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Suggest Treatment For High Sugar Levels?

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Posted on Wed, 15 Apr 2015
Question: My father has high sugar levels (71 Years) and uses Novomix (Insulin) twice a day.. but still not under control.. He is almost immobile..What would you suggest?
doctor
Answered by Dr. Saumya Mittal (1 hour later)
Brief Answer:
Need more information

Detailed Answer:
Hi
I am Dr Mittal.
I have read your query.
I think I would be able to help you.
However, I need to know how much insulin is being given
Also, are any other medications on?
Many times other medicines increase blood sugars.
Besides , what is his regular sugar chart?
One ser of values is not enough to increase the insulin dose.
Do let me know the response.
Hope to help you find the answer.
Best of luck.
Dr Mittal.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Saumya Mittal (4 hours later)
Doc,
Thanks for your response.

The current insulin dose is 20 (Morning - before breakfast) and 20 (before dinner).

Other medicines that are on can be seen in details on the prescriptions uploaded (Monotrate 20, Torlactone 10, Tonact 20, Nikoran 5, Glycomet SR 500, Urimax .4 mg, Volibo .3 mg, Glycomet 1 mg, Telday 40 mg, Zincovit, Deplatt A 75 mg, Pantocid 40DSR).

His regular sugar levels are high (tested twice a day), off the last week they have ranged from 250 to 290 in Fasting and 280 and upto 500 in PP.

Would be thankful if you could guide me on the way forward.

Regards,
XXXX

doctor
Answered by Dr. Saumya Mittal (12 hours later)
Brief Answer:
Patient 's choice?

Detailed Answer:
Hi
Thanks for the response.
I think there is a possibility of stepping up the dose of insulin. The patient is also on low dose of glycomet that can also be increased.
I don't think you need to change the other medicines. They don't seem to have hyperglycaemia as a side effect.
I would like to know whether you would like to increase the dose of insulin first or the dose of tablets.
I can make my suggestions accordingly.
Please feel free to contact us for more information. Best of luck. Dr Mittal
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Saumya Mittal (6 minutes later)
Sir,

There were 2 more medicines I missed,

Trajenta 5 and Glyciphage.

I am okay with the way forward (insulin increase or tablets) .. So would look forward to your response.

Just to add. Since yesterday dad is complaining of a head spin and it is not allowing him to even stand..

His last sugar level is 197 PP..

Regards,
doctor
Answered by Dr. Saumya Mittal (18 hours later)
Brief Answer:
consider januvia

Detailed Answer:
There is a new medicine called sitapliptin that is available in various brands like Januvia. It's available in many doses - 50 and 100.
I think I would suggest that you consider the use of this medicine.

I also feel that there is a possibility that he is developing recurrent hypoglycaemia episodes. That explains both, high sugars and vertigo. I suggest testing RBS at 3 am a couple of times. Hypoglycaemia is imminent with so many tablets.

I have tried to make it as simple as possible. I hope that the information helps you. Please feel free to contact us for more information. Best of luck. Dr Mittal.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Saumya Mittal

Diabetologist

Practicing since :2004

Answered : 2897 Questions

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Suggest Treatment For High Sugar Levels?

Brief Answer: Need more information Detailed Answer: Hi I am Dr Mittal. I have read your query. I think I would be able to help you. However, I need to know how much insulin is being given Also, are any other medications on? Many times other medicines increase blood sugars. Besides , what is his regular sugar chart? One ser of values is not enough to increase the insulin dose. Do let me know the response. Hope to help you find the answer. Best of luck. Dr Mittal.