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Suggest Treatment For Uncontrolled Diabetes
Question: diabetes -2
hba1c 8.2
medication
morning vobligose .3 with livopill ds and nutrilite
afternoon vobligose .3
night vobligose .3 and cetapin 500
with rozuvas f 10mg
still feel sleepy and lethargic
sugar levels in the morning are elevated fasting 175 pp 225
evening sugar levels at dinner fasting 140 pp 200
sgot and sgpt are borderline at 43 and 57
cholestrol 125
hdl 40
ldl 65
hba1c 8.2
medication
morning vobligose .3 with livopill ds and nutrilite
afternoon vobligose .3
night vobligose .3 and cetapin 500
with rozuvas f 10mg
still feel sleepy and lethargic
sugar levels in the morning are elevated fasting 175 pp 225
evening sugar levels at dinner fasting 140 pp 200
sgot and sgpt are borderline at 43 and 57
cholestrol 125
hdl 40
ldl 65
Brief Answer:
Uncontrolled diabetes is making you dull.
Detailed Answer:
Dear sir, hi! your diabetes is uncontrolled. you need to step up the management of diabetes. voglibose 0.3 mg thrice a day is not sufficient for you. you must increase metformin from once a day to 1000 mg twice a day. also get your TSH and FT4 checked. please let us know the result. after increasing the dose of metformin recheck your sugars fasting and pp after a week and let us know. follow strict dietary restriction and regular exercise regimen. regards!
Uncontrolled diabetes is making you dull.
Detailed Answer:
Dear sir, hi! your diabetes is uncontrolled. you need to step up the management of diabetes. voglibose 0.3 mg thrice a day is not sufficient for you. you must increase metformin from once a day to 1000 mg twice a day. also get your TSH and FT4 checked. please let us know the result. after increasing the dose of metformin recheck your sugars fasting and pp after a week and let us know. follow strict dietary restriction and regular exercise regimen. regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
dear doc
i am already taking 2 tablets that is one tablet cetapin 500 and second tablet cetapin 500 combined with voglibose .3 in the night before dinner
in the morning i take one tablet that is cetapin 500 combined with voglibose .3 before breakfast
in the afternoon i take one tablet that is cetapin 500 combined with voglibose .3 before lunch
so overall that is 1500 mg of cetapin and .9 mg voglibose in a day
what change do u recommend i forgot to add
BP is normal at 120/80 since last five years
Weight is 80-82 kgs since last five years
Height 174 cms
any other details reqd pls let me know
thanx
thanx
i am already taking 2 tablets that is one tablet cetapin 500 and second tablet cetapin 500 combined with voglibose .3 in the night before dinner
in the morning i take one tablet that is cetapin 500 combined with voglibose .3 before breakfast
in the afternoon i take one tablet that is cetapin 500 combined with voglibose .3 before lunch
so overall that is 1500 mg of cetapin and .9 mg voglibose in a day
what change do u recommend i forgot to add
BP is normal at 120/80 since last five years
Weight is 80-82 kgs since last five years
Height 174 cms
any other details reqd pls let me know
thanx
thanx
Brief Answer:
you may add DPP4 inhibitor or glimeperide
Detailed Answer:
Dear sir , sorry for not understanding the statement fully . if you are already taking cetapin 1500 mg /d and voglibose 0.3 thrice a day, and the sugars are all high. you have two options
1. add DPP4 inhibitor e.g. sitagliptine 100 mg a day /or vildagliptin 50 mg twice a day
2. you may add glimeperide 2 mg once a day before breakfast.
you need to work upon your weight a little. you are overweight by 6-8 kg. you also need to check your thyroid profile TSH and Ft4. please let me know your reports after a week. fasting and pp. regards!
you may add DPP4 inhibitor or glimeperide
Detailed Answer:
Dear sir , sorry for not understanding the statement fully . if you are already taking cetapin 1500 mg /d and voglibose 0.3 thrice a day, and the sugars are all high. you have two options
1. add DPP4 inhibitor e.g. sitagliptine 100 mg a day /or vildagliptin 50 mg twice a day
2. you may add glimeperide 2 mg once a day before breakfast.
