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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetic. On Cozaar, Glipizide And Zocor. Can Get Better Control Of Lab Numbers With Other Medications?

My 78 year old wife has had type 2 diabetes mellitus for 20 years. For 1st 6 years she was on dietary management only. She was then put on an oral hypoglycemic when her HgbA1c went above 6. Presently on Cozaar 25 mg, glipizide 10 mg bid, Zocor 60 mg daily. BP has always been normal, lipid panel, creatinine, and liver studies all normal. In the past year her FBSs has jumped into the 140 range and her HgbA1c is 7.4. In my medical group, most physicians will accept a HgbA1c below 7 though the normal is 6. Normal FBS is below 99. My question: can she get better control of her lab numbers with other meds rather than glipizide bid? I understand that there are meds which might give her better glycemic control and that glipizide in conjunction with such meds may give her less hypoglycemic episodes, which clinically she may experience once a month. I have heard that better control of diabetes may be of value in dementia; in her case loss of short term memory and loss of focus are early but not debilitating symptoms. I would like some advice before contacting her internist. Thanks for your help.
Fri, 30 Aug 2013
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General & Family Physician 's  Response
HI, thanks for using healthcare magic

Diabetes can progress due to burn out of the pancreas.

Glipizide is in the family of medication called sulfonyureas. This family of drugs can cause hypoglycemia.

There are diabetic medications that are not associated with hypoglycemia such as metformin, incretin mimetics (exenatide,liraglutide), DPP antagonists (januvia ).

Her doctors may want to consider one of these to allow the dose of the glipizide to be reduced and therefore her hypoglycemia episodes.

I hope this helps
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Diabetic. On Cozaar, Glipizide And Zocor. Can Get Better Control Of Lab Numbers With Other Medications?

HI, thanks for using healthcare magic Diabetes can progress due to burn out of the pancreas. Glipizide is in the family of medication called sulfonyureas. This family of drugs can cause hypoglycemia. There are diabetic medications that are not associated with hypoglycemia such as metformin, incretin mimetics (exenatide,liraglutide), DPP antagonists (januvia ). Her doctors may want to consider one of these to allow the dose of the glipizide to be reduced and therefore her hypoglycemia episodes. I hope this helps