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Diagnosed with diabetes. Medical test done. What does the reports says?

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Practicing since : 2009
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i have been diognised with diabeitics with hb 1ac at 11.5 in decmber 2011,after eight months of medicines( gluconorm2g forte twice daily plus 50 mg istavel once daily and telma h once my last hb1ac amonth back is around 8.recently i opted for heart check up and in echo it says in morphological data all normal and in final impression it says no rwma,lvef-60%,trace tr9pasp-33mm-hg),normal cardiac chamber compression,decreased lv complaince(agreater than e),no clot/mass/vegetation/ my tmt it says developed asymptomatic1.0-1.5mm HZST depression seen in lead 2,3,avf,v4-v6 ST-T changes reverted to basal pattern after 4 minutes recovery significant arrthymia observed during stress test,normal HR AND BP RESPONSE TO THE EXERCISE NO S3/S4 HEARD.NOW IS THE REPORTS OK OR I SHOULD GO FOR SOME MOE SPECILITY CHECKS.PLEASE GUIDE
Posted Thu, 18 Oct 2012 in Diabetes
Answered by Dr. Arnab Maji 2 hours later

Thanks for posting your query.

Your TMT report reveals that you have developped myocardial ischemic changes. Your HbA1C level is 8 which indicates that your diabetes is not yet well controlled.
Ideally it should have been between 6-7.

Now in this situation I advised to go for another test i.e. serum lipid profile which should be done with 12 hour fasting. In your case there is high chance of getting deranged lipid profile.

You do continue gluconorm forte 2 gram along with istavel 50 mg for diabetes management. Along with this you should have the following:

1. Life style modification in the form of regular exercises, 1 hour walking in the morning,
2. Diet control specially calorie and protein restriction, avoid spicy foods, red meat, junk food and fast food,
3. You should have to add the following medications -
a. Tablet aspirin 75 mg once daily,
b. Tablet clopidogrel 75 mg once daily,
c. Tablet atorvastatin 20 mg one tablet at night before going to bed
4. If there is any form of chest tightness or pain you should consult your cardiologist immediately,
5. You should have fasting and post-prandial blood sugar (FBS and PPBS) atleast once a month,
6. You should have HbA1C estimation once in every 3 months,
7. You should have an echocardiography every 6 months,
8. You should have serum lipid profile right now after 12 hour fasting,
9. Check your blood pressure twice in a month and if not controlled then change the mediacations or increase the dose by consulting a cardiologist.

Hope I have answered you. If you have further queries you can write back to me freely. Kindly write a review on my answer.

Wishing you good health,

Dr Arnab Maji

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