Brief Answer:
The reports are fair

Detailed Answer:
Hi,

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

Abnormal lab investigations:

1. HbA1c - 6.4%: in diabetic range, but well controlled for your age. Target in diabetes is less than 7%

2. Sugars higher side of normal. Target in diabetes is fasting less than 130 mg/dl ( yours 126) and after food less than 180 mg/ dl ( yours is 178)

3. Triglycerides- slightly high but no need to worry as LDL is low. A trial of 1-2g of omega 3 fatty acid will help to redux it without any side effects.

4. PSA - higher side : needs follow up +/- biopsy

5. CRP is high - an inflammatory marker in diabetes - non specific

You can continue with medications (Invokana for diabetes, sorry I couldn't read the first medication)

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

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Brief Answer:
See details

Detailed Answer:
Hi,

welcome back.

In scan 0000 (page 1) Glucose value is 126 mg/dl, blood works .pdf (page 1) Glucose value is 178 mg/dl. The normal given here is for non diabetics.

While on treatment for diabetes the accepted blood targets are:

Fasting plasma glucose < 130 mg/dl
Post prandial blood glucose < 180 mg/ dl
HbA1c < 7%

Regards
Dr Ajish TP

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Brief Answer:
You are having diabetes

Detailed Answer:
Hi,

Welcome back.

Your prescription contains one medication for diabetes - Invokana. When was you started on this medication? Was you on treatment with any anti diabetic medication before these blood tests?

If your fasting blood sugars is more than 125 mg/dl or after food blood sugars are more than 199 mg/ dl or HbA1c is more than 6.5%, you have diabetes. Your fasting is slightly above that (126 mg/dl) and HbA1c is just below that. So by definition, you are diabetic. If you are only started on medications now, you can follow diet and exercise and retest these parameters after 3 months to confirm your diabetes status.

regards

Dr Ajish TP

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Brief Answer:
Repeat the blood tests after 3 months and decide in medications

Detailed Answer:
Hi,

If you haven't started on medication so far, don't start on it. Invokana can result in some side effects.

Try diabetic diet and exercise for 3 months. Repeat a fasting blood glucose, after food blood glucose and HbA1c after 3 months. You can decide on starting medications after that.

Regards

Dr Ajish Tp

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Brief Answer:
Not aware of the medicine

Detailed Answer:
Hi,

I am sorry. I haven't heard of a medication with the name Kanoza. Please let me know the contents of the medicine if you have it.

Regards
Dr Ajish TP

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Brief Answer:
Need not start the medications now

Detailed Answer:
Hi,

Welcome back.

I have gone through the reports.

Kazano is a newer anti diabetes drug. It has got lesser side effects. It won't cause low sugars.

I think you should go ahead with life style modification for 3 months before starting on these medications.

Your Triglycerides is high and HDL ( good cholesterol) is low. Again a lifestyle modification of 3 months can be tried before starting on treatment since your bad cholesterol (LDL) is low. Adding omega 3 fatty acid in diet will help.

After 3 months, if your blood sugars and HbA1c are still high, you can be started on diabetic drugs. Again it is better to start on single drug ( Metformin) and if sugars are not controlled add on other drugs like Gliptins (alogliptin, saxagliptin, sitagliptin etc) or drugs like Invokana.

Wishing you good health

Regards
Dr Ajish TP

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