66 year old male, 179 cm tall, weights about 109 kg. Has a minisc injury in his knee and often collects fluid which has been extracted several times in the hospital. Has been struggling with high blood pressure and gout for twenty years. Has also been diagnosed with Diabetes type 2, three years ago. In the beginning he was prescribed tablets, Metformin 500 mg, two tablets in a day but they were unsuccessful. Has recently been to a Diabetic Specialist who has given him
Victoza liraglutid 0,6 mg x2, and Lantus Solostar insulin giargin 54 units. Although the Diabetic Specialist told my father to increase two-four units every second day, his blood sugar levels still remain very high. On a emty stomach at midday his levals range from 13-17. He has never been a morning person and therefore skips breakfast and lunch. When he does eat its in the evening and a portion for 3 persons. He has always been very fit and skinny in his youth but for the last 10 years he is very over weight. Because of the weight, the gout and minisc injury in his knee it is very hard for him to walk. His feet are very swollen and his back hurts no doubt from the weight he is carrying. As his daughter I'm very afraid for him cause the injections dont seem to work on him. What do you suggest Dr. L K Shankdhar?
His medicine list is the fallowing Trombyl 75mg 1x1, Spironolakton Nycomed 25 mg 1x1, Bisoprolol Ratiopharm 5 mg 1x1, Amlodipin Actavis 5 mg 1x1, Zyloric 200 mg 1x1, Lyrica 600 mg , Zoloft 200 mg, Lergigan 150 mg, Victoza 0.6mg x 2, Lantus Solostar insulin giargin 54 units.
Lab tests results
B-Leukocyter 7,3 x10(9)/L 3,5-8,8
B-Erytrocyter 4,5 x10(12)/L 4,2-5,7
B-Hemoglobin 130 g/L 134-170
B-EVF 0,40 0,39-0,50
Erc(B)-MCHC 328 g/L 317-357
B-Trombocyter 136 x10(9)/L 145-348
P-Glucose 16,0 mmol/L 4,0-6,0
P-Natrium 137 mmol/L 137-145
>P-Kalium 4,4 mmol/L 3,6-4,6
P-Kreatinin 171 mikromol/L 100
P-Troponin I >0,03 mikrog/L
(AMI):<0,11
P-CRP 21 mg/L >3
P-APT-tid 34 s 28-40
Area at heparinbeh.) 70-140 s.
P-PK (INR)>0,9 INR > 1,2