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Does Daily Intake Of Metpure XL Cause Diabetes?

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Posted on Tue, 7 Oct 2014
Question: Dear Doctor, please review my medical profile, am I on right medical track ? I am taking METPURE XL-12.5 daily does it increases my chances of becoming diabetic.
doctor
Answered by Dr. Anantharamakrishnan (8 hours later)
Brief Answer:
Nothing urgent or serious

Detailed Answer:
Dear friend,
Welcome to Health Care Magic

LDL is bad cholesterol – lower, the better.
In the absence of any other risk factor 100 is ideal for LDL-C. / In the presence of ischemia, 70 should be the aim.

     Keep your weight to normal / even a little less
     Quit smoking, if you are a smoker
     Do regular EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week. Isometric exercise (like bull worker) is bad.
     Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / XXXXXXX sweets are made in ghee.../ Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil.

Repeat the lipids test in 6 weeks. .. You may also do Glucose Tolerance Test (GTT) at the same time
Cholesterol can still be high, in spite of diet and exercise – you need drugs; because it is also manufactured in the liver – and that is determined by heredity. Statin is the first choice. Some start it straight away – even with normal levels, even without problems (Primary Prophylaxis)

It is not clear why you are taking Metoprolol (Metpure). It does not increase the chance of getting Diabetes.

Take care
Good luck
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (2 days later)
Dear Doctor,
In my question, I have requested you to examine my medical history given in my profile and advise me weather I am on right track i.e am I required to do any interventional treatment to get my blockages treated ?

I have listed the drugs, I am presently taking. Are they ok? Do they have any side effects to increase my risk of adiabatic tendency?

I had given my exercise routine. I need your comments?

I am taking Metoprolol as advised by Doctor? Is it not required?

My body weight is 80kg, and a height of 171cm.

Looking for a specific reply to my case.
Regards,
doctor
Answered by Dr. Anantharamakrishnan (8 hours later)
Brief Answer:
Overweight

Detailed Answer:
Hi

There is no medical history given in the profile –
Only some lab results / no past, personal or family history / No examination findings / No exercise routine details…
Probably omitted to upload -

No specific response is therefore feasible …
Check again / talk with service provider / Or Write again

You are overweight / Your BMI is 27.4

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (16 hours later)
Dear Doctor my Medical History:
CARDIOLOGY : TMT POSITIVE-inducible Myocardial Ischemia, in annual medical check up in Dec,2001,
Angiogram Oct.2002, indicates LMCA- Normal, LAD-Type-III and irregularities thought its course, Diagonals were normal, LCX- Non- dominant with 100% block after thin OMI with TIMI flow distally, RCA- Dominant and had 95% stenosis at the crux. PDA and PLB had proximal 90% lesion respectively.
Myocardial perfusion Study XXXXXXX 2002 XXXXXXX 2004& Aug 2006- Normal resting LVEF, Good effort tolerance, Evidence of stress induced LV dysfunction seen, Significant areas of reversible ischemia are seen in inferior, inferolateral and mid anterior walls of myocardium. No evidence of reversible ischemia is seen anywhere else in the myocardium,
Exercise Stress Echo Dec,2013-Inview of these ST-T changes TMT is strongly Positive for inducible ischemia, but no regional wall motion abnormality at peak exercise suggestive of stress echo is negative for reversible myocardial ischemia, till 104% of THR achieved.
Leading active normal life, Working as XXXXXXX executive, Everyday one hour morning brisk walk and climb 13 floors to my flat.
I have no symptoms of any breathlessness or any signs of cardiac problems.

In my question, I have requested you to examine my medical history and advise me weather I am on right track i.e am I required to do any interventional treatment to get my blockages treated ?

I have listed the drugs, I am presently taking. Are they ok? Do they have any side effects to increase my risk of adiabatic tendency?

I had given my exercise routine. I need your comments?

I am taking Metoprolol as advised by Doctor? Is it not required? I have come across the medical literature where it states that Metoprolol has a tendency to increase the risk of diabetes.

Some other doctor advised me to take ZAART-25(LosartanPotassium) instead of Metoprolol. What is your opinion?

