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What Do These FBS And PPBS Values Indicate?

Posted on Mon, 11 Jan 2016

Question: I have a 145 glucose fasting and a little over 200 after meals. I take janumet 50/1000 and
have kidney disease. What alternative medicine I should be taking . Thank you.

IF POSSIBLE AS A FOLLOW UP QUESTION, DIET THAT TAKES INTO
CONSIDERATION KIDNEY DISEASE AND DIABETICS

Answered by Dr. Rakesh Madhyastha (2 hours later)

Brief Answer:
Need more info

Detailed Answer:
Hello

Thanks for the query

I understand that you have chronic kidney disease as well as diabetes. Howver in order to help you I need a few more details

1. what is your current serum creatinine?
2. what is your weight and height ?
3. in brief please tell me about your average day and exercise routine
4. do you consume animal meat? if yes please mention how often and the type of meat. Example beef, fish , etc

Please get back to me, I am awaiting your reply

Regards

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Rakesh Madhyastha (1 hour later)

SERUM CREATINIE 2.2
W.87 KGS H 183CM
NO EXERCISE TO SPEAK OF
3 TIME A WEEK LEAN MEAT, OR CHICKEN AND FISH MODERATE QTY.

Answered by Dr. Rakesh Madhyastha (14 hours later)

Brief Answer:
Needs immediate attention

Detailed Answer:
Hello

Thanks for the query

1. Janumet contains a drug called metformin which is not given in patients with creat of more than 1.8mg/dl as it is known to cause severe metabolic acidosis. I strongly recommend you to stop taking this combination drug. I suggest you to plain sitagliptin and since the sugars are not under control the dosage will require adjustments. The other drug that you can be on is a short acting sulfonylurea called glipizide, please speak to your doctor about this. Furthermore, studies have shown that CKD patients are best managed with short acting insulin, in fact all my patients are on insulin. It might be annoying first but the long term results are great

2.The other drug that I usually put my patients on is a soda bicarbonate tablet, CKD patients are acidotic and this causes some amount of mineral bone disorder, I suggest you to be on sodabicarbonate supplements. On your next visit along with creat get Hb, uric acid, serum bicarbonate, calcium and phosphorus done. These parameters are to be looked into on your every visit

3. You are slightly over weight, I would prefer you to be 70-75kg. I suggest you to exercise daily, a simple brisk walking 30 min a day is more than sufficient to bring down your weight over a period of time

4. Avoid potassium rich food like fruits ( you can have apples, papaya, pineapples and guava as they are low in potassium), fast food like pastas, pizzas.
It is very important that you cut down on salt, do not consume pickles, fast food, pop corn, chips, nachos, etc.
Keep your fluid intake to less than 1.5 litres per day, if you notice edema then I suggest you to cut down further
You can eat chicken and sea food, please avoid red meat.

I hope I was of help, if you have any further queries please get back to me

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (3 hours later)

Thank you very much Dr. Madhyastha for your valuable medical advice.

Answered by Dr. Rakesh Madhyastha (11 minutes later)

Brief Answer:
Welcome

Detailed Answer:
Hello

I am glad you approached us. Please get back to me for any doubts you may have in the future. I will be happy to get back

Regards

Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Sonia Raina