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Are GalvusMet With Vidagliptin And Metformin Effective In Treatment Of Diabetes?

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Posted on Wed, 27 Aug 2014
Question: Sir,
This query is for my wife and is in the nature of seeking a second opinion from a specialist. She underwent Whole Body Check recently at Apollo Clinic, Kotturpuram, XXXXXXX and the report is attached. She was on Glycomet- GP1 for more than 6 years, After the check-up, our Family Physician attached to this clinic (Dr.VAP) has prescribed GalvusMet 50/500 b.d along with other drugs like Eltroxin 50 mcg, Ursocol 300, Shellcal, Tonact 1mg and Renerve. My request to you is to kindly go through the lengthy report and confirm whether this is the right prescription for diabetes, whether the tablet is to be taken before or after food, whether any side-effect like bladder cancer has been reported (like pioglitazone) and which is the right time to go for a review ( 3months or six months). Also please advise treatment for aphthous ulcers she gets frequently.
doctor
Answered by Dr. Dr. Phanindra Dulipala (25 minutes later)
Brief Answer:
GalvusMet should be taken after food

Detailed Answer:
Hi Sir, I had gone through your query and understood your concerns.

Sir, first let me remind you that the report is not attached. So, Please try to attach the report.

Regarding the other queries you have asked, GalvusMet 50/500 is a very effective drug with Vidagliptin and metformin. The tablet should be taken after food around 5-10minutes.

No, serious side effects are there as of now.

As the drug is changed, Its better to go for a review after 4 weeks time. After that every 3 months is sufficient.

For Aphthous ulcers,
Tab. Flagyl 400mg. 3 times daily for 5 days.
Cap. Becosules 1/day for 5 days
Metrogyl DG gel for local application 3 times/day.
Zytee lotion for local application to prevent pain during eating.

Hope this guides you. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you do not have any clarifications, you can close the discussion and rate the answer.
Wishing your family good health.
Dr Phanindra Dulipala.
Diabetologist.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr. Phanindra Dulipala (1 hour later)
I am giving below important details from the lengthy report. Please go through and give your advice.

Also I would be grateful if you can include a brief paragraph on diet - like what to avoid and what to restrict etc.

GLUCOSE - SERUM / PLASMA (FASTING) 153 mg/dL 70 - 100
URINE SUGAR Nil
GLUCOSE - SERUM / PLASMA (POST PRANDIAL) 231 mg/dL

GLYCOSYLATED HEMOGLOBIN (HbA1C) - WHOLE BLOOD 7.3 %

CHOLESTEROL - SERUM / PLASMA 155 mg/dL
HDL CHOLESTEROL - SERUM / PLASMA 42 mg/dL
LDL CHOLESTEROL - SERUM / PLASMA 90 mg/dL
TRIGLYCERIDES - SERUM 113 mg/dL

doctor
Answered by Dr. Dr. Phanindra Dulipala (3 hours later)
Brief Answer:
Avoid single high concentrated meals.

Detailed Answer:
Dear Sir welcome back,

The report other than sugar levels are absolutely in normal range.

The sugar levels are slightly higher, The medication you doctor has prescribed is fine. Just have a check of sugar levels after 4weeks, and see whether the dosage suits. or need any slight increase. This normally is done while changing the dosage. Once the dose is set to control the sugar levels, You can continue the same.

Coming diet:

* Avoid single high concentrated meals.
* Small frequent meals more times in a day.
* Food high in fibre content like vegetables, whole pulses, fruits, etc.

Take unrestricted:--
* Salads (cucumber, tomato, onion, raddish, salad leaves).
* Vegetables (cabbage, baigan, lady fingers, french beans, methi, palak).
* Fruits (except banana, chockoo or mangoes).
* Sprouted beans and pulses.
* XXXXXXX biscuit (with less sugar).
* Clear soups, Lemon juice, Buttermilk

Do not eat at all:--
Sugar, jam, syrups, honey, sweets, chocolates, fruit juices, ice creams, cold drinks, glucose drinks, cakes and pastries, sweet biscuits, puddings and protein powder with sugar.
Eat in moderation:--
Bread, chapatis, oat porridge, cornflakes (No sugar), Cheese, butter, Noodles or spaghetti, macroni, Thick soups, Milk & milk products, Chicken, lean meat, fish.

Eat a low-cholesterol, low-fat diet, which includes cottage cheese, fat-free milk, fish, vegetables, poultry, and egg whites. Use monounsaturated oils such as olive, peanut, and canola oils or polyunsaturated oils such as corn, safflower, soy, sunflower, cottonseed, and soybean oils.
Avoid foods with excess fat in them such as meat (especially liver and fatty meat), egg yolks, whole milk, cream, butter, shortening, pastries, cakes, cookies, gravy, peanut butter, chocolate, olives, potato chips, coconut, cheese (other than cottage cheese), coconut oil, palm oil, and fried foods.

Hope this guides you. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you do not have any clarifications, you can close the discussion and rate the answer.
Wishing your family good health.
Dr Phanindra Dulipala.
Diabetologist.

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Dr. Phanindra Dulipala (2 hours later)
Thanks for such detailed answers which give the feeling of actually sitting across the table and talking to you. This will be my last query before closing the review. My wife takes Thronorm 25 mcg early morning. Along with GalvusMet 50/00, she takes Ursocol 300 mg twice daily for 'fatty liver'. Please let me know whether there is any drug-interaction. Is there a need to space the medicines? Also please let me know whether taking Thyronorm on empty stomach early morning is right or should it be taken at bed-time as some reports suggest.

(I was with XXXXXXX as General Manager, Training till a few years back and so you will pardon me for such questions because of my half-baked knowledge!)
doctor
Answered by Dr. Dr. Phanindra Dulipala (5 hours later)
Brief Answer:
Timing of her medication is correct.

Detailed Answer:
Hi Sir, Welcome back.

Galvusmet50/100 and Urosol has no drug interaction sir.
Thyronorm must be taken early in the morning before food only.

So, No need of any change in timing of medication sir.

Nice to meet you sir.
Thank you.
Dr Phanindra Dulipala.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Dr. Phanindra Dulipala

Diabetologist

Practicing since :2008

Answered : 722 Questions

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Are GalvusMet With Vidagliptin And Metformin Effective In Treatment Of Diabetes?

Brief Answer: GalvusMet should be taken after food Detailed Answer: Hi Sir, I had gone through your query and understood your concerns. Sir, first let me remind you that the report is not attached. So, Please try to attach the report. Regarding the other queries you have asked, GalvusMet 50/500 is a very effective drug with Vidagliptin and metformin. The tablet should be taken after food around 5-10minutes. No, serious side effects are there as of now. As the drug is changed, Its better to go for a review after 4 weeks time. After that every 3 months is sufficient. For Aphthous ulcers, Tab. Flagyl 400mg. 3 times daily for 5 days. Cap. Becosules 1/day for 5 days Metrogyl DG gel for local application 3 times/day. Zytee lotion for local application to prevent pain during eating. Hope this guides you. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you do not have any clarifications, you can close the discussion and rate the answer. Wishing your family good health. Dr Phanindra Dulipala. Diabetologist.