Looking for a specific reply to my case.
doctor
Answered by Dr. Anantharamakrishnan (5 hours later)
Brief Answer:
Metoprolol & Intervention MUST

Detailed Answer:
Hi
TMT reflects function (Physiology) – there is inducible ischemia.
A negative stress ECHO means there is no abnormal wall motion – till now
It is less sensitive than Perfusion study – which is more accurate and has shown definite deficiency

Angio shows structure (Anatomy)
YES – There is mechanical obstruction and it certainly needs mechanical relief.
Intervention is necessary for sure – that is the only certain and disease modifying treatment….other approaches are palliative / symptomatic.
Absence of symptoms is no proof of absence of disease…
Sudden death or heart attack is the first symptom in many people and hence the need to be proactive…
The drugs are OK
Metoprolol is a beta-blocker and is appropriate for this situation and should be continued…
The beta-blockers have a very small but sure effect in increasing the blood sugar or masking low sugar – but its benefits far outweigh the risks. You are taking the least (maximum 200 mg or more) and there is no concern from this aspect. Even in proved diabetics, that is the drug of choice.
It is likely that you already have Mild Diabetes or Impaired Glucose Tolerance - have a Glucose Tolerance Test (GTT)

NO – you should not stop Metoprolol.
You can supplement it not supplant with losartan… it is from a different class / has additional benefits – helping in reduction of blood pressure, modulation of ventricle enlargement and so on

Your target LDL is 70
Statins will definitely be useful in such situations. They also have effects beyond cholesterol – like antioxidant properties. They too have a small incidence of the issue if inducing diabetes – but the incidence is very small and the benefits far outweigh the risks

You should also be taking antiplatelet drugs like aspirin

The life style modification (exercise routine) is excellent.

Discuss with your cardiologist and followup

Regards
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Anantharamakrishnan (3 days later)
Dear Doctor,
Thanks for the detailed reply. Please bear with me for some inquisitive questions.
The blockages have been detected almost 13 years back. All these years I have not encountered any problems or symptoms. Does this mean around these blocked arties sufficient secondary's are available to take care of oxygenated blood flow to that part heart mussel.

Can I postpone the intervention some time? As I am growing older does it become more complicated ?

I have a advise from a Cardiologist, who says do not any intervention as long as you do not have any symptoms.

I am taking Clopivas AP-75 instead of asprin.

Looking for your advise.
doctor
Answered by Dr. Anantharamakrishnan (9 hours later)
Brief Answer:
Intervention safer than wait & watch

Detailed Answer:
Dear Mr XXXXXXX

CLOPIVAS AP 75 has TWO anti-platelet drugs – Aspirin AND Clopidogrel

You are lucky / blessed – to be free of symptoms or morbidity
It is because the blood supply is safeguarded by collaterals (“secondary arteries”) … one never knows the state of the collaterals and their reaction…

With increasing age, the disease can only be expected to progress or at the best, remain stationary. Rarely does it regress – with life style modification and medicines

Absence of symptoms is no proof of absence of disease –
I am still for intervention…
With time, it may be difficult or impossible in some complete blocks to do angioplasty / needing bypass surgery…
Earlier the better – the aim is to ensure blood flow. The collaterals may remain dormant and help in future too, if there is progression of the pathology

Regards
May Lord Venkateswara bless you

Note: For further queries related to coronary artery disease and prevention, click here.

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

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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Does Daily Intake Of Metpure XL Cause Diabetes?

Brief Answer: Nothing urgent or serious Detailed Answer: Dear friend, Welcome to Health Care Magic LDL is bad cholesterol – lower, the better. In the absence of any other risk factor 100 is ideal for LDL-C. / In the presence of ischemia, 70 should be the aim. Keep your weight to normal / even a little less Quit smoking, if you are a smoker Do regular EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week. Isometric exercise (like bull worker) is bad. Healthy FOOD is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / XXXXXXX sweets are made in ghee.../ Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil. Repeat the lipids test in 6 weeks. .. You may also do Glucose Tolerance Test (GTT) at the same time Cholesterol can still be high, in spite of diet and exercise – you need drugs; because it is also manufactured in the liver – and that is determined by heredity. Statin is the first choice. Some start it straight away – even with normal levels, even without problems (Primary Prophylaxis) It is not clear why you are taking Metoprolol (Metpure). It does not increase the chance of getting Diabetes. Take care Good luck