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Dear Doctor I Am Having High Sugar Level In The

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Posted on Mon, 22 Jul 2019
Question: Dear Doctor
I am having high sugar level in the morning--last seven days it ranges between 140 to 170 on empty stomach at 0645 in the morning--after breakfast and measurement after 2 hours there is an increase of 50 points in the sugar levels
kindly advise


I am uploading the blood report for the month of may and XXXXXXX 2019

medicine is as under

Breakfast
Tab Amaryl m1 before breakfast
Cetapin 500 after breakfast
Vildagliptin 50 mg after breakfast
Metabolis
Nu eye
Venlor XR 75



Lunch
Nil

Dinner
Cetapin 500 after dinner
Vildagliptin 50 mg after dinner
Rosuvastatin & Fenofibrate (Rosumac F) 5 mg
would it be better to restart
tab gibtulio 25 mg before breakfast(twice/thrice a week)

rather than increase amaryl

i had stopped the gibtulio in XXXXXXX 2019
pls advise regards
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Follow up: Dr. Elona (0 minute later)
Dear Doctor
I am having high sugar level in the morning--last seven days it ranges between 140 to 170 on empty stomach at 0645 in the morning--after breakfast and measurement after 2 hours there is an increase of 50 points in the sugar levels
kindly advise


I am uploading the blood report for the month of may and XXXXXXX 2019

medicine is as under

Breakfast
Tab Amaryl m1 before breakfast
Cetapin 500 after breakfast
Vildagliptin 50 mg after breakfast
Metabolis
Nu eye
Venlor XR 75



Lunch
Nil

Dinner
Cetapin 500 after dinner
Vildagliptin 50 mg after dinner
Rosuvastatin & Fenofibrate (Rosumac F) 5 mg
would it be better to restart
tab gibtulio 25 mg before breakfast(twice/thrice a week)

rather than increase amaryl

i had stopped the gibtulio in XXXXXXX 2019
pls advise regards
doctor
Answered by Dr. Elona (2 hours later)
Brief Answer:
Insist with more physical activities and healthy diet.

Detailed Answer:
Hello
I have gone through your query and here is my advice.

Your blood sugar results(fasting and 2h after meals) are not too high.
YOur Diabetes is relatively under control.

In my opinion your diabetes medication are Ok!
My advice is to add Amaryl 1mg before lunch and Metformine 850 mg after dinner.(if you are overweight.)

Your little problem is fasting blood sugar levels.
I suggest to insist and to be careful with the a strict diabetic diet.
Try to reduce your carbohidrate intake and choose healthy carbohydrates, such as fruit, vegetables, whole grains, beans, and low-fat milk, as part of your diabetes meal plan.

To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine.
I suggest to do more physical activities because this will be very helpful to have perfect blood sugar results.

Yes you can restart Empagliflozin 25 mg,but in my opinion it is better for you,considering all your medications(you have a polipharmacy),to not add another antidiabetic class of medications in this moment.

In my opinion,It is more appropriate to adjust the dosis of your actual medications,rather than add another medication and increase the riscs of potential drug interactions.

Last advice:If you were my patoent ,i will ask to do an HbA1test ,(to understand better your Diabetes situation.)

Hope this is helpful.
Let me know if i can assist you further.
Take care








Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Elona (0 minute later)
Brief Answer:
Insist with more physical activities and healthy diet.

Detailed Answer:
Hello
I have gone through your query and here is my advice.

Your blood sugar results(fasting and 2h after meals) are not too high.
YOur Diabetes is relatively under control.

In my opinion your diabetes medication are Ok!
My advice is to add Amaryl 1mg before lunch and Metformine 850 mg after dinner.(if you are overweight.)

Your little problem is fasting blood sugar levels.
I suggest to insist and to be careful with the a strict diabetic diet.
Try to reduce your carbohidrate intake and choose healthy carbohydrates, such as fruit, vegetables, whole grains, beans, and low-fat milk, as part of your diabetes meal plan.

To manage your blood glucose, you need to balance what you eat and drink with physical activity and diabetes medicine.
I suggest to do more physical activities because this will be very helpful to have perfect blood sugar results.

Yes you can restart Empagliflozin 25 mg,but in my opinion it is better for you,considering all your medications(you have a polipharmacy),to not add another antidiabetic class of medications in this moment.

In my opinion,It is more appropriate to adjust the dosis of your actual medications,rather than add another medication and increase the riscs of potential drug interactions.

Last advice:If you were my patoent ,i will ask to do an HbA1test ,(to understand better your Diabetes situation.)

