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Can Oral Anti-diabetic Medicine Be Taken After LVAD Implantation?
Question: Is it impossible to stop taking Insulin and should my Doctor just say I will never be able to go to an oral med or stop taking the shots. I am 71 years old and have had a heart attack nearly 5 years ago when I was first labeled diabetic because of a 245 blood sugar. My blood sugar (I am ordered to take it 4X a day) ranges from 98 to 165 before meals. My Doctor just dismisses my questions and makes the blanket statement that I'll never be able to get off insulin injections.
Brief Answer:
Need to know more for better opinion.
Detailed Answer:
Hi,
To answer your question whether you can stop insulin and use oral antibiotics I want to know -
1) Your current prescription.
2) Heart status like 2DEcho report (to know pumping capacity of heart), any procedure done like angiography or angioplasty.
3) Kidney function by knowing serum creatinine level, other kidney function tests, ultrasonography of kidneys.
4) Presence of any associated conditions like blood pressure, cholesterol problems, any current infections.
5) Your height and weight.
6) Discharge documents of heart attack 5 years back at least urine report, arterial blood gas analysis reports.
7) At the time of first detection of diabetes your symptoms like vomiting, abdominal pain, need for intravenous insulin.
8) Family history of Diabetes.
Hope you will upload all required information at least which is available.
I will be happy to answer your future questions.
Need to know more for better opinion.
Detailed Answer:
Hi,
To answer your question whether you can stop insulin and use oral antibiotics I want to know -
1) Your current prescription.
2) Heart status like 2DEcho report (to know pumping capacity of heart), any procedure done like angiography or angioplasty.
3) Kidney function by knowing serum creatinine level, other kidney function tests, ultrasonography of kidneys.
4) Presence of any associated conditions like blood pressure, cholesterol problems, any current infections.
5) Your height and weight.
6) Discharge documents of heart attack 5 years back at least urine report, arterial blood gas analysis reports.
7) At the time of first detection of diabetes your symptoms like vomiting, abdominal pain, need for intravenous insulin.
8) Family history of Diabetes.
Hope you will upload all required information at least which is available.
I will be happy to answer your future questions.
Above answer was peer-reviewed by :
Dr. Shanthi.E
1. 38 units Levemir and sliding scale
2. I had an LVAD (left ventricular assist device) implanted in my left ventricle due to damage from the heart attack in October 2010.
3. Kidney function is normal had regular ultrasounds each year since 2010.
4. My hypertension is under control with medication. No current infections.
5. 5'5" wt. is 200
6. Urine is clear, no uti's, ABG's are currently done as follow up with LVAD
7. I had no symptoms upon initial diagnosis except blood sugar of 245. They gave me IV insulin at the ER as a precaution
8. No history of diabetes in family, but ho history of heart failure either.
I will pick up your answer tomorrow. Thank you for your consideration.
2. I had an LVAD (left ventricular assist device) implanted in my left ventricle due to damage from the heart attack in October 2010.
3. Kidney function is normal had regular ultrasounds each year since 2010.
4. My hypertension is under control with medication. No current infections.
5. 5'5" wt. is 200
6. Urine is clear, no uti's, ABG's are currently done as follow up with LVAD
7. I had no symptoms upon initial diagnosis except blood sugar of 245. They gave me IV insulin at the ER as a precaution
8. No history of diabetes in family, but ho history of heart failure either.
I will pick up your answer tomorrow. Thank you for your consideration.
Brief Answer:
Options need to be discussed with your doctors.
Detailed Answer:
Hi,
After going through information provided by you there are three main factors that prevents the use of oral antidiabetic medicine in you.
1) Your age.
2) Weight ( Body Mass Index of >35).
3) Heart status- You have LVAD implanted. It is used when there is significant reduction in pumping capacity of heart (which can be known from 2DEcho report by parameter LVEF, left ventricular ejection fraction) which make you prone for recurrent heart failure. LVAD helps in prevention of episodes of heart failure in your case.
All these factors makes you prone for development of side effects of oral antidiabetic medicines like further weight gain, recurrent hypoglycemia (low blood sugar levels) episode of hypoglycemia may be more dangerous for you due to your age and heart condition.
Keeping all these factors insulin is the best option for you.
If you really want to get rid of insulin there are following 2 possible options which needs to discuss with your treating doctors-
1) Bariatric surgery keeping your heart condition in mind if your cardiologist allows you to undergo surgery, it will be the best option according to my experience.
2) GLP2 receptor agonist- though it's use in heart failure is not recommended but it can help you in Diabetes control and weight reduction. But again it is injectable drug. And it's benefit and risk in your case need to be discussed with your endocrinologist.
Hope I have clarified all your queries.
If so close the discussion and vote the answer.
Regards,
Dr Abhay Mali
Diabetologist.
Options need to be discussed with your doctors.
Detailed Answer:
Hi,
After going through information provided by you there are three main factors that prevents the use of oral antidiabetic medicine in you.
1) Your age.
2) Weight ( Body Mass Index of >35).
3) Heart status- You have LVAD implanted. It is used when there is significant reduction in pumping capacity of heart (which can be known from 2DEcho report by parameter LVEF, left ventricular ejection fraction) which make you prone for recurrent heart failure. LVAD helps in prevention of episodes of heart failure in your case.
All these factors makes you prone for development of side effects of oral antidiabetic medicines like further weight gain, recurrent hypoglycemia (low blood sugar levels) episode of hypoglycemia may be more dangerous for you due to your age and heart condition.
Keeping all these factors insulin is the best option for you.
If you really want to get rid of insulin there are following 2 possible options which needs to discuss with your treating doctors-
1) Bariatric surgery keeping your heart condition in mind if your cardiologist allows you to undergo surgery, it will be the best option according to my experience.
2) GLP2 receptor agonist- though it's use in heart failure is not recommended but it can help you in Diabetes control and weight reduction. But again it is injectable drug. And it's benefit and risk in your case need to be discussed with your endocrinologist.
Hope I have clarified all your queries.
If so close the discussion and vote the answer.
Regards,
Dr Abhay Mali
Diabetologist.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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