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Suggest Treatment For High Blood Sugar Levels

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Posted on Fri, 4 Nov 2016
Question: Hello,
My father was diagnosed with blood Sugar around 450 fasting 1 month back 65 years. but now his is on medication azulix-2 1-0-1 and volix-.3 1-1-1 along with food. now for the past fews days i see blood sugar level is low random check @ 8 pm yesterday it was 57 and today it was 91 @ 8 pm , Today morning fasting it was 91, and 2 hrs after breakfast it was 140. should he continue the medicines or need some changes
doctor
Answered by Dr. Dr. Abhay A Mali (56 minutes later)
Brief Answer:
Need immediate medical attention and changes in medication.

Detailed Answer:
Hi,

Thanks for your question.
Noted your concern.

Tab Azulix 2 contains Glimepiride 2mg.
Glimepiride in such a high dose of 4mg per day has high potential of developing hypoglycemia (low blood sugar levels).
In such a case I may suggest -
- Stop taking Tab Azulix 2 and Consult his treating diabetologist immediately.
- Detailed history taking and physical examination. Screening for risk factors for developing hypoglycemia (low blood sugar levels). For which following investigations may be suggested-
- Complete blood count.
- Renal function test.
- Liver Function Test.
- HbA1c.
- Urine examination.

Depending upon his detailed clinical examination and above test results more safer medicines which has very low chances of developing Hypoglycemia like Metformin, DPP4 inhibitors can be considered.

Hope this helps.

Regards,
Dr. Abhay Mali.
Diabetologist.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Abhay A Mali (1 hour later)
Thanks, Sir for your reply, I have not given Azulix-2 tonight and I have checked Blood sugar after 2hrs of dinner and it was 170. without Azulix-2 & volix

Checked below 7 days back

Serum Creatinine 1.39
Sodium Serum 138
Serum Pottasium 4.30
chloride 105

urine test result
volume 40 ml
color watery
appearence clear
sp.gravity 1.015
reaction ph acidic
urine sugar nil
urine albumin nil
rbc not found
pus cells 1-2
Epithelial cells 0-2
casts not found
crystals not found
bacteria nil
doctor
Answered by Dr. Dr. Abhay A Mali (8 hours later)
Brief Answer:
I may suggest modification in treatment.

Detailed Answer:
In such a case I may suggest to stop current treatment completely.
And may suggest combination of Metformin 500mg + Sitagliptin 50mg twice a day with repeat blood sugar (Fasting and post-prandial blood sugar levels) after 2 to 3 weeks depending upon blood sugar level further changes in medicines can be suggested.

Metformin and Sitagliptin when use alone or in combination with each other have very minimal chances of hypoglycemia and are very effective medicines for blood sugar control (they keep blood sugar levels under control but not below normal levels).

It is better to consult his treating diabetologist as any changes in medicines requires close monitoring and choice of medicines may vary depending upon physical examination.

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

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 807 Questions

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Suggest Treatment For High Blood Sugar Levels

Brief Answer: Need immediate medical attention and changes in medication. Detailed Answer: Hi, Thanks for your question. Noted your concern. Tab Azulix 2 contains Glimepiride 2mg. Glimepiride in such a high dose of 4mg per day has high potential of developing hypoglycemia (low blood sugar levels). In such a case I may suggest - - Stop taking Tab Azulix 2 and Consult his treating diabetologist immediately. - Detailed history taking and physical examination. Screening for risk factors for developing hypoglycemia (low blood sugar levels). For which following investigations may be suggested- - Complete blood count. - Renal function test. - Liver Function Test. - HbA1c. - Urine examination. Depending upon his detailed clinical examination and above test results more safer medicines which has very low chances of developing Hypoglycemia like Metformin, DPP4 inhibitors can be considered. Hope this helps. Regards, Dr. Abhay Mali. Diabetologist.