Talk to Endocrinologist on Diabetes T2
Asking for Other, Male, 40 years old, Rawalpindi/Islamabad
My College Alwani 40, has been diagnosed as T2DM in 2011. his 1st Hba1c was 9.4. % with exercise and Treviamet,50/1000mg his Hba1c com down to 5.4% ,and he maintained it till 2018 in the range of 6.4 or 6.2 not touched even 7%. he reduces about 40 pounds weight in 5 months his Uric acid, LFT, RFT, Lipid etc all labs were normal even in 2018 he did CT Angiography that was Normal. he got ankle sprain injury. so he was unable to walk daily. then he left his diet and walk for one year. three months back his HBA1C was 9.4%. his Doctor Prescribed, Glemiprizid 8mg daily+ 2000mg metformin daily. with Tab, Empagliflozin(Jardy(25mg daily + Sitagliptin 100mg daily. now he is facing with Hypoglycemia. more then foure times daily his BG level less than 60mg/dl. he has no energy to walk. his Doctor is not ready to reduce his dosage of Amaryl. so my Question is that if All of You /Doctors /could help him, guide him. what he can do? does he repeat A1c after 8 weeks? will changes will reflect in 8 we
Dr. Awais Masood - Endocrinologist
MBBS, Diplomate American Board of Internal Medicine, Diplomate American Board of Endocrinology Diabetes and Metabolism. | Lahore
312 Positive Reviews
Looks like a very compliant patient.Recurrent frequent hypoglyyis dangerous. Cut glimipride to half - if still issues with hypoglycemia then stop it.
My best
AM
Assoc. Prof. Dr. Javaid Iqbal - Endocrinologist
MBBS, FCPS (Medicine), Fellow in Endocrinology Diabetes and Metabolism | Lahore
579 Positive Reviews
I think his jardy and glimepride be stopped check sugar values thrice. Fasting before lunch and bedtime...avoid hyypoglycemia as it can be dangerous ...send sugar record of 24 hours
Member
Anonymous User
Dear,Dr.Javeid Iqbal saheb. Fasting BG 88mg., after breakfast 140, before lunch 70mg/dl, after,160mg/dl. evening,usaly 55mg/dl to 90mgdl until morning,i am trying to send a file of my Accu check softwar log book data or screen shots
Blood sugar appears OK except for evening and nocturnal hypos. You should consult one doctor with whom u have faith. certainly you need reduction of some drugs as hypo are damaging.Also repeat HbA1c to see long term control.
Dr. Zeeshan Javed - Endocrinologist
MBBS, MD (USA), PhD Medical sciences (UK), Speciality Certificate in Endocrinology & Diabetes (Royal college UK), Diploma Endocrinology & Diabetes (QMUL-UK) | Gujranwala
120 Positive Reviews
Even one low blood sugar can cause cardiac arrest which could be very fatal. I agree with other doctor Sahiban that Glimepiride should be stopped. Secondly is he taking medicines as a single dose like metformin 2000mg at one time?? If yes then divide it to 1000mg twice daily with Empagliflozin in the morning and sitagliptin 100mg at Lunch time. Avoid too much medication at night as he could have more hypos in the evening and overnight. Then after 3 months look at HBA1C and BSL chart what happens.
Dr. Zeeshan Javed - Endocrinologist
MBBS, MD (USA), PhD Medical sciences (UK), Speciality Certificate in Endocrinology & Diabetes (Royal college UK), Diploma Endocrinology & Diabetes (QMUL-UK) | Gujranwala
120 Positive Reviews
If he cannot walk then I would suggest cycling at home or if available swimming for exercise.
Dr. Zeeshan Javed - Endocrinologist
MBBS, MD (USA), PhD Medical sciences (UK), Speciality Certificate in Endocrinology & Diabetes (Royal college UK), Diploma Endocrinology & Diabetes (QMUL-UK) | Gujranwala
120 Positive Reviews
Numbers not coming right above: Start with following regimen:
Stop Glimepiride
Metformin thousand mg twice daily
Empagliflozin twenty five mg with breakfast
Sitagliptin hundred mg at Lunch time
Dr. Zeeshan Javed - Endocrinologist
MBBS, MD (USA), PhD Medical sciences (UK), Speciality Certificate in Endocrinology & Diabetes (Royal college UK), Diploma Endocrinology & Diabetes (QMUL-UK) | Gujranwala
120 Positive Reviews
That's good. But main issue is low blood sugars. That should not occur.
Member
Anonymous User
@Dr Zeeshan Jvaed Saheb!. here is my new post.Dear, Doctors, Saheban.our last hope is Allah and then Marham. As I explained in the Previous post that Glimepiride 8 mg daily + jardy 25mg+metformin 2000mg +Sitagliptin lowering my BG level to Hypo level. Your advice was to stop Glimepiride. my healthcare was not ready to stop Glimepiride, another one added Tab Glucobay 100mg. yesterday after 38 days our HBA1c has come down from 9.4 to 8%.one your advice now I am started Metformin 1000mg 1+1, Jordy 25+, and Admit100 dinner time. Before Dinner Bg was 100mg/dl, early in the morning 3:00 am BG was 103mg/dl. is this okay for me? waiting for your great response.attached is prescription.
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Dear, Doctor Saheb. Thanks for your response. Do you think we can meet you are maybe you can suggest us a Doctor? Do you think after 8 weeks his A1c will change?
1 month ago