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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetes. Blood And Urine Test Shows ESR 22, Blood Glucose 131, PP BF 258, Microalbuminuria 159. Suggested Glycomet, Volix, Repace, Seval Tabltes. Opinion?

Dear Doctor,

I am a diabetic female diabetic since 15 years. blood and urine test reveal; ESR 1 Hr:22, Blood glucose (f):131 and (PP BF: 258, Microalbuminuria:159 and urine albumin : nil. BP: 140/80, having a normal ECG. I am advised 1. Glycomet GP 3/850, 2). Tab.Volix 0.3 mg, 3) Tab.Repace 50 mg/covance and 4) Tab Seval . I solicit your expert opinion on the drugs prescribed.

Thanks and regards
Madhumathy
Bangalore
India.
Wed, 24 Jul 2013
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General & Family Physician 's  Response
Hello,
After going through your reports and drugs I understand that you have
1) Diabetes Mellitus
2) Mild hypertension
3) Micro albuminuria
ECG is normal. Micro albuminuria can be easily rectified by taking plenty of water and treating UTI if you have. USG and urine culture if necessary - for kidney if done it is better.
Your BP is under control with the current tab of Repace. Continue salt, oil, fat restricted diet and tension free life.
You post prandial blood sugar is very high even after tab Voglbo which prevents the absorption of dietary glucose
Regarding Glycomet GP (metformin + glimepride) - As once or twice a day is not mentioned -you can try some other combination of metformin with a twice a day dosage schedule. Of course diabetic diet and physical work are primarily important.
Best wishes
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General & Family Physician Dr. Lohit K's  Response
Hi Madhumathy, Thanks for using HCM.
With the report you are uncontrolled with the drugs and also nephropathy.
Glycomet GP 3/850 and Tab.Volix 0.3 mg is for diabetes. Take volix with food to reduce absorpyion. Tab.Repace 50 mg/covance for BP and Tab Seval is multivitamine drug. Continue all the drug. Your drugs need to be adjusted or if no improvement need to be shifted to insulin.Get done HbA1c, lipid profile, retinal examination to know the status. Have adequate regular sleep, plenty of fluids, nutritious diet with required calorie and regular outdoor exercises for your wellbeing.
Hope I answered your question. Consult your doctor for further management.
Feel free to ask me if you have any further queries.
Wish you good health. Take care.

Regards
Dr. Lohit K
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
Hello,
Your reports suggest uncontrolled diabetes with high blood pressure and microalbuminaria.
Microalbuminaria is an important clinical finding because it not only tends to progress to macroalbuminaria and renal failure but also various cardiovascular events.generally macroalbuminaria arises around 5 to 10 years after microalbuminaria.
The problem is that decline in renal functions and hypertension occurs in a diabetic while in microalbuminaria stage.
Treatment is very tight control of your blood sugar levels and BP below 120/80 and HBA1c below 7 and your LDL cholesterol below 80 and triglycerides below 150.
Although your medicines are all right but my advice to you is to get yourself treated by a diabetologist and nephrologist together.
I hope it helps
ThanksĀ 
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Diabetes. Blood And Urine Test Shows ESR 22, Blood Glucose 131, PP BF 258, Microalbuminuria 159. Suggested Glycomet, Volix, Repace, Seval Tabltes. Opinion?

Hello, After going through your reports and drugs I understand that you have 1) Diabetes Mellitus 2) Mild hypertension 3) Micro albuminuria ECG is normal. Micro albuminuria can be easily rectified by taking plenty of water and treating UTI if you have. USG and urine culture if necessary - for kidney if done it is better. Your BP is under control with the current tab of Repace. Continue salt, oil, fat restricted diet and tension free life. You post prandial blood sugar is very high even after tab Voglbo which prevents the absorption of dietary glucose Regarding Glycomet GP (metformin + glimepride) - As once or twice a day is not mentioned -you can try some other combination of metformin with a twice a day dosage schedule. Of course diabetic diet and physical work are primarily important. Best wishes