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Query about latest drugs used in Anti diabetic ranges - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Diabetes
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
Doctor :   hi
Doctor :   how can i help you?
User :   Hi Doctor good day
Doctor :   Good day to you too
Doctor :   please go ahead with your query
User :   Doctor i would like to know the latest drugs used in the Anti diabetic ranges
Doctor :   ok
Doctor :   For Administrative and health purposes, Please provide these details of the patient-Age: Gender: Occupation: Location: Marital Status: Weight and Height: Dependents: Yes/ No.
User :   since my mother is diabetic she was earlier on insulin injection but now she is on oral hypo glymci agents
Doctor :   ok
User :   age she is 60, female, house wife, she is 5 ft 3 inches in height and weight i think she is 75 kgs
Doctor :   ok
Doctor :   does she have any other health problems?
User :   now the thing is that she has being on 3 different combiantion drugs but again her glucosle level is not under control
User :   no
Doctor :   ok
Doctor :   did she get her Lipid Profile done?
User :   she takes appr 10 Tablets per day
Doctor :   ok
User :   i don't remeber exact figures she has little more of LDL
Doctor :   ok
User :   it was done month back
Doctor :   the best management in such cases is strict diet control and exercise
Doctor :   if that is not done she may have to be shifted to insulin
User :   even diet control does not gives any better results
Doctor :   as she is also overweight i would recommend that she exercises regularly
Doctor :   1/2 hr of walking regularly
User :   ok one thing i rember she has become now arthertic now her joints have added more troubles to her
User :   she cant walk now
Doctor :   ok
User :   for a long distance
Doctor :   then diet control is the only way
User :   climbing steps , she is feeeling difficutl
Doctor :   ok
Doctor :   she should then follow a strict diabetic diet
User :   now suggest what best can be done to her
Doctor :   what drugs is she taking now?
User :   she is taking rosigitazone, metformin, pioglitzone, glimipride and even gliclazide all moost all the anti diabetic drugs she has been prescribe
User :   i think the dosage regime has to optimised
Doctor :   ok
Doctor :   what are her blood sugars now?
User :   her fasting sugar level is 210 and PPBS is around 280-300
Doctor :   is she on storvas or any drug for her lipids?
User :   yes simvastatins 10 and fenofibrate 10 mg i think
Doctor :   ok
Doctor :   then she might need insulin therapy for some more time
User :   now wither i should take her for walking or i should keep her at rest because now she is complaining about the joint pains
Doctor :   ok
Doctor :   diet restriction needs to be done
User :   we stopped insluin because she has developed the insulin resistance, i,e her ppbs was more as compared to FBs
Doctor :   she should take only complex starches like wheat and ragi
Doctor :   she should try and avoid rice
Doctor :   she should take more soluble fibre like pulses, beans, sprouts
Doctor :   ok
User :   now how about fruits which one can she take and how much qty
Doctor :   try giving her ragi malt instead of regular diet
Doctor :   try to avoid fruits for now
Doctor :   till her sugars improved
Doctor :   she can take vegetable juice
User :   malt will increase the blood sugar raher than decreasing because it will be in semi solid form
Doctor :   ragi is still complex starch than rice
Doctor :   she needs to take it as a replacement for rice
User :   ok so you suggest ragi malt
User :   atr what qty she should take
Doctor :   it should be made of ragi powder
Doctor :   mixed with water and boiled
Doctor :   with a little bit of saly
Doctor :   salt
Doctor :   she can take a glass of it instead of a meal
User :   one glass will it be sufficient
Doctor :   she needs to be monitored regularly
Doctor :   yes
Doctor :   it is calorie dense
Doctor :   also she needs to take frequent small meals
User :   Does it will cause constipation
Doctor :   may be 6-7 small meals per day
Doctor :   as she will also be taking other fibres like salads and sprouts
Doctor :   constipation may not be a problem
User :   these small meals should of around how qty
Doctor :   she should take a calorie requirement of 1500-1800 calories per day
Doctor :   not more than that
User :   ok
Doctor :   the sprouts and salads need not be restricted
Doctor :   in amount
User :   then now she require walking or not
Doctor :   she can take 2 phulkas for lunch and dinner
Doctor :   2-3
Doctor :   papayas are good options for diabetics
Doctor :   Green leafy vegetables, tomatoes, cucumber, soups, buttermilk should be taken more
Doctor :   she should be monitored regularly
User :   ok well how much qty of papayas
Doctor :   not more than a few slices per meal
Doctor :   say 5-6 medium sized slices
User :   ok
Doctor :   i suggest that for better info on the diet
Doctor :   you check out
Doctor :   or WWW.WWWW.WW
Doctor :   YYYY@YYYY Mobile : 91-0000
Doctor :   please confirm your details
User :   yes it is true
Doctor :   ask her to try walking for atleast 10-15 min
Doctor :   at a slow pace
Doctor :   as it would make a lot of difference
User :   ok but about her pain
Doctor :   she can use a topical gel like volini gel or spray
Doctor :   and apply hot fomentation
Doctor :   or cold compresses
User :   bbut it is not giving any relief even i tried for a haprain gel with that she just got some inflamation relived
Doctor :   did you get an xray done for her?
User :   shall i put her on glucosamine
User :   no
Doctor :   ok
Doctor :   are you a physician?
User :   at what dose shall i start
Doctor :   no
User :   no i am scientist
Doctor :   i suggest that you get an xray and an orthopedician consultation done for her
Doctor :   as i cannot prescribe the dosage to you online for her own safety
User :   ok
Doctor :   she needs to get examined by an orthopedician
User :   does she require any anti oxidants
Doctor :   you can give her evion tablets 400mg
User :   and calcium supplimnets
Doctor :   for 3 months
User :   ok
Doctor :   and calcium can also be given
Doctor :   but i suggest an xray first

Doctor :   Please fill the feedback form say done when done

Doctor :   YYYY@YYYY

Mobile : 91-0000
Doctor :   please confirm your details
User :   ok doctor i have already started on calcium and anti oxidants just ffor how many days i have to give
User :   yes
Doctor :   ok
Doctor :   evion shouldnt be given for more than 3 months
Doctor :   calcium i suggest to be given after ortho consultation
User :   since she is taking all these medcines she has now gastric problmes that is acidity
Doctor :   ok
User :   she is on omeprazole and domepridone
Doctor :   ok
User :   combination
Doctor :   ok
User :   now can you suggest me weither i can go ahead with this or antacid will be better , because above drugs act systemicly and this topical
Doctor :   please continue the combination
Doctor :   as antacids are not sufficient to supress acidity alone here
User :   ok she also started to develop resistance and domepridone can't be given for more days
Doctor :   then put her on omeprazole alone
User :   ok doctor
Doctor :   anything else?
User :   no doctor i will take all the suggestion which you have given ,
Doctor :   ok
User :   thank you very much for the suggestions i will get back to you shortly
User :   good day
Doctor :   Thanks for consulting Health care magic. Bye for now. Please refer your friends to our service
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