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What Causes High Fasting Blood Sugar Levels?
Question: Endocrinology
Dear Doctor,
I am 72 year old male. I had Type ii diabetes in the yea 2010. Hypothyroidsm in the year 2011. I take glycomet 250 mg twice a day and thyronorm 88 mcg a day. I am a vegetarian and and had moderate habit of eating . I walk for 4 km every day. I eat only 2 chapthis during the night and a glass of buttermilk. In the morning i take 3 idlys as breakfast and lunch at 1 pm.From the begining my fasting glucose levels oscillating between 100 to 120 and on very few occassions to 125. these are glucometer levels.My post lunch levels are always low and goes upto 140 . The fasting level as on today (laboratory test result) is 125 and the post lunch level is 140. The TSH is 0.5 T4 is 9.8. Kindly adivse me why my fasting levels are high and why my pp levels are low.How can i reduce this fasting level to below 100 . I think since i have hypothyrodism, my metabolism is not upto the mark. is it so? Can i use any medicine to reduce the fasting level? If you require any further info, kindly question me.
Dear Doctor,
I am 72 year old male. I had Type ii diabetes in the yea 2010. Hypothyroidsm in the year 2011. I take glycomet 250 mg twice a day and thyronorm 88 mcg a day. I am a vegetarian and and had moderate habit of eating . I walk for 4 km every day. I eat only 2 chapthis during the night and a glass of buttermilk. In the morning i take 3 idlys as breakfast and lunch at 1 pm.From the begining my fasting glucose levels oscillating between 100 to 120 and on very few occassions to 125. these are glucometer levels.My post lunch levels are always low and goes upto 140 . The fasting level as on today (laboratory test result) is 125 and the post lunch level is 140. The TSH is 0.5 T4 is 9.8. Kindly adivse me why my fasting levels are high and why my pp levels are low.How can i reduce this fasting level to below 100 . I think since i have hypothyrodism, my metabolism is not upto the mark. is it so? Can i use any medicine to reduce the fasting level? If you require any further info, kindly question me.
Brief Answer:
You have to increase the dose of metformin
Detailed Answer:
Hi XXXXXXX
Welcome to HCM.
The fasting levels are usually high and PP levels are low in early diabetes. This is called reactive hypoglycaemia. This is due to high levels of insulin in body early in diabetes. This is our body's response to decrease sugar.
The metformin dose you are taking is very low. You can increase the dose of metformin after discussing with your treating doctor - usual dose is 500 - 2500 mg/day. That will help you to bring the fasting sugars to normal. Have 3 meals and 3-4 snacks a day.
Your thyroid functions are normal now, so don't worry about metabolism. Continue with same dose of medications
Hope I have answered your query. If you have any further questions I will be happy to help.
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.
You have to increase the dose of metformin
Detailed Answer:
Hi XXXXXXX
Welcome to HCM.
The fasting levels are usually high and PP levels are low in early diabetes. This is called reactive hypoglycaemia. This is due to high levels of insulin in body early in diabetes. This is our body's response to decrease sugar.
The metformin dose you are taking is very low. You can increase the dose of metformin after discussing with your treating doctor - usual dose is 500 - 2500 mg/day. That will help you to bring the fasting sugars to normal. Have 3 meals and 3-4 snacks a day.
Your thyroid functions are normal now, so don't worry about metabolism. Continue with same dose of medications
Hope I have answered your query. If you have any further questions I will be happy to help.
With warm regards,
Dr Ajish TP (MD,DM)
Consultant Endocrinologist.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Can i take metformin 500 mg once a day or twice a day? If single dose, can i take during the bed time?
Brief Answer:
It's better to take twice a day.
Detailed Answer:
Hi XXXXXXX
Welcome back.
It's better to take Metformin 500mg twice a day. Please do an HbA1C (3 month average blood glucose) which is a better test to guide your treatment. It should be less than 7%.
It is always better to discuss regarding change of any dose of the drugs they have prescribed as to have regular followups with them.
Good day
Regards
Dr Ajish TP
Consultant Endocrinologist
It's better to take twice a day.
Detailed Answer:
Hi XXXXXXX
Welcome back.
It's better to take Metformin 500mg twice a day. Please do an HbA1C (3 month average blood glucose) which is a better test to guide your treatment. It should be less than 7%.
It is always better to discuss regarding change of any dose of the drugs they have prescribed as to have regular followups with them.
Good day
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Dear Doctor,
MY HBA1c is 6.9 as of now. last three quarters it stood at 6.5.I have contacted my doctor and he has advised me to take 500 mg in the night and 250 mg during the morning. Also he suggested me upriseD3 60k one per week for a month since i have D3 at 25.He has changed the stamlobeta hich was being taken by me for the last 20 years to Cresar 40 mg once a day.
MY HBA1c is 6.9 as of now. last three quarters it stood at 6.5.I have contacted my doctor and he has advised me to take 500 mg in the night and 250 mg during the morning. Also he suggested me upriseD3 60k one per week for a month since i have D3 at 25.He has changed the stamlobeta hich was being taken by me for the last 20 years to Cresar 40 mg once a day.
Brief Answer:
Follow your doctor's instructions
Detailed Answer:
Hi XXXXXXX
Welcome back.
Your HbA1c is well controlled. The target HbA1c at this age is less than 7%. That may be the reason why your doctor has only slightly increased the Metformin dose. We can follow up the Hba1c after 3 months.
The change of antihypertensive is also appropriate, as Cresor ( Telmisartan) is an ideal antihypertensive for diabetes as it prevents diabetic kidney disease.
So your doctor is thinking in right direction. Follow up with him.
Good health
Regards
Dr Ajish TP
Consultant Endocrinologist
Follow your doctor's instructions
Detailed Answer:
Hi XXXXXXX
Welcome back.
Your HbA1c is well controlled. The target HbA1c at this age is less than 7%. That may be the reason why your doctor has only slightly increased the Metformin dose. We can follow up the Hba1c after 3 months.
The change of antihypertensive is also appropriate, as Cresor ( Telmisartan) is an ideal antihypertensive for diabetes as it prevents diabetic kidney disease.
So your doctor is thinking in right direction. Follow up with him.
Good health
Regards
Dr Ajish TP
Consultant Endocrinologist
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
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