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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had C-scetion. ALT-SGPT Abnormal. Can Augmenten Be The Reason?

Hi, I am a 32 year old female with a BMI of 31.4. I had a baby 4 months ago through a c-section. I have had 2 babies in the past 2 years, and in my last pregnancy I had gestational diabetes . Though it was controlled by diet and I did not take any medication for it. I have a history of PCOs since 15 years. Since the past 3 weeks I had been feeling very drowsy, it felt almost like a jet-lag. I started getting pangs of hunger even though i had eaten my last meal just 2-3 hours before. I checked my blood sugar levels regularly for about 4 days, ( all random though) and the results were between 90-108. I visited a local practitioner and he prescribed some tests. All came out normal except my Insulin Fasting which was 23.30 uU/ml ( normal range being between 1.0 - 17.5) and my ALT - SGPT which was 124 U/L. ( normal range 30-65) After seeing these results he had me screened for Hepatitis B and C. Both came out below the cut off level. One thing I would like to point out is that all throughout August my sleep pattern was very disturbed. I was hardly getting around 4-5 hours of sleep. Also I had very high anxiety during this period. I had been severe acidity in the past 3 weeks. Now I am taking Omeprozole and Gaviscon. Although it has made me feel much better and I am not drowsy. I feel a faint pain in my sternum after having food, which gets better after I take gaviscon. and since the past 2 days I have slight pain in my abdomen, similar to the period pain. I also took a course of Augmenten 365mg plus Iboprufen 200mg (twice daily). My practitioner said this could also be a cause of high sgpt. However I just wanted to get another opinion. What could this be and what should I do to decrease the insulin levels. N
Mon, 10 Sep 2012
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Diabetologist 's  Response
Hi

Thanks for the query

1.Your drowsiness and sleep disturbance appear to be because of the babysitting and babyfeeding during odd night hours or else you might be having obstructive sleep apnea attacks because of obesity.

2.Your insulin levels are high because of obesity and insulin resistance commonly seen in PCOS patients.

3.Obese patients(BMI more than 30 Kg/m2) have fatty liver and higher ALT - SGPT levels.

4.Pain in sternal area may be because of reflux of acid and stomach contents in foodpipe again due to higher body weight or else higher cholesterol levels may lead to development of gallstones which produce such symptoms.

In my opinion you need to reduce your body weight drastically through intensive lifestyle interventions like strict low fat low carbohydrate diet and vigorous physical activity e.g. walking 175 minutes per week.
Please undergo following tests too -
1.Blood sugar - Fasting and PP (2hrs)
2.HbA1C
3.Fasting serum lipid profile
4.Ultrasonography of whole abdomen and Pelvis
5.Sleep studies to rule out obstructive sleep apnea
6.Renal function tests including serum electrolytes.

Warm regards

Dr RAVINDRA MATHUR
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Had C-scetion. ALT-SGPT Abnormal. Can Augmenten Be The Reason?

Hi Thanks for the query 1.Your drowsiness and sleep disturbance appear to be because of the babysitting and babyfeeding during odd night hours or else you might be having obstructive sleep apnea attacks because of obesity. 2.Your insulin levels are high because of obesity and insulin resistance commonly seen in PCOS patients. 3.Obese patients(BMI more than 30 Kg/m2) have fatty liver and higher ALT - SGPT levels. 4.Pain in sternal area may be because of reflux of acid and stomach contents in foodpipe again due to higher body weight or else higher cholesterol levels may lead to development of gallstones which produce such symptoms. In my opinion you need to reduce your body weight drastically through intensive lifestyle interventions like strict low fat low carbohydrate diet and vigorous physical activity e.g. walking 175 minutes per week. Please undergo following tests too - 1.Blood sugar - Fasting and PP (2hrs) 2.HbA1C 3.Fasting serum lipid profile 4.Ultrasonography of whole abdomen and Pelvis 5.Sleep studies to rule out obstructive sleep apnea 6.Renal function tests including serum electrolytes. Warm regards Dr RAVINDRA MATHUR