Hope this is helpful.
Let me know if i can assist you further.
Take care








Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Elona (53 minutes later)
Dear Doctor
Thanks for your support
My HbA1C results over the last few years are as under
jun 2019 7.8
may 2019 6.9
mar 2019 7.1 XXXXXXX 2019 6.7
oct 2018 7.1
sep 2018 7.1
aug 2018 7.5
sep 2017 6.7
jun 2017 6.3
may 2017 6.7
mar 2017 6.9
apr 2017 6.6 XXXXXXX 2017 7.7
apr 2014 8.4 XXXXXXX 2008 5.1
please advise
Regards
JS Bibra
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Follow up: Dr. Elona (0 minute later)
Dear Doctor
Thanks for your support
My HbA1C results over the last few years are as under
jun 2019 7.8
may 2019 6.9
mar 2019 7.1 XXXXXXX 2019 6.7
oct 2018 7.1
sep 2018 7.1
aug 2018 7.5
sep 2017 6.7
jun 2017 6.3
may 2017 6.7
mar 2017 6.9
apr 2017 6.6 XXXXXXX 2017 7.7
apr 2014 8.4 XXXXXXX 2008 5.1
please advise
Regards
JS Bibra
doctor
Answered by Dr. Elona (1 hour later)
Brief Answer:
All your test results are within the range.

Detailed Answer:
Hi again
I have reviewed your attached reports.

I can say that you are a healthy man because all your test results are normal.
Complete blood count, Comprehensive Metabolic Panel ,Hormone tests are all within the range.
Apart a deficient 25-Oh Vit D level and a borderline-low Calcium level,all the other reports are normal.
Adequate sun exposure and calcium+vit D fortified foods is all you need to normalise your actual 25-OH vitD3 and calcium levels.

About you HbA1C levels,i see that you had better results in the past.
7,8% means that you have Estimated average glucose 170-180mg/dl.
The goal is an HbA1C <7%.

To conclude:I suggest to start the dosis adjustments that i write and check your blood sugar (fasting and 2 h after the meals) for 2-3 days.

Let me know the results and i will be happy to guide you further.

I'm sure that you can meet your target goal and stay healthy ,in the future.

Regards.





Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Elona (0 minute later)
Brief Answer:
All your test results are within the range.

Detailed Answer:
Hi again
I have reviewed your attached reports.

I can say that you are a healthy man because all your test results are normal.
Complete blood count, Comprehensive Metabolic Panel ,Hormone tests are all within the range.
Apart a deficient 25-Oh Vit D level and a borderline-low Calcium level,all the other reports are normal.
Adequate sun exposure and calcium+vit D fortified foods is all you need to normalise your actual 25-OH vitD3 and calcium levels.

About you HbA1C levels,i see that you had better results in the past.
7,8% means that you have Estimated average glucose 170-180mg/dl.
The goal is an HbA1C <7%.

To conclude:I suggest to start the dosis adjustments that i write and check your blood sugar (fasting and 2 h after the meals) for 2-3 days.

Let me know the results and i will be happy to guide you further.

I'm sure that you can meet your target goal and stay healthy ,in the future.

Regards.





Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
default
Follow up: Dr. Elona (39 minutes later)
Thanks
Will revert after additional inputs
Regards
JS Bibra
default
Follow up: Dr. Elona (0 minute later)
Thanks
Will revert after additional inputs
Regards
JS Bibra
doctor
Answered by Dr. Elona (13 minutes later)
Brief Answer:
OK

Detailed Answer:
Ok
Very probably, it will be necessary to modify the regymen or the dosis of your antidiabetic drugs,accordingly to your blood test results in order to archeive the recommended goal,in the future.

You can write me a direct question,in my hcm profile and i can assist you to have a perfect and stable Diabetes control.

Wish you good health.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Elona (0 minute later)
Brief Answer:
OK

Detailed Answer:
Ok
Very probably, it will be necessary to modify the regymen or the dosis of your antidiabetic drugs,accordingly to your blood test results in order to archeive the recommended goal,in the future.

You can write me a direct question,in my hcm profile and i can assist you to have a perfect and stable Diabetes control.

Wish you good health.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Elona

Endocrinologist

Practicing since :2008

Answered : 941 Questions

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Dear Doctor I Am Having High Sugar Level In The

Dear Doctor I am having high sugar level in the morning--last seven days it ranges between 140 to 170 on empty stomach at 0645 in the morning--after breakfast and measurement after 2 hours there is an increase of 50 points in the sugar levels kindly advise I am uploading the blood report for the month of may and XXXXXXX 2019 medicine is as under Breakfast Tab Amaryl m1 before breakfast Cetapin 500 after breakfast Vildagliptin 50 mg after breakfast Metabolis Nu eye Venlor XR 75 Lunch Nil Dinner Cetapin 500 after dinner Vildagliptin 50 mg after dinner Rosuvastatin & Fenofibrate (Rosumac F) 5 mg would it be better to restart tab gibtulio 25 mg before breakfast(twice/thrice a week) rather than increase amaryl i had stopped the gibtulio in XXXXXXX 2019 pls advise regards