On Metformin, Enalapril And Metroprolol For Diabetes And High BP. Sugar Level And BP Elevated After Infection. Suggest?

Posted on Sun, 29 Sep 2013

Question: I'm a diabetic for over 6 years. Prior to Feb. of this year, my primary doc hade taking metformin 500 mg once a day along with enalapril & metoprolol ER for my diabetes & High blood pressure. In Feb. I caught a nasty viral infection which elevated my sugar levels. My doc increased my Metformin to 1000 mg 2x a day and since my BP elevated as well she added norvasc 5 mg once every evening. I've been taking these since that time. About 2 days ago I was hospitalized for chest pains and given a stress test (which came out normal). During my stay at the hospital, they did not give me any of my meds but the enalapril. They stated that I couldn't take them due to the contrast I received for the stress test. They monitored both my BP & sugar closely. Which I have been doing since my release. My BP has remained well below 120/80 all day. My sugar does elevate to about 200 after eating but has generally stayed around 110 - 120. On an empty stomach around 90. I haven't been able to contact my doc to know if I should go back to the regimen I was on due to the weekend. I don't want to take the medication fearing it may drop my sugar too low or continue not taking any and my sugar suddenly goes too high. What should I do?

Answered by Dr. Dr. Shruti Rijhwani (14 minutes later)

Brief Answer:
Get an HbA1c test done.

Detailed Answer:
Dear Sir,

Thank you for posting your query on XXXXXXX

Well looking into our problem I see that you are having fluctuating sugar levels . You should get an HbA1c test that gives an idea about the sugar control over 3 months . This will help you to assess the sugar control .

Dont worry metformin does not lead to hypoglycemia as it increases the peripheral insulin sensitivity not the insulin release so it will not lead to hypoglycemia .

Take care.

Dr. Shruti

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

Follow up: Dr. Dr. Shruti Rijhwani (3 minutes later)

Is this test one that i can get at a pharmacy or do i need a doctors order for a lab?

Answered by Dr. Dr. Shruti Rijhwani (4 hours later)

Brief Answer:
Depends on where you reside.

Detailed Answer:
Dear sir,

It is a routine test for diabetics . But I think you will require doctors order for lab . It differs from country to country that you need prescription or not.

Dr. Shruti

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

Follow up: Dr. Dr. Shruti Rijhwani (1 hour later)

I was able to find the test at a local pharmacy. My A1c result was 6.4%. Also I took the Metformin 500mg this morning as you recommended. My sugar level is 104 now after a small meal. I will continue to monitor it this evening and confer with my primary doc tomorrow to determine what I will be taking on a daily basis. Is my A1c okay for now?

Answered by Dr. Dr. Shruti Rijhwani (18 hours later)

Brief Answer:
Yes its OK.

Detailed Answer:
Dear sir,

You almost have HbA1c in normal range.

Dr. Shruti

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

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