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Question: Hi Dr. Grief,
I am male 61 year old. My blood sugar level before meal in the morning vary from 9-13. After about 5 years using Diabex (Metformin) tablets 500mg two tablets twice a day, I have recently been prescribed with new sugar level tablets, Amryl (glimepiride 3mg) along Trajenta (linagliptin 5mg once a day after morning meal. I am also taking Micardis Plus tablets 80/12.5 for my blood preasure,(telmistran 80mg & Hydrochlorothiazide along Adalt Oros 60mg, both once a day.
I have been told by my doctor to stop using Micardic Plus with new sugar level treatment, instead to use Micardis 80mg.
I am concerned about my new blood sugar treatment especially I red about pancreas damage. Also by blood preasure went up by not using Micardis Plus. Both new treatment I am taking for three days now.
Could you please give me advice about this matters.
Thank you very much for your time
XXXX
I am male 61 year old. My blood sugar level before meal in the morning vary from 9-13. After about 5 years using Diabex (Metformin) tablets 500mg two tablets twice a day, I have recently been prescribed with new sugar level tablets, Amryl (glimepiride 3mg) along Trajenta (linagliptin 5mg once a day after morning meal. I am also taking Micardis Plus tablets 80/12.5 for my blood preasure,(telmistran 80mg & Hydrochlorothiazide along Adalt Oros 60mg, both once a day.
I have been told by my doctor to stop using Micardic Plus with new sugar level treatment, instead to use Micardis 80mg.
I am concerned about my new blood sugar treatment especially I red about pancreas damage. Also by blood preasure went up by not using Micardis Plus. Both new treatment I am taking for three days now.
Could you please give me advice about this matters.
Thank you very much for your time
XXXX
Brief Answer:
Metformin and trajenta are good in diabetes
Detailed Answer:
Hi,
I read your question and i am able to understand your concern. To help you understand better, I would like to share some general information about diabetes pathology. There are two main features involved.
1.insulin resistance
2. insulin production defect from beta cells of pancreas.
During initial stages of diabetes the insulin supply and demand can be maintained by reducing insulin resistance. This is achieved by drugs like metformin and physical activity. But in due course of time beta cell capacity to produce insulin will decrease and blood sugars cannot be maintained. Hence we depend on second line of medication to increase the production of insulin from beta cells by using drugs like Amaryl.
Trajenta is a very good choice because it helps in recovery of beta cells and also influences your satiety center in brain. By influencing your satiety center most of your eating habits will be regularized and the good news is this medicine is weight neutral.This medication will not cause hypoglycemia.
Yes, amaryl will stimulate beta cells of your pancreas and produces more insulin. Due to excessive stimulation of beta cells they will go into failure and Amaryl is also known for weight gain and hypoglycemia. If you are worried about this side effect, I would suggest you to increase physical activity and increase dose of metformin along with trajenta for a better control of diabetes. You can discuss about this plan of action with your treating doctor.
As far as hypertensive management is concerned, I am not very pleased with the current change. Tab micardis is not a effective controller of hypertension when compared to Micardis plus. I understand your doctor has prescribed micardis for renal protection in view of existing diabetes. But when your sugars come under control, you should discuss about switching over to plus.
Kindly let me know your height weight and waist circumference.
Regards
Metformin and trajenta are good in diabetes
Detailed Answer:
Hi,
I read your question and i am able to understand your concern. To help you understand better, I would like to share some general information about diabetes pathology. There are two main features involved.
1.insulin resistance
2. insulin production defect from beta cells of pancreas.
During initial stages of diabetes the insulin supply and demand can be maintained by reducing insulin resistance. This is achieved by drugs like metformin and physical activity. But in due course of time beta cell capacity to produce insulin will decrease and blood sugars cannot be maintained. Hence we depend on second line of medication to increase the production of insulin from beta cells by using drugs like Amaryl.
Trajenta is a very good choice because it helps in recovery of beta cells and also influences your satiety center in brain. By influencing your satiety center most of your eating habits will be regularized and the good news is this medicine is weight neutral.This medication will not cause hypoglycemia.
Yes, amaryl will stimulate beta cells of your pancreas and produces more insulin. Due to excessive stimulation of beta cells they will go into failure and Amaryl is also known for weight gain and hypoglycemia. If you are worried about this side effect, I would suggest you to increase physical activity and increase dose of metformin along with trajenta for a better control of diabetes. You can discuss about this plan of action with your treating doctor.
As far as hypertensive management is concerned, I am not very pleased with the current change. Tab micardis is not a effective controller of hypertension when compared to Micardis plus. I understand your doctor has prescribed micardis for renal protection in view of existing diabetes. But when your sugars come under control, you should discuss about switching over to plus.
Kindly let me know your height weight and waist circumference.
Regards
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr. XXXXXXX
I would like to thank you very much for your fast and most valuable respond to my questions. I am now certain that you have fully understand my concern expressed in relation to my new treatment by using Amaryl and Trajenta and do not continuing with Micardis Plus tablets.
As I have mentioned in my initial query my concern is Amaryl tablets 3Mg that I red can in medical publication pancreas cells can be seriously damaged in longer use of this medication.
It is not clear to me could I increase usage of metformin (diabex 500mg), I was taking four of these tablets (two in morning and two at night) along with Trajenta tablets as you suggested. In that case I could go back to my MicardisPlus tablets again?
As you requested my high is 180cm, current weigh 91kg (may vary 3kg - or + My
waist is 97cm.
Thank you vary much for your time,
Kind regards,
XXXX
I would like to thank you very much for your fast and most valuable respond to my questions. I am now certain that you have fully understand my concern expressed in relation to my new treatment by using Amaryl and Trajenta and do not continuing with Micardis Plus tablets.
As I have mentioned in my initial query my concern is Amaryl tablets 3Mg that I red can in medical publication pancreas cells can be seriously damaged in longer use of this medication.
It is not clear to me could I increase usage of metformin (diabex 500mg), I was taking four of these tablets (two in morning and two at night) along with Trajenta tablets as you suggested. In that case I could go back to my MicardisPlus tablets again?
As you requested my high is 180cm, current weigh 91kg (may vary 3kg - or + My
waist is 97cm.
Thank you vary much for your time,
Kind regards,
XXXX
Brief Answer:
Metformin and trajenta are good in diabetes
Detailed Answer:
Dear sir
Thank you for providing required information.
In my opinion your metformin dose is good and i suggest you to continue the same.
Your present BMI is 28,Which is slightly more.
increase your physical activity to reduce your BMI to 25.
Regarding amaryl i suggest you to hold for few days
By doing so your insulin requirements can be reduced and sugars will be in control.
switching back to Micardis Plus is a good idea but kindly take advised of your doctor.
Daily do exercise for 45 minutes and follow a diet plan
Regarding amaryl I suggest you to hold for few days and lets try to control by diet and exercise.
Continue trajenta and metformin as usually.
Regards
Metformin and trajenta are good in diabetes
Detailed Answer:
Dear sir
Thank you for providing required information.
In my opinion your metformin dose is good and i suggest you to continue the same.
Your present BMI is 28,Which is slightly more.
increase your physical activity to reduce your BMI to 25.
Regarding amaryl i suggest you to hold for few days
By doing so your insulin requirements can be reduced and sugars will be in control.
switching back to Micardis Plus is a good idea but kindly take advised of your doctor.
Daily do exercise for 45 minutes and follow a diet plan
Regarding amaryl I suggest you to hold for few days and lets try to control by diet and exercise.
Continue trajenta and metformin as usually.
Regards
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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