Suggest Ways To Control Diabetes And Hypertension

Posted on Tue, 15 Dec 2015

Question: I am a pre diabetic patient since for the last 6 years. But I never use medicine up till now because with diet control and exercise I am able to keep my blood sugar especially fasting blood glucose within normal level which is always below 100. But if I don't control my diet, it inceases above 100 even upto 118. And post fasting after two hours is 160 - 190. Uptill now i don't have any diabetic symptoms. My blood pressure is also high. Diastolic used to be in the range of 130 - 150 and systolic is 90 - 100. For blood pressure, now for about 4/5 months I am starting to take telma 40mg tablet, 1 tablet after every 3/4 days.

Actually I don't want to take medicine for both diabetes and high blood pressure because people say that taking such medicine has adverse side effects. Especially I fear if it causes erectile dyfunction. I am thinking to try with my best with exercise and diet control. Please advise me what I should do and if I must take medicine which medicine will be better

Answered by Dr. Rajesh Teli (30 minutes later)

Brief Answer:
you must accept regular medication if needed

Detailed Answer:
Hello,
I am Dr.Rajesh Teli,MD.
I have gone through your query.Thanks for using HCM.
First of all you must know the target values of controlled Blood pressure and Diabetes Mellitus.
At your age your BP Must remain below 140/90 ,but as you have borderline diabetes it should be below 130/80mmof Hg.
Your fasting Blood sugar should be below 100,Post meal blood sugar below 160 .Most Important to judge ideal control of diabetes is HBA1C.It gives average of past 3 months sugar.It must be between 6.5 to 7%.
If you are able to maintain this target with diet and exercise then its ok,otherwise you must take regular medication.Taking Telma every 3 /4 days is not helpful and can be infact harmful.You must take it daily.This drug is not known to cause erectile dysfunction.If you do not control sugar in target range,it may lead to erectile dysfunction.(only beta Blockers used for hypertension may cause erectile dysfunction).
I request you to get your HBA1C and Lipid profile done amd infomr me reports ,I shall be able to guide you about need for medicine after getting these reports,meanwhile continue Telma on daily basis,
My best wishes
Dr.Rajesh Teli,MD.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Rajesh Teli (19 hours later)

HDL Cholesterol is 31 and LDL is 108
AST (SGOT) is 82 and ALT (SGPT) is 118
ULTRA SOUND ABDOMEN = Grade 1 fatty liver.
Vitamin D total serum is 12.4 ng/ml
HBA1C test cannot be done.
Others like ECG, X- RAY, CBC, URINE TEST ETC are all normal.
I also have piles/hemorrhage in the stage 2 with anal fissures.
I have erectile dysfunction and premature ejaculation problem.

Answered by Dr. Rajesh Teli (12 hours later)

Brief Answer:
HBA1C is very important parameter to decide your treatment

Detailed Answer:
hello,
HBA1C is very important to plan long term treatment strategy for your borderline hyperglycaemia.You must follow strict diet plan to keep you blood sugar in target range.
Your liver enzymes are high.I would like to know whether you take alcohol ? did you have jaundice in past ?I would like to know if you are on any herbal or alternative medicines ?
Your HDL is low.This is protective cholesterol.It should remain above 35 in your case.You should take almonds and walnuts everyday to raise your HDL.Brisk walk for 30 min daily will too help you.
Your Vit D is insufficient .you should take Vit.D3 60 K sachets or tab Once a week for 8 weeks followed by Vit.D3 1k daily for 4 months.
you should undergo surgery for piles and anal fissure.
you may take Viagra for your erectile dysfunction having discussed your reports with your treating doctor,(If you are smoker please stop smoking)
My best wishes
Dr.Teli.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rajesh Teli (3 hours later)

Can I take medicines for diabetes, hypertension, fatty liver, vitamin D insufficiency and for erectile dysfunction altogether at the same time

Answered by Dr. Rajesh Teli (53 minutes later)

Brief Answer:
you do not need medicines for all ailments

Detailed Answer:
Hello,
Basically your diabetes is borderline hence you do not need any medicine as on today.There is no specific medicine for fatty liver ,control your weight,control cholesterol is all you need.
You may combine vit D and BP medicine.
You may take Viagra for erectile dysfunction
My best wishes
Dr.Teli.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rajesh Teli (38 minutes later)

Doctor please clarify one more point. Can I take viagra while taking BP medicine and also can I apply ointment for anal fissure while talking medicine for BP. I ask because some people said it's not possible. I am a non smoker, non drinker.
Thank you so much Doctor

Answered by Dr. Rajesh Teli (4 hours later)

Brief Answer:
you may use viagra

Detailed Answer:
Hello,
Use of Viagra is contraindicated if one is taking nitrate group of medicine for angina.It has no interaction with Telma or local cream which is used for anal fissure.
My best wishes
Dr.Teli.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rajesh Teli (1 hour later)

Supposing after taking medicine for BP for about a month and if my BP comes to normal or below or can be in normal range without using medicine again, what should I do after that and in future

Answered by Dr. Rajesh Teli (19 hours later)

Brief Answer:
you have to take life long medication for high BP

Detailed Answer:
Hello,
You have to take BP medicine life long.scientifically it is observed that the dose and number of medicines which help to get the target control must be continued life long.If BP goes on lower side I .e.less than 90/60 you may reduce the dose or cantinue same .
My best wishes
Dr.Rajesh Teli

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Rajesh Teli (2 hours later)

Doctor can I start by 20 mg once daily instead of 40 mg because I am starting taking medicine by this time only. Are telma and olmax tablets the same. Can I use any of these tables starting by 20mg.
Thank you so much, Doctor

Answered by Dr. Rajesh Teli (16 hours later)

Brief Answer:
you may start with Telma 20

Detailed Answer:
Hello,
Yes you may start with Telma 20 mg once a day.olmax is not same as telma.
You monitor your blood pressure regularly and target your BP to less than 140/90.if after 2 weeks of 20 mg BP is above this target increase telma to 40.If still BP is high you may need additional medicine for which you should follow your treating doctor .
My best wishes
Dr.Teli.

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Rajesh Teli (9 hours later)

I want more advice about my piles. Last year Doctor said, my piles is both internal and external in the stage 2 with anal fissure. As for anal fissure, it doesn't remain all the time. It occurred last year once and again this time only. Actually my piles occured after I had surgery of inguinal hernia in the year 2013. I believed this because after the surgery because of taking medicines, I had severe constipation for 4 days, not bowel movement at all. But as of now, there's not bleeding or pain because of the piles. What I am worrying is if the lump in the right side of the anus, (external piles) becomes malignant one day. Though it is not paining or bleeding, it never vanishes away completely. It keeps on changing it size depending on the food I take. If I take lot of fibre food, it decreases its size, if not, it becomes bigger. I've mild constipation

Answered by Dr. Rajesh Teli (4 hours later)

Brief Answer:
you must undergo surgery for piles and fissure

Detailed Answer:
hello,
Decision to operate can only be taken by a surgeon who examines you.I request you to trust your surgeon and follow his advise.My personal opinion is in favour of surgery.
My best wishes
Dr.Rajesh Teli,MD.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj