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Diabetic. On Insulin. Taking Diamicron. SGOT Above Normal:59.5 And SGPT Above Normal: 117. Help?

Posted on Thu, 7 Nov 2013

Question: I am diabetic from last 5 years and now I am 31.
I am on insulin (Lantus) from last 2 to 3 years (36 units at night) and also taking tablets (Diamicron xr mex 500mg) in morning and after lunch. But my HbA1c is saying Unsatisfactory Control value is 8.9.

I am taking Rozavel F from last 2 years at night and now my cholesterol is below normal level.
Total Cholesterol: 104
HDL: 24
LDL: 58

SGOT Above Normal : 59.5
SGPT Above normal : 117

Hemoglobin Low: 12.9
Iron below normal: 51
Moderate anisopoikilocytosis, Predominantly microcytic and hypochronic cells with ovalocytes & elliptocytes.
T3, T4, TSH Normal
Exerciser: 15 to 20 min walk after dinner
Food: Normal food, no sugar in food, no potato
Life style: Mostly sitting job, currently no stress

What is wrong???? Please help

Answered by Dr. Anantharamakrishnan (4 hours later)

Brief Answer:
Need more tests / life style changes / drugs

Detailed Answer:
Hi friend,
Welcome to Health Care Magic

There are several issues involved.
The best option will be to get admitted to a Multi-speciality Tertiary Care Hospital / get fully evaluated / and follow up with a diabetologist

Liver enzymes are mildly elevated / could be from fatty liver or the statins.
Need to repeat it after a month
Ultrasound of the liver can shed light.
Hepatologist (liver specialist) consultation may be useful for reassurance.

There is mild anaemia
Iron deficiency is most likely
Haematologist may order a few more investigations, before treatment

Sugar is poorly controlled.
A better option is to take short acting insulin before each meal (3 times) in addition to basal insulin like lantus

Diamicron may not help, if there is no intrinsic insulin
Metformin dose may be increased
Alpha-glucosidase inhibitor drugs like acarbose or voglibose that inhibit absorption can be added

Life style changes – reduction of weight /stricter food / more exercise / stopping tobacco and alcohol – are important

The best option will be to get admitted to a Multi-speciality Tertiary Care Hospital / get fully evaluated / and follow up with a diabetologist

Take care
Wishing all well
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (8 hours later)

Hi
1.Do you think taking Rozavel F 10mg has resulted in low level of Cholesterol. What is the normal course ( time ) for reducing Cholesterol did i took it for too long?
What are the side effects low Cholesterol levels?

2.Diamicron may not help, if there is no intrinsic insulin. What is intrinsic insulin.
Dr. Mutha Pune, I have combination of Type 1 and Type 2 diabetics
Dr. XXXXXXX Phadke, said that I have Type 2 diabetics.
I am not over weight. but have family history (mon and dada) both were diabetic.

Thank you again for your valuable inputs and time.
Regards
XXXXXX

Answered by Dr. Anantharamakrishnan (24 minutes later)

Brief Answer:
No worry of low cholesterol

Detailed Answer:
Hi

This level of cholesterol is no cause for concern / no side effects from this
It is very favourable in Diabetic (LDL level of 70 or lower is the aim)
It is difficult to achieve in most people!
The drug needs to be taken lifelong…

The level of body’s insulin (or C-peptide) can be measured / and concludes Type 1 or 2

Regards

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar