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What Causes Elevated Fasting Blood Sugar Level Despite Taking Medication?

Posted on Tue, 11 Aug 2015

Question: Hi, I take galvusmet (50/1000) twice daily but my fasting sugar is still around 230 mg/dl. What can I do to reduce my fasting sugar?

Answered by Dr. Binu Parameswaran Pillai (28 minutes later)

Brief Answer:
DIFFERENT OPTIONS

Detailed Answer:
Good day Mr XXXXXXX
Noted your concern. Galvus Met is a good drug. I would like to know if you had a recent HbA1C test ?
Please do a blood sugar by glucometer in one of these days at 3 am ( just one day)
The best option for you is to start a small dose of basal insulin (Lantus) at bedtime along with Galvus Met.

Second ( less preferred) option would be to add a tablet before breakfast in the morning called as Diamicron..
But I would like to know your recent HbA1C before I can advice further.
regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (34 minutes later)

Dear Dr.,

My recent HBA1C about a month back is 9%.

Regards.

Answered by Dr. Binu Parameswaran Pillai (11 minutes later)

Brief Answer:
Best option is insulin

Detailed Answer:
Thank you. In that case, adding Lantus insulin after dinner would be the best way. I strongly encourage that. Don't wait too long to start insulin.
But if you are hesitant to start insulin, the other option would be to add either Amaryl or Diamicron before breakfast. You should continue GalvusMet.
I hope you had your eyes checked this year. Also get lipid profile, urine routine, Kidney functions also checked every year. If you have hypertension , that also need to be controlled well.
Regards
Binu

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (26 minutes later)

Dear Dr. XXXXXXX

1) Which would you recommend to start first Amaryl or Diamicron?
2) My understanding is I continue with Galvusmet, just add either Amaryl or Diamicron. Is this correct?
3) If I opt for Lantus insulin, do I still continue with Galvusmet & (Amaryl or Diamicron)

Thank you.

Answered by Dr. Binu Parameswaran Pillai (6 minutes later)

Brief Answer:
Options

Detailed Answer:
My suggestion.(first option)
1. continue Galvusmet
2.Add Lantus at night.

check fasting sugars daily and we have to adjust dose of Lantus accordingly.

Second option.
1. Continue Galvusmet
2.Add Diamicron before breakfast.
wait for a month and if sugars still uncontrolled, then add Lantus to this combination.

I recommend the first option.

The dose can't be prescribed online due to legal reasons. where do you live?
You may have to meet an Endocrinologist in person to get a prescription.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Binu Parameswaran Pillai (6 minutes later)

Thank you.

I live in Malaysia.

I would like to try Diamicron first before Lantus.

I will try 30mg dose of Diamicron first and monitor sugar.

I understand that the dosage cannot be prescribed but as I have suggested the dosage, would you be able to comment on it?

Regards.

Answered by Dr. Binu Parameswaran Pillai (8 minutes later)

Brief Answer:
Yes. That's reasonable

Detailed Answer:
yes. that is a reasonable dose to start with. Take Diamicron ten minutes before breakfast.
wish you healthy life .

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar