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Question: sir, my mother is 59 yrs old,diabetic and is taking following medicines for last 3 years:
1. sitagliptin 100 mg or linaglipitin tablets 5 mg (01 tablet before food once a day)
2. multivitamins - biplex forte
3. calcium- cipcal -500 cipla
4. blood pressure- telmisafe 40 40 mg.
i have consulted another medical specialist doctor for review of medicines. he has prescribed the following:
1. metformin tablets 500, thrice a day after food
2.ecosprin -75, once a day after food
3. losarfine-25, (morepen laboratories) once a day after food
4. calcium- afdcal+d3
5. beplex forte- biotin 260 mcg
my mother is 59 years old. her Bp is under 130/85. her last medical checkup details are:
sugar(F)- 125 mg/100 ml
sugar (PP) - 149bmg/100ml
s. urea 25
creatine 0.7
total cholestrol- 171
triglyceride- 112
hdl cholestrol- 43
ldl cholestrol- 103
urine test- normal.
request check the new medicines and the dosages are correct. Should she switch over to new medicines? any side effects? for how long she should take theses medicines for next review? any further tests to be carried out.? further guidance...
thanks and regards
1. sitagliptin 100 mg or linaglipitin tablets 5 mg (01 tablet before food once a day)
2. multivitamins - biplex forte
3. calcium- cipcal -500 cipla
4. blood pressure- telmisafe 40 40 mg.
i have consulted another medical specialist doctor for review of medicines. he has prescribed the following:
1. metformin tablets 500, thrice a day after food
2.ecosprin -75, once a day after food
3. losarfine-25, (morepen laboratories) once a day after food
4. calcium- afdcal+d3
5. beplex forte- biotin 260 mcg
my mother is 59 years old. her Bp is under 130/85. her last medical checkup details are:
sugar(F)- 125 mg/100 ml
sugar (PP) - 149bmg/100ml
s. urea 25
creatine 0.7
total cholestrol- 171
triglyceride- 112
hdl cholestrol- 43
ldl cholestrol- 103
urine test- normal.
request check the new medicines and the dosages are correct. Should she switch over to new medicines? any side effects? for how long she should take theses medicines for next review? any further tests to be carried out.? further guidance...
thanks and regards
Brief Answer:
You can choose either of these medications
Detailed Answer:
Hi XXXXXX,
Welcome to HCM. Thanks for the questions.
Your mother's diabetes, cholesterol and BP are near to target.
Whatever be the treatment you choose, the target control is:
1. Fasting blood sugar less than 130 mg/dl, after food less than 180 mg/dl and HbA1c ( a measure of 3 month average blood sugar) less than 7%.
2. LDL cholesterol less than 100 mg/dl
3. BP less than 140/90 mm hg
I will explain the treatment given by both doctors.
Diabetes treatment:
Sitagliptin/Vildagliptin : relatively safe drug, rare side effect is pancreatitis. Less hypoglycaemia. Expensive but good drug to start with.
Metformin : First drug usually started in diabetes. Less expensive. Side effects is mostly gastritis.
Hypertension:
Telmisafe and Losarfine are same group of medication. Both are good and ideal antihypertensive in diabetes
Other medications:
Calcium and multivitamins can be continued.
Ecospirin is a blood thinner that can be taken at this age as it can prevent heart disease.
So the treatment she is on is fairly good. The new treatment is less expensive as Sitagliptin is replaced by Metformin. The first line recommended treatment in diabetes is Metformin or Sitagliptin. I prefer Sitagliptin as most patients are comfortable with this medication.
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
You can choose either of these medications
Detailed Answer:
Hi XXXXXX,
Welcome to HCM. Thanks for the questions.
Your mother's diabetes, cholesterol and BP are near to target.
Whatever be the treatment you choose, the target control is:
1. Fasting blood sugar less than 130 mg/dl, after food less than 180 mg/dl and HbA1c ( a measure of 3 month average blood sugar) less than 7%.
2. LDL cholesterol less than 100 mg/dl
3. BP less than 140/90 mm hg
I will explain the treatment given by both doctors.
Diabetes treatment:
Sitagliptin/Vildagliptin : relatively safe drug, rare side effect is pancreatitis. Less hypoglycaemia. Expensive but good drug to start with.
Metformin : First drug usually started in diabetes. Less expensive. Side effects is mostly gastritis.
Hypertension:
Telmisafe and Losarfine are same group of medication. Both are good and ideal antihypertensive in diabetes
Other medications:
Calcium and multivitamins can be continued.
Ecospirin is a blood thinner that can be taken at this age as it can prevent heart disease.
So the treatment she is on is fairly good. The new treatment is less expensive as Sitagliptin is replaced by Metformin. The first line recommended treatment in diabetes is Metformin or Sitagliptin. I prefer Sitagliptin as most patients are comfortable with this medication.
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
thanks for the reply. We will go with the new prescription i.e metformin tablets 500, thrice a day after food.
Sir are the dosages correct? plz check for all the medicines.
and how long for the next review,?
and how often checkups to be done?
regards
Sir are the dosages correct? plz check for all the medicines.
and how long for the next review,?
and how often checkups to be done?
regards
Brief Answer:
Dosages are correct. Review at least 3 monthly
Detailed Answer:
Hi XXXXXX,
Welcome back.
The dose prescribed is correct. The dose of Metformin is 500 - 2500 mg/day. Now the dose is 1500 mg /day - a good dose to start with. The dose of other medications are ok. The dose of antihypertensive (Losarfine) has to be adjusted based on BP.
Follow up depends on diabetes control. In your mother sugars are now well controlled. So follow up with:
1. FBS/PPBS every month
2. HbA1c every 3 months
3. Lipid profile every 6 months
4. Kidney and liver function, diabetic retinopathy screening, neuropathy test, urine microalbumin every year ( Most hospitals do these tests as annual diabetes package)
Follow up with physician every 2-3 months. The duration can be increased or decreased based on the investigation reports.
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Dosages are correct. Review at least 3 monthly
Detailed Answer:
Hi XXXXXX,
Welcome back.
The dose prescribed is correct. The dose of Metformin is 500 - 2500 mg/day. Now the dose is 1500 mg /day - a good dose to start with. The dose of other medications are ok. The dose of antihypertensive (Losarfine) has to be adjusted based on BP.
Follow up depends on diabetes control. In your mother sugars are now well controlled. So follow up with:
1. FBS/PPBS every month
2. HbA1c every 3 months
3. Lipid profile every 6 months
4. Kidney and liver function, diabetic retinopathy screening, neuropathy test, urine microalbumin every year ( Most hospitals do these tests as annual diabetes package)
Follow up with physician every 2-3 months. The duration can be increased or decreased based on the investigation reports.
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
sir, can she take any other medicine other than Metformin, as she has to take it three times a day, which is troublesome for her.
she is having gastrics also. . Is it from the medicines?
kind regards
she is having gastrics also. . Is it from the medicines?
kind regards
Brief Answer:
You can switch over to Sitagliptin or linagliptin
Detailed Answer:
Hi XXXXXXX,
Welcome back.
The major problem with Metformin is gastritis.
The options you have are:
1. Switch back to Sitagliptin or Linagliptin as they are better tolerated.
2. Change the brand of Metformin - Brands like Carbophage are with less gastric irritation.
3. Swith to long acting Metformin- XR and SR forms are available with less gastric irritation
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
You can switch over to Sitagliptin or linagliptin
Detailed Answer:
Hi XXXXXXX,
Welcome back.
The major problem with Metformin is gastritis.
The options you have are:
1. Switch back to Sitagliptin or Linagliptin as they are better tolerated.
2. Change the brand of Metformin - Brands like Carbophage are with less gastric irritation.
3. Swith to long acting Metformin- XR and SR forms are available with less gastric irritation
Hope I have answered your questions. If you have any further queries I will be happy to help you.
Regards,
Dr Ajish TP [MD,DM]
Consultant Endocrinologist
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Prasad
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