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Metformin for diabetes - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   Hi
User :   hi there, i am 30 yrs old, and 88 kgs in wieith and 5'4" high.
User :   Have been recently diagnosed with metabolic syndrome !!!
Doctor :   ok
User :   then and have been put on Metformin 500 mg Cardace Onglyza Simvotin
Doctor :   ok
Doctor :   do u know your HBA1C ?
User :   8.6%
Doctor :   THAT is very high
User :   :(
Doctor :   so u are a diabetic , with high BP and a high cholesterol
User :   High albumin too
User :   Is it diabetic or insulin resistance ?
Doctor :   so kidney is also involved , and with probable nephropathy
Doctor :   diabetic or insuline resistance is one and the same
User :   none are reversible ??
User :   how can it be reversed ?
Doctor :   adequate diabetic control with medicines , physical exercise are helpful
User :   Probability of permanent reversal ?
User :   Sorry to add, ALT (SGPT) was also high (77)
Doctor :   it can be controlled and brought back to normal ,
Doctor :   but you need to be very diciplined and follow a strenuous and strict diet and medication
User :   But the moment i will withdraw diabetic controls (temporarily) it will re-manifest ?
Doctor :   yes
Doctor :   but not suddenly
Doctor :   if you stop treatment permanently, progression and deterioration will be rapid
User :   Does it mean, if glucometer depicts normal range fasting and pp, then also i can not be off metformin ?
Doctor :   until your AIC is less than 5.0, there will be no talk of reducing medications or getting off them
User :   Ok, so i should get that done every three months ?
Doctor :   yes thats right
User :   I learn that weight loss (since my BMI is very high) is going to be helpful, i needed to know if i have to reach 65-70 Kgs as my weight, through excersices and dietery measures....what should be the intensity of both these
Doctor :   reduce your weight and follow a good diet (low carbs, and fats )
Doctor :   minimum 45 min of workouts , for 5 days a week with a goal to reduce at least 1- 1.5 kilos a week
Doctor :   or 5 kilos a month,
Doctor :   would help
User :   But i also heard that Metformin has some side effects?
Doctor :   yes, it does ,
Doctor :   but its the best medication to help in diabetes
User :   What are the threats ...??
Doctor :   lactic acidosis, nausea, liver damage, diarrhea, are some
User :   Liver damage seems to be really threatening especially when i already have high ALT
User :   What do i need to do to get a customized diet chart ?
User :   or Plan ?
Doctor :   You can drop a mail
Doctor :   and they will get back to you
User :   What could be the reason for high ALT ?
Doctor :   also a dietician will make a telephonic interview and get a plan speciic for you
Doctor :   liver damage is the main reason for high ALT
User :   when with metformin it could be even more threatning
Doctor :   no
Doctor :   a mild elevation upto 70 is not dangerous
Doctor :   it is only when the levels are above 400 +
User :   ok, also i am a ocasional drinker, 3-4 pegs in month. can it add to the condition??
Doctor :   yes
User :   or do i need to quit it completely?
Doctor :   intake of alcohol can also result in liver damage and also worsen diabetes
Doctor :   quiting alcohol would be very helpful
User :   smoking ?
User :   2-3 in a day
Doctor :   you should reduce it too
User :   is 2-3 on a higher side??
Doctor :   it is not on the higher side
Doctor :   but being a diabetic and hypertensive and then smoking , can speed up atherosclerosis and cause more vascular damage and result in events like stroke
Doctor :   so quitting it would be in the best interest for you
User :   Thanks doc, I think just at 30 i will have to live like a 50 yrs old person. :(
Doctor :   since you have all the conditions and risk factors that cause health hazards, you might do it as well for yourself and your family
User :   i know doc, will consult the dietician for a personalized diet plan.
Doctor :   good
User :   It was nice talking to you Dr, really appreciate it....
Doctor :   you are most welcome
Doctor :   take care and have a good day
User :   same to you
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