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Will regulating diabetics drugs dosages advisable to keep blood sugar in control?

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General & Family Physician
Practicing since : 2009
Answered : 5166 Questions
I am Type 2 diabetic..long term, aged 62 overweight etc...I have recently been taken off ACTOS and noticed my blood sugar fasting levels to be raised considerably. I am now taking double the units to maintain around '< 7'mmol. I use a LANTUS Solostar with 45-50 units around 9:00pm at night.I am taking 60mg of DIAMICRON MR, and wondering if I raise it to 120mg of DIAMICRON (gliclazide) will assist in lowering the BSL and accordingl my insulin doseage?? Or s it likely the effectiveness of the gliclazide is long passed? Looking forward to opinions and advice thank you. XXXXXXX from Gold Coast, Australia Sorry error in medication. METFORMIN 2x 1000mg, split morning and night. I feel MUCH better since getting off ACTOS, and reducing my Atorvastin from 40mg to 20mg. I dont think I should even be taking glicazide now I am on insulin...what do you think? Regards XXXXXXX
Posted Thu, 23 Jan 2014 in General Health
Answered by Dr. Chobufo Ditah 2 hours later
Brief Answer: We need more information Detailed Answer: Hi and thank you so much for trusting us with your health query. I am so sorry to hear about this long standing battle with diabetes and the recent difficulties in getting your blood sugar values within the recommended range. Regulating the dosages of diabetics drugs requires more information. Though fasting blood sugar gives us an idea how well the control is, we often want to get a minimum of 4values per day over a couple of days to know exactly which drug and when needs to be adjusted. For example, a high blood sugar in the morning may suggest an insufficient drug dosages at bedtime. The values that we need are fasting blood sugar, prelaunch, pre-diner, and bedtime values. Also, an estimate of the glycated hemoglobin would shed more light on the long term control of your diabetes. If this is possible, then I would very much appreciate it to give a more rounded recommendation that you can discuss with your doctor. If all ii have is what you have provided, then I will suggest that the night dosages are insufficient. Diamicron is typically taken daily in the morning. You have not yet reached he maximum recommended and this could be a drug for us to try manipulating to see what we get. However, changing a drug regimen based on a single value is not the wises thing to do. I will very much appreciate more numbers to make more solid recommendations. The effectiveness of glycazide has not been exceed because dosages of up to 120mg daily are acceptable and you have not yet reached this maximum level. Insuin can be combined with glycazide. However, manipulating to get the appropriate dosages for each can be done. Also, you may want to eliminate oral drugs and rely entirely on insulin by increasing the dosages. These are all options you need to confront your doctor with. I cannot over emphasis on the need on an honest discussion with your doctor concerning these drugs. I hope you find this helpful. I wish you well. Please, feel free to ask for more information or clarification if need be. Thanks. Dr. Ditah, MD.
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