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Diabetes,hypertension,hypoglycemia,calcium deficiency,weigh gain

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Internal Medicine Specialist
Practicing since : 2007
Answered : 362 Questions
My age is 49Y Has been diabetic since last 20 years. Since last three years physician has prescribed me Glimulin MF - 1/day, Pioglit MF 15 - 2/day. I also has hypertension. Other drugs daily are cardace 2.5, Ecosprin & Roseday 1 each. Glimulin MF prescribed first 1 year was 2 MF which was reduced to 1 MF since sugar levels were consistently whthin control. Ocassionally evening time i experience hypoglycemia. One of other physian also recently suggested that regime will impact calcium deficiency & weight gain in long term and hence has recommended Janumet 500 X 2. What are the side effects of Glimulin & Pioglit combination ? Will Janumet better recommendetion for minimum side effects ?
Posted Fri, 20 Apr 2012 in Diabetes
Answered by Dr. Kiran Kumar 1 hour later

I understand your concerns and will try to give you an appropriate advice which is up-to-date with current recommendations.
There are many medications available for treatment of Diabetes Mellitus
The most studied and most used ones belong to two of the following categories.
1. Sulfonylureas - Glimulin belongs to this category
2. Metformin - M in Glimulin MF and Pioglit MF contains Metformin.

Now, Both these medications are great and essential for treatment of diabetes,
Off late, there has been a concern that Metformin reduces absorption of Vitamin B12 by antagonizing the calcium dependent process. Such Vitamin B12 deficiency can be treated with calcium supplementation.

However, this not a major concern and out of 100 nearly 90 % patient will be on Metformin with no adverse effects.

Pioglit contains Pioglitazone which is added to Glimulin and Metformin if sugars are not well controlled.
The only side effect of pioglit worth mentioning is that it can lead to fluid accumulation and swelling of legs/weight gain.

Janumet is a newer medication which contains Januvia and Metformin. So, it does contain metformin which may require calcium supplementation.

As your blood sugars are well controlled with the current medicines, there is not need to change or add any newer medicine.

So, you must continue with Glimuln MF 1 and Poglit MF 15.
As of now, Janumet will not add any more benefit.

Hope this answers your query.
Please get back if you need any further information

Thanks and Regards

Dr Kiran

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