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Taking glycomet for diabetes. Suggest proper medicine to control diabetes

DOCTOR OF THE MONTH - Jan 2013
Jan 2013
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Internal Medicine Specialist
Practicing since : 2003
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Hi! This is XXXXXXX from nagpur.I am 40yrs and diabetic since 4yrs.I am taking glycomet 250 mg 1and 1/2 tab each i.e(375mg) dose during lunch and dinner.My average fasting is 142 mg/dl and pp is 180mg/dl.Kindly suggest me proper medicine so as to control my diabetes properly.
Posted Wed, 20 Mar 2013 in Diabetes
 
 
Answered by Dr. Mayank Bhargava 18 minutes later
Hi XXXXXXX
Welcome to XXXXXXX forum.

There are multiple medicines available in market used for control of blood sugar.
Few of them works on fasting blood sugar and few on postprandial blood sugar.
Different group of medicines have different mechanism for control of blood sugar.

Metformin (Glycomet) and pioglitazone never cause hypoglycemia so its useless to take these medication in two divided dosage such as 250 mg and 125 mg.
Metformin is also available in 1000 mg preparation in combination with other medicines.

You should consult with your treating doctor/ XXXXXXX medicine specialist/ endocrinologist and should go for thorough check up.
You should also go for glycosylated hemoglobin (HbA1c) for exact status of your blood sugar in last three months.
As you are young with expectation of a long life, you should take DPP IV inhibitors such as Vildagliptin 50 mg.
This will help in control of blood sugar both fasting and postprandial.
You should start with 50 mg Vildagliptin (available with name of Galvus/ Zomelis/ Jalra) once in a day with lunch.
This medicine is also available in combination of metformin.

You should go for repeat blood sugar both fasting and postprandial after 10 days of taking these medications.
You should also go for renal function test, lipid profile, urine routine microscopy for better clarification.

There are other ways for control of blood sugar like by use of Sulfonylureas and insulin. But with considering your blood sugar status and age, its better to take Vildagliptin with metformin.

You can ask direct query on this URL: http://bit.ly/Dr-Mayank-Bhargava

Hope that helps.
Let me know if I can address any more concerns.
Take care,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
Follow-up: Taking glycomet for diabetes. Suggest proper medicine to control diabetes 6 hours later
sir,will the combination of glimeperide and metformin will be suitable for me.kindly suggest me thethe medicine with dosage if possible.
 
 
Answered by Dr. Mayank Bhargava 7 hours later
Hi,
Glimipride is a sulfonylureas and it acts by releasing increased insulin from beta cells of pancreas. Persistent use Glimipride cause exhaustion of beta cells with progressive decrease in beta cells.
Vildagliptin acts by inhibiting degradation of available insulin and thus insulin acts for longer period.
Vildagliptin doesn't cause exhaustion of beta cells.

Your blood sugar is not in higher range and it can be better controlled with use of Vildagliptin + Metformin.
If your blood sugar won't control by this medicine or in higher range like 300-400 mg% then I would definitely suggest Glimipride.

Best regards,
Dr. Mayank Bhargava
Above answer was peer-reviewed by
 
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