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Suggest Treatment For Severe Chest Pain In A Diabetic

Posted on Fri, 23 Sep 2016

Question: my mother is having diabetes from past 15 years.Initially for the past 13 years she use to have gluconorm sr 500 mg twice a day. From the last 2 years she is using zomelis met 50/500 mg and the sugar levels are in control. When she started using this she is facing pain the upper past of the chest,pain not related to heart.When checked it was gas pain.So does the pain is due to high power of zomelis or is it normal pain which can be ignored. Now since the sugar levels are in control can you suggest any other tablet which is good for sugar control as well as with out any side effects

Answered by Dr. Dr. Abhay A Mali (48 minutes later)

Brief Answer:
Want to know more.

Detailed Answer:
Hi,

Thanks for your question.
Noted your concern.

Zomelis Met contains Sitagliptin and Metformin.
Gastric upset may be the side effect of both but more common with metformin in initial part of treatment.
But she was on Metformin (Content of Gluconorm Sr) since long so gastric upset due to metformin is unlikely.

For better opinion I want to know
- Which tests have been done to rule out possibility of pain related to heart.
- Pain related to food, exertion.
- Associated symptoms like burping, palpitations, sweating.

In such case I may suggest following tests-
- Complete blood count.
- HbA1c.
- Lipid Profile.
- Liver function test.
- Serum Amylase and Lipase.
- Renal function test.
- Urine examination.
- Ultrasound of abdomen and pelvis.
- ECG and 2 DEcho of heart.

Combination of Metformin and Sitagliptin is really good for blood sugar control.
If you really want to change it different options can be suggested depending upon Blood sugar level fasting, Post-prandial and HbA1c and above test results.

Hope this helps.

Regards,
Dr. Abhay Mali.
Diabetologist.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Abhay A Mali (21 minutes later)

all the tests mentioned above were performed in the month of may and the cardiologist confirmed that there is nothing wrong with the heart.Even TMt was done at that time.Her sugar level is sometimes getting very low as much as 45 and HB1sac which is the 3 month avergae is also in control.So what is medicine you would suggest for good sugar control and with out any side effects

Answered by Dr. Dr. Abhay A Mali (16 hours later)

Brief Answer:
Much more combinations may be used as alternative.

Detailed Answer:
I may not suggest change in Zomelis- Met. I may suggest some antacids like Omeprazole or Pantoprazole along with current medicines.

If you really want some alternative I may suggest Combination of Metformin 500mg + Glimepiride 1mg before breakfast and Metformin 1gram after dinner instead of current Zomelis Met. Recheck fasting and postprandial blood sugar level after 3 to 4 weeks and accordingly further changes in medicines may be suggested.

Continue other medicines as before.

You should consult her treating diabetologist for appropriate changes in medicines.

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. Priyanka G Raj