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What Do These HbA1C Level, Lipid Profile And Urine Report Indicate?
Question: my father is 60 years old known diabetic type 2 for more than 15 yrs ago , also have glaucoma in both eyes surgery was done today, idiopathic epilepsy was controlled well ,on Na valproate 800mg/day (400mg on morning , 200mg on afternoon, 200mg at night ) , his blood glucose investigated yesterday FBS= 312 , HbA1c = 13% , Lipid profile , renal , Liver , CBC = Normal ,
Urine general has trace albumin and one cross acetone , . Now on Januvia 100mg BiD , Glucophage 750mg Bid , Lisinopril 5mg , and other eye drops for cataract .
I think he may need absolutely an insulin but I now my father he cannot comply with insulin and I afraid from hypoglycemic effects >
Please I need your opinions (endocrinologist (diabetologist)+ Epiliptologist for reviewing the treatment state with his actual condition and gave me an your advises.
what can be modified or changed or added regard his glycemic control and antiepileptic plan?
great thanks
Urine general has trace albumin and one cross acetone , . Now on Januvia 100mg BiD , Glucophage 750mg Bid , Lisinopril 5mg , and other eye drops for cataract .
I think he may need absolutely an insulin but I now my father he cannot comply with insulin and I afraid from hypoglycemic effects >
Please I need your opinions (endocrinologist (diabetologist)+ Epiliptologist for reviewing the treatment state with his actual condition and gave me an your advises.
what can be modified or changed or added regard his glycemic control and antiepileptic plan?
great thanks
Brief Answer:
Yes,your father needs to start immediately the insulin therapy.
Detailed Answer:
Hi XXXXX
I have gone through your question.
I can understand your concern.
From the test results i deduct that the diabetes of your father is not under control(HbA1Cis 13%; the goal for a diabetic is AbA1C<=7% and his FBG=312mg/dl is very high.
This means that his treatement has nor been effective and he need urgently to start an insulin regymen for his uncontrolled Diabetes.
At the other side i can see that he has aceton positive in his urine.
This is a condition called Diabetic ketoacidosis.
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.
The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
My advice is to contact immediately your father's doctor or seek emergency care because your father need urgently insulin therapy.
Thr situation ca be more serious if he has multiple signs and symptoms of diabetic ketoacidosis — excessive thirst, frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath, confusion.
Don't worry a lot of diabetics doesn't accept the insulin therapy at the beggining and they want to continue with the oral antidiabetics but when they are informed about the serious riscs of uncontrolled diabetes ,they understand the importance of insulin and take the necessary information how to avoid hypoglicemia.
For the long term controll of diabetes there is necessary a healthy eating plan or a diabete diet,more physical activities(if there are not contraindications) and the insulin therapy.
For the antiepileptic treatement i suggets to consult his neurologist if you think that the treatement with Na valproate is nor effective.
Hope my information is helpful.
If you have other question,i wil be happy to help.
Thank you for using HCM.
Wish you good health.
Yes,your father needs to start immediately the insulin therapy.
Detailed Answer:
Hi XXXXX
I have gone through your question.
I can understand your concern.
From the test results i deduct that the diabetes of your father is not under control(HbA1Cis 13%; the goal for a diabetic is AbA1C<=7% and his FBG=312mg/dl is very high.
This means that his treatement has nor been effective and he need urgently to start an insulin regymen for his uncontrolled Diabetes.
At the other side i can see that he has aceton positive in his urine.
This is a condition called Diabetic ketoacidosis.
Diabetic ketoacidosis is a serious complication of diabetes that occurs when your body produces high levels of blood acids called ketones.
The condition develops when your body can't produce enough insulin. Insulin normally plays a key role in helping sugar (glucose) enter your cells. Without enough insulin, your body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis if untreated.
My advice is to contact immediately your father's doctor or seek emergency care because your father need urgently insulin therapy.
Thr situation ca be more serious if he has multiple signs and symptoms of diabetic ketoacidosis — excessive thirst, frequent urination, nausea and vomiting, abdominal pain, shortness of breath, fruity-scented breath, confusion.
Don't worry a lot of diabetics doesn't accept the insulin therapy at the beggining and they want to continue with the oral antidiabetics but when they are informed about the serious riscs of uncontrolled diabetes ,they understand the importance of insulin and take the necessary information how to avoid hypoglicemia.
For the long term controll of diabetes there is necessary a healthy eating plan or a diabete diet,more physical activities(if there are not contraindications) and the insulin therapy.
For the antiepileptic treatement i suggets to consult his neurologist if you think that the treatement with Na valproate is nor effective.
Hope my information is helpful.
If you have other question,i wil be happy to help.
Thank you for using HCM.
Wish you good health.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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