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What are the findings from HbA1c and thyroid function test?

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Practicing since : 1998
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need an opinion on my mothers medication. kindly refer to the attached reports. diabetic for 15 yrs reports are attached to the query raised on 28th october 2013
Posted Sat, 28 Dec 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Minal Mohit 25 hours later
Brief Answer: Reports seem to be all acceptable. Detailed Answer: Dear XXXXXXX Hi! I am not sure what are you exactly looking for. Your query was there for some Dr. by name and at the same time your query was also there without any name of the doctor specifies. initially i overlooked as the other doctor was answering it, but today i had time so i went through your mother's reports. All reports are within acceptable limits. What i searched for and did not find to comment upon medications is 1. her sugar values both fasting and PP 2. her HbA1c 3. her BP monitoring 4. Her TSH / FT4 5. her lipid profile. 6. creatinine. 7 her present complaints/ symptoms. what I mean is that you have asked for an opinion on medications but i cannot comment upon medications from these reports what you have sent me. what ever you have sent me is all resonably normal. So if you want me to comment upon medications please tell me all those reports which I have asked for. Regards!
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Follow-up: What are the findings from HbA1c and thyroid function test? 14 days later
Dear Dr. XXXXXXX Her HbA1c is 6.6 , sugar both fasting and PP are within the acceptable range, likewise T3/ T4/ TSH and lipid profile. At present she is taking 16 units of Novomix insulin ( 70 slow relaese : 30 immediate release ) before breakfast and before dinner and aslo taking 500 mg of Metmorphin for controlling her sugar. the query is wrt to change of medication and initiating a newly introduced drug Januvia - sitagliptin phosphate . Kindly suggest if Januvia or any similar drug is better than metmorphin and if its recommended , how to go abaout initiating this kindly note its 500 mg before breakfast and before dinner along with Insulin
Answered by Dr. Minal Mohit 39 hours later
Brief Answer: Continue same treatment. Detailed Answer: Dear XXXXXXX hi thanks for all the communication. Your mom's HbA1c is good and if she is tolerating metformin there is no need to change to januvia. januvia is a good drug but if things are anyways under control just continue same. Regards!
Above answer was peer-reviewed by
Follow-up: What are the findings from HbA1c and thyroid function test? 9 minutes later
we are given to understand the Januvia is a better drug than metformin and it reduces the the requirements of Insulin and replaces metformin , hence the query, if its recommended for a switch. my mother's sisters who are also diabetic have been moved to Januvia and their insulin intake has reduced to half and likewise metformin. Thanks for your advise.
Answered by Dr. Minal Mohit 26 minutes later
Brief Answer: That can definitely be done. Detailed Answer: Dear XXXXXXX if you are looking for insulin dose reduction , yes that can be done. in that case you put her on Janumet 50/500 (januvia 50 + metformin500) twice a day. before breakfast and dinner. and reduce the dose of novo mix by one third. monitor sugars regularly fasting and pp and go on adjusting insulin dose every third day. make sure her creatinine is normal. tell me if you can why was she put on insulin and is not on tablets. regards !
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