you need to work upon your weight a little. you are overweight by 6-8 kg. you also need to check your thyroid profile TSH and Ft4. please let me know your reports after a week. fasting and pp. regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you doctor XXXXXXX
i need to apologize for one error in my data
actually it adds up to 2000mg of cetapin per day and not 1500mg--kindly see the above mentioned dosages
secondly is the glimepride similar to amaril since i had hypo issues with amaril so should i start with 1 mg of glimpride
thirdly should i continue with the cetapin and vobligose as given above
i shall off course get tsh and ft4 done now and after one week again once u revert
sorry for the errata once again
regards
i need to apologize for one error in my data
actually it adds up to 2000mg of cetapin per day and not 1500mg--kindly see the above mentioned dosages
secondly is the glimepride similar to amaril since i had hypo issues with amaril so should i start with 1 mg of glimpride
thirdly should i continue with the cetapin and vobligose as given above
i shall off course get tsh and ft4 done now and after one week again once u revert
sorry for the errata once again
regards
Brief Answer:
Cetapin and voglibose are fine.
Detailed Answer:
dear sir it's fine with cetapin and voglibose. amaryl is glimeperide but 1 mg a day should not give you hypo. you should take 1 mg with breakfast and eat small frequent meals. still if you are worried you may start with XXXXXXX gliptins 100 mg a day. recheck sugars after a week and thyroid test is required only once. regards!
Cetapin and voglibose are fine.
Detailed Answer:
dear sir it's fine with cetapin and voglibose. amaryl is glimeperide but 1 mg a day should not give you hypo. you should take 1 mg with breakfast and eat small frequent meals. still if you are worried you may start with XXXXXXX gliptins 100 mg a day. recheck sugars after a week and thyroid test is required only once. regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ref our previous conversation
the tsh level is 1.22
free t4 level is 0.96
i have started vildagliptin 50 mg twice at breakfast and lunch with the prior medicine as already explained above, that is, cetapin 2000mg per day and vobligose 0.3 mg thrice a day
i am uploading the sugar levels 10 days after starting vildagliptin on 08 apr 2014
previous to taking vildagliptin the sugar levels were touching 250 and even above
however now the sugar levels are restricted to 145 so the new medicine has been helpful
the tsh level is 1.22
free t4 level is 0.96
i have started vildagliptin 50 mg twice at breakfast and lunch with the prior medicine as already explained above, that is, cetapin 2000mg per day and vobligose 0.3 mg thrice a day
i am uploading the sugar levels 10 days after starting vildagliptin on 08 apr 2014
previous to taking vildagliptin the sugar levels were touching 250 and even above
however now the sugar levels are restricted to 145 so the new medicine has been helpful
Brief Answer:
you are doing good.
Detailed Answer:
Dear Sir, Hi! I remember the conversation very well. I have gone through your reports and you are really good. so the idea is to continue the same plan. your thyroid is normal. keep checking your blood sugars once a week. hba1c once in three months. regards!
you are doing good.
Detailed Answer:
Dear Sir, Hi! I remember the conversation very well. I have gone through your reports and you are really good. so the idea is to continue the same plan. your thyroid is normal. keep checking your blood sugars once a week. hba1c once in three months. regards!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
need to revise the treatment.
Detailed Answer:
Dear sir, you are facing drug side effect. both voglibose and metformin are known to cause these side effects. so if you are really troubled first you can try with pantoperazole 40 mg once or twice a day. if that does not solve your problem, take off voglibose. if sugars worsen by removing voglibose let me know. we will give you some thing else. if symptoms do not improve even after removing voglibose and adding pantoperazole, we will have to reduce metformin from 2000 mg to 1500 or may be 1000 mg and add something like glimeperide 1 mg. so in this manner we will proceed. regards!
need to revise the treatment.
Detailed Answer:
Dear sir, you are facing drug side effect. both voglibose and metformin are known to cause these side effects. so if you are really troubled first you can try with pantoperazole 40 mg once or twice a day. if that does not solve your problem, take off voglibose. if sugars worsen by removing voglibose let me know. we will give you some thing else. if symptoms do not improve even after removing voglibose and adding pantoperazole, we will have to reduce metformin from 2000 mg to 1500 or may be 1000 mg and add something like glimeperide 1 mg. so in this manner we will proceed. regards!
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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