself may affect glucose. Use cessation medicine according to a clinician’s or pharmacist’s advice, especially if you take insulin or tablets that can cause hypoglycemia.
Thirty minutes of comfortable activity is still valuable, but do not push through worsening pain after a fall. Until the knee is assessed, consider low-impact options that do not aggravate symptoms, such as a stationary bicycle with light resistance, swimming or water exercise, seated upper-body activity and clinician-approved strengthening exercises.
Stop an activity that causes sharp pain, instability or increasing swelling. Seek prompt assessment if you cannot bear weight, the knee is deformed, locked, very swollen, red or hot, or pain remains significant. The related discussion on diabetes and knee problems explains why persistent knee pain should not automatically be attributed to diabetes.
Bitter melon can be eaten as a vegetable, but studies have not established a reliable therapeutic dose for diabetes. “Two pieces” is not a precise dose because fruit size, preparation and concentration vary. Evidence is insufficient to recommend taking it several times daily to lower glucose.
Concentrated juice, powder or capsules may cause digestive symptoms and may add to the effects of insulin or diabetes tablets. Hot weather does not make bitter melon a proven treatment; dehydration itself can worsen glucose. Drink according to your medical needs, particularly if you have heart or kidney disease. See the evidence and cautions in our diabetic herbs safety guide.
Do not assume that a product is safe or effective because it is described as natural. The exact ingredients and strength of Madhunashini products may differ, and good human evidence for diabetes control is lacking. Some Ayurvedic products have also been found to contain undeclared lead, mercury, arsenic or other harmful substances.
Show the actual package and full ingredient list to your doctor or pharmacist. Do not combine it with bitter melon or prescribed diabetes medicine without a medication review, and never use it as a substitute for proven treatment.
Seek urgent care for severe weakness, confusion, fainting, chest pain, difficulty breathing, repeated vomiting, moderate or high ketones, or persistently very high glucose with dehydration. Treat suspected hypoglycemia promptly according to your diabetes plan. For the knee, urgent assessment is appropriate after a fall if you cannot bear weight, there is obvious deformity, rapidly increasing swelling, or the joint becomes red and hot.
Answered by: Dr. Albana Greca Sejdini, MD, MMedSc
Medically reviewed by: Dr. Ruden Cakoni, MD, Endocrinologist
Last reviewed: July 2026
Medical disclaimer: Educational only—not personal medical advice. Diagnosis and treatment should come from a qualified clinician who knows the patient’s medical history.
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