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How Effective Is Sitagliptin For Diabetes?
Question: I HAVE TYPE 2 DIABETES FOR LAST 8 YEARS . EARLIER I WAS TAKING GLAZID 80 WITH GLUCEPHAGE 500 MG IN THE MORNING AND GLYCEPHAGE 1000 MG IN THE EVENING . WHEN THE LEVELS WERE CONTROLED I HAVE CHANGED TO GLYCOMET GP2 BEFORE BREAKFAST AND VOGLINORMGM2 BEFORE DINNER . THE LEVELS ARE STILL NOT CONTROLLED . FASTING GOING AS HIGH AS 220 AND RANDOM ALSO IN THE SAME RANGE . SHALL I START SITAGLIPTIN 25 BD . WHAT I SHOULD TAKE IN ADDITION TO THIS . OR IF THERE IS ANY OTHER SUGGESION . I AM 71 YEARS PLUS . ALSO HAVE HIGH BP AND TAKE TELMA AM FOR THAT O.D IN THE MORNING
Brief Answer:
You can start sitagliptin 50 mg BD
Detailed Answer:
Hi XXXX,
Welcome to HCM. I have gone through your question and understand your concerns.
You need to have some additional tests done before adding medications. Do an HbA1C (3 months' average blood glucose), kidney function tests and diabetic retinopathy screening (eye test).
If HbA1C is high (>9%), it is better to add insulin at least once daily (basal insulins like glargine) along with your oral medications. If it is less than 9% or if you don't prefer insulins you can increase the dose of Glycomet GP2 to twice daily and add sitagliptin. The dose of sitagliptin is 50 mg twice daily if your kidney function is normal.
Hope I have answered your query. If you have any further questions I will be happy to help.
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.
You can start sitagliptin 50 mg BD
Detailed Answer:
Hi XXXX,
Welcome to HCM. I have gone through your question and understand your concerns.
You need to have some additional tests done before adding medications. Do an HbA1C (3 months' average blood glucose), kidney function tests and diabetic retinopathy screening (eye test).
If HbA1C is high (>9%), it is better to add insulin at least once daily (basal insulins like glargine) along with your oral medications. If it is less than 9% or if you don't prefer insulins you can increase the dose of Glycomet GP2 to twice daily and add sitagliptin. The dose of sitagliptin is 50 mg twice daily if your kidney function is normal.
Hope I have answered your query. If you have any further questions I will be happy to help.
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Shall i stop VoglinormGM2 and take GlycometGP2 instead or take GlycometGP2 in addition to Voglinorm 2GM2 . The HbA1C level is 8.8 , kidney function test creatinin 0.68, BUN 10.48 URIC ACID 5.2 AND CALCIUM 9.2 ALL IN THE NORMAL RANGE , hdL cHOLESTROL IS LOWER 31 AND ldl CHOLESTEROL IS HIGHER 131 . TC/HDL RATIO IS 5.4 AND LDL/HDL RATIO 4.2 WHICH ARE HIGHER THAN NORMAL .
BESIDES SUGAR LEVEL WHAT OTHER THINGS TO WATCH WHILE TAKING SITAGLIPTIN . AFTER HOW MANY HOURS OF TAKING THE DRUG THE SUGAR LEVEL SHOULD BE MONITORED . THE MEDICINE TO BE TAKEN HOW MUCH BEFORE BREAKFAST AND DINNER . BOTH SITAGLIPTIN AND GLYCOMET GP2 CAN BE TAKEN TOGETHER OR SOME GAP OF TIME IS TO BE THERE
BESIDES SUGAR LEVEL WHAT OTHER THINGS TO WATCH WHILE TAKING SITAGLIPTIN . AFTER HOW MANY HOURS OF TAKING THE DRUG THE SUGAR LEVEL SHOULD BE MONITORED . THE MEDICINE TO BE TAKEN HOW MUCH BEFORE BREAKFAST AND DINNER . BOTH SITAGLIPTIN AND GLYCOMET GP2 CAN BE TAKEN TOGETHER OR SOME GAP OF TIME IS TO BE THERE
Brief Answer:
See detailed answers
Detailed Answer:
Hi XXXX,
Welcome back.
Noted your reports - HbA1C is high, but not very high. Kidney function normal. Little bit more control on you cholesterol values needed.
The answers to your questions
1. You can take Glycomet GP2 in morning + Voglinorm 2GM2 in evening for the time being. If sugars are not controlled by adding sitagliptin, and if you don't prefer insulin, increase the dose of Glycomet GP2 to morning and night before food with Voglinorm 2GM2 before lunch.
2.You can start on Sitagliptin either 100 mg once daily or 50 mg twice daily. Can take it with Glycomet GP2. No timing needed with food or other tablets. Once daily dose 100 mg is as good as twice daily 50 mg dose. The chance of low sugars is less with sitagliptin - relatively safe drug. One rare complication is pancreatitis - so report your doctor if you are having abdominal pain.
3. The LDL cholesterol in diabetics should be less than 100 mg/dl - so if you cant bring it down with diet and exercise, you need to be started on medications.
4. You can do a repeat fasting and after food (after 2 hours) blood sugars after 5 days of changing the medications. Insulin will be a good option if sugars are not coming to target within 2 weeks time of adding sitagliptin.
Hope this information was useful to you
Regards
Dr Ajish TP
See detailed answers
Detailed Answer:
Hi XXXX,
Welcome back.
Noted your reports - HbA1C is high, but not very high. Kidney function normal. Little bit more control on you cholesterol values needed.
The answers to your questions
1. You can take Glycomet GP2 in morning + Voglinorm 2GM2 in evening for the time being. If sugars are not controlled by adding sitagliptin, and if you don't prefer insulin, increase the dose of Glycomet GP2 to morning and night before food with Voglinorm 2GM2 before lunch.
2.You can start on Sitagliptin either 100 mg once daily or 50 mg twice daily. Can take it with Glycomet GP2. No timing needed with food or other tablets. Once daily dose 100 mg is as good as twice daily 50 mg dose. The chance of low sugars is less with sitagliptin - relatively safe drug. One rare complication is pancreatitis - so report your doctor if you are having abdominal pain.
3. The LDL cholesterol in diabetics should be less than 100 mg/dl - so if you cant bring it down with diet and exercise, you need to be started on medications.
4. You can do a repeat fasting and after food (after 2 hours) blood sugars after 5 days of changing the medications. Insulin will be a good option if sugars are not coming to target within 2 weeks time of adding sitagliptin.
Hope this information was useful to you
Regards
Dr Ajish TP
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have taken Sitagliptin 100 mg for the last two days . Monitored sugar level in the morning which is 174 and today 182 . BP yesterday was 146/96 and pulse 78 , today 154/98 and pulse 86 . I am taking Telma Am in the morning . There is drowsy feeling and there was one time Cramp in the left hand thumb and index finder yesterday .
You think it is normal or advice some thing more
You think it is normal or advice some thing more
Brief Answer:
Sugars still high
Detailed Answer:
Hi XXXX,
Welcome back.
Your sugars are still on the higher side. We can wait for another 2-3 weeks for full action of new regimen. The symptoms are due to uncontrolled sugars. I think it is better to wait for sugars to come down. rather than add on new medications.
Regard
Dr Ajish TP
Sugars still high
Detailed Answer:
Hi XXXX,
Welcome back.
Your sugars are still on the higher side. We can wait for another 2-3 weeks for full action of new regimen. The symptoms are due to uncontrolled sugars. I think it is better to wait for sugars to come down. rather than add on new medications.
Regard
Dr Ajish TP
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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