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Is Glyiyphage, Glavus And Pioz The Right Treatment For Controlled Diabetes?
Question: My name is XXXXXX,Iam 49 year old,I am a diabetic patient for the last four yers,my HbA1c test resulis 8.2 Now am taking glcyphage G2 half morning.Pioz 15 ,one after noon,and Galvusmet 50/500mg night,At present bloodsugar is 120-160 to max220 after food,after two hours,treatment is sufficient,or need any change medicine or dosage,please help
Brief Answer:
Switch to Glargine and titrate oral drugs
Detailed Answer:
Hi dear.Thanks for giving me an opportunity to answer your query.
I would like to know your latest fasting sugar value if you may have?
In my practice most of my patients achieve the HBA1c goal between 7-7.5 which I would prefer ideally.
In my opinion since sugars have been optimally controlled by oral hypoglycemic drugs like glycyphage and glavus and Pioz it is advisable to start on a low dose of long acting Insulin(glargine) to control your sugars (fasting thereby postprandial) to achieve HBA1c goals.Optimal goals prevent/postpone the complications of the diabetes.
Glargine is given once daily and chance of hypoglycemic episodes are less since it mimics the normal basal rhythm of insulin secretion in the body(peakless insulin).But this might add to the cost of therapy.Depending on the sugars levels I would adjust/lower the dose of the oral drugs.
Hope this anwers your query.
Switch to Glargine and titrate oral drugs
Detailed Answer:
Hi dear.Thanks for giving me an opportunity to answer your query.
I would like to know your latest fasting sugar value if you may have?
In my practice most of my patients achieve the HBA1c goal between 7-7.5 which I would prefer ideally.
In my opinion since sugars have been optimally controlled by oral hypoglycemic drugs like glycyphage and glavus and Pioz it is advisable to start on a low dose of long acting Insulin(glargine) to control your sugars (fasting thereby postprandial) to achieve HBA1c goals.Optimal goals prevent/postpone the complications of the diabetes.
Glargine is given once daily and chance of hypoglycemic episodes are less since it mimics the normal basal rhythm of insulin secretion in the body(peakless insulin).But this might add to the cost of therapy.Depending on the sugars levels I would adjust/lower the dose of the oral drugs.
Hope this anwers your query.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Insulins alone help in late stages
Detailed Answer:
Hi dear.Thanks for writing me back.
Glargine is a basal insulin which mimics the basal insulin secretion in the body.It is a long acting insulin and is given once daily.
Dosage depends on the body weight(starting dose is approximately 10 units) and adjusted depending on the fasting sugars.
I were to continue both oral drugs along with initiation of insulin and monitor your HBA1c and fasting sugars.As long as sugars are under control you may continue the same medication.If the goals are not achieved and HBA1c is high (>8.5) this means that the secretion of the insulin in the body is gradually declining due to the failure of cells in the body to produce insulin (disease progression).
Then I were to switch to insulins(combination of rapid acting analogues (aspart/ glulysine)+ long acting analogues(glargine).Thus insulins alone are used when oral drugs are no longer beneficial.
Cost of glargine depends on the generic chosen.Lantus costs approximately 2500/- for 10ml vial which lasts for approximately 3 months.
Hope this answers your question.
Insulins alone help in late stages
Detailed Answer:
Hi dear.Thanks for writing me back.
Glargine is a basal insulin which mimics the basal insulin secretion in the body.It is a long acting insulin and is given once daily.
Dosage depends on the body weight(starting dose is approximately 10 units) and adjusted depending on the fasting sugars.
I were to continue both oral drugs along with initiation of insulin and monitor your HBA1c and fasting sugars.As long as sugars are under control you may continue the same medication.If the goals are not achieved and HBA1c is high (>8.5) this means that the secretion of the insulin in the body is gradually declining due to the failure of cells in the body to produce insulin (disease progression).
Then I were to switch to insulins(combination of rapid acting analogues (aspart/ glulysine)+ long acting analogues(glargine).Thus insulins alone are used when oral drugs are no longer beneficial.
Cost of glargine depends on the generic chosen.Lantus costs approximately 2500/- for 10ml vial which lasts for approximately 3 months.
Hope this answers your question.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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