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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest An Alternative Of Farxiga To Manage Diabetes

Hi, Yes I do have a few questions. I m a diabetic and my long time endocrinologist has retired. I ve not found another close to me as of yet. Before she retired, she had taken me off Farxiga because I was having urinary retention and I had fallen and broke and fractured numerous bones and it was thought to maybe have added to my problem. I am on metformin 1000 mg ER twice daily and I take a shot of 34 units of lantus each night. They did not replace the Farxiga and since my blood sugar has continuely gone back up. I had last HA1C that had went back up from 7.8 t0 10.4 and I m sure it s heighten now since we ve had holidays and now it s already Feb of a new year. I called to remind them I was still awaiting another replacement med before they completely closed their office and their nurse called, left me a message that she had called in a new med and I would not be able to call them again for they would be closed. I went the next day to get the medicine and she had called in Farxiga again! Even my pharmacy said, I think this was one you can not take. Now what do I do? My primary care doc is in a walk in type clinic and with flue rampage right now, they don t advise me to come in as a well patient. I cannot take the flu vaccine so I ve been waiting for a good time, and right now it just is too much to put myself at risk; I ve tried to stay away from crowds and children for the time being. I know I have to have something else to bring down my blood sugars. My morn reading is from 165 to 210. I vary during the day, but no reading has been low where it should in several months.
Tue, 22 May 2018
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Internal Medicine Specialist,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

It seems that your diabetes is well out of control. Stopping Dapagliflozin (Farxiga) is not a good enough reason to explain the rise in HbA1c levels. Perhaps you should check your food intake as well? The quantity and quality of food is an important parameter. Another really important parameter is physical activity. Walking every day (or at least every other day) is as effective as a new pill. 20-30 minutes of fast walking is enough.

Regarding your current regimen. I usually advise patients like you to increase their insulin dosage gradually until they reach acceptable fasting measurements. For older patients a little higher readings are acceptable as well. Targeting a fasting blood glucose around 100 mg% per day is fine.

When the fasting blood sugar gets under control again, you can start checking your postprandial glucose levels. You can send another question then.

Until you get your blood sugar under control again, make sure you drink enough fluids. Dehydration is a danger is your water intake cannot match the increased losses due to hyperglycemia.

I hope you find my comments helpful! You can get back to me if you'd like more information or any clarification.
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Suggest An Alternative Of Farxiga To Manage Diabetes

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It seems that your diabetes is well out of control. Stopping Dapagliflozin (Farxiga) is not a good enough reason to explain the rise in HbA1c levels. Perhaps you should check your food intake as well? The quantity and quality of food is an important parameter. Another really important parameter is physical activity. Walking every day (or at least every other day) is as effective as a new pill. 20-30 minutes of fast walking is enough. Regarding your current regimen. I usually advise patients like you to increase their insulin dosage gradually until they reach acceptable fasting measurements. For older patients a little higher readings are acceptable as well. Targeting a fasting blood glucose around 100 mg% per day is fine. When the fasting blood sugar gets under control again, you can start checking your postprandial glucose levels. You can send another question then. Until you get your blood sugar under control again, make sure you drink enough fluids. Dehydration is a danger is your water intake cannot match the increased losses due to hyperglycemia. I hope you find my comments helpful! You can get back to me if you d like more information or any clarification.