What Causes Drop In Blood Sugar Level Along With Palpitations After Taking GP1 Forte?

Posted on Thu, 26 Feb 2015

Question: Dr I was taking medicine Janumet 50/500 from the last one year and my HbA1c remain 7-7.5 Now I consult one new Dr. he prescribed me GP1 forte. After taking the GP1forte my sugar level fall down immediately RBS 90 and I am feeling heart beat and headache. Please guide me to what should I continue the medicine. Please guide dose Janument/GP1forte
Regards

Answered by Dr. Ajish TP (3 hours later)

Brief Answer:
Need to reduce the dose

Detailed Answer:
Hi XXXX

Welcome to HCM. I have gone through the question and understand your concerns.

I have gone through your lab reports. My comments:
1. HbA1c borderline elevated
2. High cholesterol (LDL) and TG
3. Vitamin D deficiency
4. Other investigations fairly ok

Regarding medications.

Hope you were taking Janumet twice daily till now.

Unlike Janumet, Glimepiride (GP1) is associated with hypoglycaemia ( low sugars). So you need to decrease the dose. The dose can be made to 0.5 mg/ day and if you still is having low sugars, you have to stop GP1.

Another good option is to stop GP1 forte and increase the dose of Metformin in Janumet. That means from Janumet 50/500 twice daily to Janumet 50/1000 twice daily. This will control blood sugars without hypoglycaemia.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Ajish TP (19 hours later)

Dr. I was taking the following medicine earlier:-
Janumet 50+500
Telvas-20
Cap-Metolar xR25
Ecosprin-AV 75

But after the latest lab report I consulted the physian who suggested me to add GP1 forte add on above mentioned medicine. As and when I take GP1 forte my sugar level reduce to 90 after meal. I feel pain in my muscles and fast heart beat and headache. Please guide me proper does of medicine as per my latest report.
Thanks

Answered by Dr. Ajish TP (6 minutes later)

Brief Answer:
You can stop GP1 forte and increase Janumet

Detailed Answer:
Hi XXXX
Welcome back

You can stop GP 1 Forte as it is producing hypoglycaemia (low sugars).

You can increase the dose of Janumet 50+500 to twice daily ( morning and night) and monitor sugars.

You can continue other medications for hypertension and cholesterol.

Regards
Dr Ajish TP

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar