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Suggest Remedies For High Blood Pressure Levels

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Posted on Thu, 28 Apr 2016
Question: MY MOM 77 YEARS, DIABETIC 20 YEARS ON JANUMET , GALVUSMET TABLETS . PAST 3 MONTHS SUGAR LEVELS 350 TO 400 . STOMACH PROBLEM NO HUNGER NO TASTE , HOSPITALISED , LANTUS AND ACTRAPID GIVEN 60 UNITS TOTAL FOR 7 DAYS ,NOW NO STOMACH PROBLEM . BUT STILL SUGAR LEVEL 300 TO 320 . PLSUGGEST MEDICATION
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Answered by Dr. Dr. Abhay A Mali (2 hours later)
Brief Answer:
I may prefer continuation of Insulin in her case.

Detailed Answer:
Hi,

Thanks for your question.
Noted your concern.

Considering your mother's age and 20 years of diabetes, I may prefer to continue three doses of Insulin Actrapid and one dose of Insulin Lantus.

Tab Janumet (contain Sitagliptin & Metformin) and GalvusMet (contains Vildagliptin & Metformin) both are of same group she should continue only one of them.

With age of 77yrs and 20yrs of diabetes there might be possibility of deranged kidney and heart function which may be contraindicate use of some oral antidiabetic medicine.

In such case I may suggest to do -
- Complete Blood count.
- HbA1c.
- Serum Creatinine, urea, uric acid, electrolytes.
- Arterial blood gases.
- Liver function test.
- Calcium Profile.
- T3, T4, TSH.
- ECG & 2DEcho of heart.
- Urine examination with ketones.

(She might have underwent all these tests when was hospitalized.)

Depending upon her clinical examination and above test results appropriated decision regarding oral medications can be taken.
Home monitoring of blood sugar level with Glucometer is also important in her case.

Hope this help you.
I will be happy to answer your follow up queries if any.

Regards,
Dr. Abhay Mali.
Diabetologist.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Answered by
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Dr. Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 807 Questions

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Suggest Remedies For High Blood Pressure Levels

Brief Answer: I may prefer continuation of Insulin in her case. Detailed Answer: Hi, Thanks for your question. Noted your concern. Considering your mother's age and 20 years of diabetes, I may prefer to continue three doses of Insulin Actrapid and one dose of Insulin Lantus. Tab Janumet (contain Sitagliptin & Metformin) and GalvusMet (contains Vildagliptin & Metformin) both are of same group she should continue only one of them. With age of 77yrs and 20yrs of diabetes there might be possibility of deranged kidney and heart function which may be contraindicate use of some oral antidiabetic medicine. In such case I may suggest to do - - Complete Blood count. - HbA1c. - Serum Creatinine, urea, uric acid, electrolytes. - Arterial blood gases. - Liver function test. - Calcium Profile. - T3, T4, TSH. - ECG & 2DEcho of heart. - Urine examination with ketones. (She might have underwent all these tests when was hospitalized.) Depending upon her clinical examination and above test results appropriated decision regarding oral medications can be taken. Home monitoring of blood sugar level with Glucometer is also important in her case. Hope this help you. I will be happy to answer your follow up queries if any. Regards, Dr. Abhay Mali. Diabetologist.