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Suggest Treatment For Pneumonia And Shortness Of Breath In A Diabetic Person
Question: IA 64 year old non-smoking male has been diagnosed with community acquired pneumonia. He also has type 2 diabetes. Glu 275 mg/dL . He is taking Metformin 1,000 mg orally daily. Does that sound correct??? How should he be treated for the pneumonia?? He is tired, fever 100.4, chills, productive cough,coughing up colored mucus, mild shortness of breath. he has been this way for the past 3 days after he came in from shoveling the snow on an extremely cold day.
Brief Answer:
sugars need to be controlled. antibiotics need to be started
Detailed Answer:
hi
i am dr mittal
i have read your query
i think that the symptoms are definitely suggestive of pneumonia.
However, his sugars are not well controlled.
He may need dose adjustment for sugars.
The 1000 mg of metformin may not be enough.
However, just one reading of random sugars cannot be relied upon.
We need to monitor his fasting sugar levels to know the exact medications needed.
As for pneumonia, he is going to need antibiotic cover.
He will also need to get a chest x ray, and if needed a ct chest.
That will tell us the extent of pneumonia.
And since his sugars are not well controlled, it is better that you meet a physician locally and get him admitted to a hospital.
Antibiotics need a prolonged course with uncontrolled diabetes,
And infections spread more quickly, which may cause him to have a more severe infection.
Intravenous antibiotics would be better for him
Best of luck
Feel free to contact me for more details
Dr Mittal
sugars need to be controlled. antibiotics need to be started
Detailed Answer:
hi
i am dr mittal
i have read your query
i think that the symptoms are definitely suggestive of pneumonia.
However, his sugars are not well controlled.
He may need dose adjustment for sugars.
The 1000 mg of metformin may not be enough.
However, just one reading of random sugars cannot be relied upon.
We need to monitor his fasting sugar levels to know the exact medications needed.
As for pneumonia, he is going to need antibiotic cover.
He will also need to get a chest x ray, and if needed a ct chest.
That will tell us the extent of pneumonia.
And since his sugars are not well controlled, it is better that you meet a physician locally and get him admitted to a hospital.
Antibiotics need a prolonged course with uncontrolled diabetes,
And infections spread more quickly, which may cause him to have a more severe infection.
Intravenous antibiotics would be better for him
Best of luck
Feel free to contact me for more details
Dr Mittal
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you. How about male 65..5' 6' weighing 182 pounds. Fasting Blood sugar level 154. How much Metformin should this patient be on???
Also what should his RR be?? If his BP is 124/74?
Also what should his RR be?? If his BP is 124/74?
Brief Answer:
At 154, his sugars seem to be ok
Detailed Answer:
Hi
At 154, his sugars seem to be ok.
however, prior levels were reportedly high
So I would suggest you get a regular charting done before we change the dose.
As for the respiratory rate, its not directly related to blood pressure.
It should be about 12-18 per minute and nothing more.
I still suggest that you should get a x ray and start iv antibiotics.
I hope that the information helps.
Best of luck
Dr Mittal
At 154, his sugars seem to be ok
Detailed Answer:
Hi
At 154, his sugars seem to be ok.
however, prior levels were reportedly high
So I would suggest you get a regular charting done before we change the dose.
As for the respiratory rate, its not directly related to blood pressure.
It should be about 12-18 per minute and nothing more.
I still suggest that you should get a x ray and start iv antibiotics.
I hope that the information helps.
Best of luck
Dr Mittal
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Please help by answering this final question. What would his sugar level need to be requiring Metformin 1,000 mg orally daily?? This is for a case study I am working on. What course of antibiotic would keep him out of the hospital??? For the community acquired pneumonia what is the differential diagnosis along with the acute and chronic conditions. That's it, Thanks
Brief Answer:
First, this platform is for medical problems, not academic queries.
Detailed Answer:
First, this platform is for medical problems, not academic queries.
The sugar levels of the patient show lots of changes. The OHA dose has to be individualized. There is no level system.
The course of antibiotics will depend on the sputum culture report.
Differential diagnosis is easily available in any book and has to be individualized. Could be COPD and Asthma with pneumonia. These would be chronic conditions.
Could be diabetes induced sepsis and chest infection. This could be acute condition. If history permits, smoke toxicity etc sghould be considered.
Any infection will be acute
Best of luck
Dr Mittal
First, this platform is for medical problems, not academic queries.
Detailed Answer:
First, this platform is for medical problems, not academic queries.
The sugar levels of the patient show lots of changes. The OHA dose has to be individualized. There is no level system.
The course of antibiotics will depend on the sputum culture report.
Differential diagnosis is easily available in any book and has to be individualized. Could be COPD and Asthma with pneumonia. These would be chronic conditions.
Could be diabetes induced sepsis and chest infection. This could be acute condition. If history permits, smoke toxicity etc sghould be considered.
Any infection will be acute
Best of luck
Dr Mittal
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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