• question-icon

    How to manage diabetes while suffering from Crohn's disease?

default
Posted on Tue, 31 May 2016 in Diabetes
Question: I have been currently diagnosed as Diabetic which could be side effects of the multiple medicines I take for Chrons, Thyroid and related. Currently my Chrons is again active and having a lot of issues. I bleed in stools. I feel too dizzy. No matter how much I eat, I am eternally hungry because I run to the washroom within 20-25 mins of having food. I fear that this could lead to mismanagement of diabetes. I am already worried on how to manage my diabetes as I have not informed my family about this disease and cannot do for some more time. Kindly help.
doctor
Answered by Dr. Abhay A Mali 53 minutes later
Brief Answer:
Need to modify antidiabetic medicines depending upon blood sugar levels.

Detailed Answer:
Hi Mr. XXXXXXX

Thanks for your question.
Sorry to know about your condition.

Depending upon your blood sugar levels (Fasting, Post-prandial & HbA1c), Kidney and heart function, I may suggest use of antidiabetic medicines which are rarely cause hypoglycemia (low blood sugar levels) even in patients with variable food intake.

At present you are taking Tab Cyblex M which contains Giclazide 60mg & Metformin 500mg.

Metformin is good as it very rarely cause hypoglycemia but it may not be used in full dose in your case as it may cause stomach upset (which may aggravate symptoms of crohn's disease).

Gliclazide is a insulin secreting drug. Insulin secreting action is independent of food intake. Hence drugs from similar group usually associated with hypoglycemia in patient with variable food intake.

Your symptoms of dizziness may be related to hypoglycemia which can be easily confirmed by doing blood sugar level by home glucometer during episode of dizziness.
Otherwise if symptom of dizziness get relieved after eating sugar containing food it may be related to hypoglycemia ie. effect of Giclazide.

In such case I may suggest to stop Tab Cyblex M & to increase the dose of Metformin to 1gram in divided doses with close monitoring of symptoms related to stomach upset and blood sugar levels.
Depending upon blood sugar level if required I may add DPP4 inhibitors (like Sitagliptin, Linagliptin, Tineligliptin).

You should discuss this with your treating doctor.

Also both Crohn's disease & Diabetes are life long disease you should reveal it with your close family members. You can take help of your treating doctor for same.

Hope this helps you.

Regards,

Dr. Abhay Mali.
Diabetologist.


Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Abhay A Mali 24 minutes later
Thank you for the response Dr. Abhay. This helps me understand why the Chrons is now more active than before. Do you recommend that I visit a Diabetologist or an endocrinologist? Also want to check if I need to consult a gastroenterologist or will it be taken care with my visit to the diabetes specialist?
doctor
Answered by Dr. Abhay A Mali 20 hours later
Brief Answer:
Required combined help of diabetologist & gastroenterologist.

Detailed Answer:
Thanks,

In your case there is need for combined involvement of Diabetologist or Endocrinologist, Dietician & Gastroenterologist.

Hope this helps you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Abhay A Mali 31 hours later
Hello Doctor Abhay,

I visited an endocrinologist in my howetown and she suggested me to get on insulin doses right away. To be honest, I am scared after all that she suggested.

Is there a way you could suggest any alternative medicine in place of Cyblex M 60? She did suggest that Metaformin should be avoided and I am overall more confused.

I would also like to mention that I have severe ED and also the foreskin doesn't pullback. I have a slight burning sensation on the penile area, thankfully not when passing urine.

One last question, My wife and I were thinking of having another child. With the numerous diseases that I currently suffer from, will the child inherit any/all? I am too worried on this too. She is not pregnant now but planning to have a child once my ED and foreskin issue is resolved.

Kindly Help.

Thanks,
XXXX XXXXXXX
doctor
Answered by Dr. Abhay A Mali 13 hours later
Brief Answer:
Follow the advise of endocrinologist.

Detailed Answer:
Hi,

It is better for you to follow endocrinologist's advise, as he personally went through your case also done your physical examination.

In your case there may be major issue with use of metformin like-
- Stomach upset attributable to metformin use.
- Kidney issue like raised serum creatinine.
- Heart issue like decreased ejection fraction on 2DEcho.
- Active infection due to para-phimosis (inability to retract penile fore skin) as you have mentioned.
- Complications of uncontrolled blood sugar level which warrants rapid blood sugar control Erectile dysfunction is one of them.

There may be certain benefits of insulin in your case.
- Insulin is a what is deficient in diabetes we are providing in ready made form.
- Rapid control of blood sugar level.
- Can be used safely in kidney or heart dysfunction.
- No harmful effect on any organ.

Only issue with use of insulin may be hypoglycaemia which can be overcome with adequate knowledge of insulin use & hypoglycaemia (prevention, early detection & rapid correction).
Instead of becoming panic you should enhance your knowledge about safe insulin use.

You should plan pregnancy after good blood sugar control with consultation with your endocrinologist and gastroenterologist.

Hope this helps you.


Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 805 Questions

premium_optimized

The User accepted the expert's answer

Share on

Recent questions on  Sitagliptin

doctor1 MD

i would like to know the side effects of istamet sitagliptin i have been using the above mentioned tablet with no noticable improvement in the...

doctor1 MD

hii my mom is 55 yrs old and diabetic since 7 yrs, recently his doctor changed his medicines from Euglim MP2 (twice a day ) and voglistar md...

doctor1 MD

A friend of mine has 5 moderate interactions with medications. I am concerned. I am an RN. I was taught that this is potentially dangerous. what is...

doctor1 MD

My husband is 77 years old; normally active and engaged. He has the following: 1. COPD (CAT B) (on inhalers Levolin and Formoflo) was on ABPhylline...

doctor1 MD

I am having hard stool for 2 weeks and having looz for last one week and having cucumber for three to four days , had dark green stool today

doctor1 MD

Dear Dr. My mom is Type 2 Diabetic for 15 years. She is on following daily medications , DIAMICRON . XR60 before breakfast 1 tab. SITAGLIPTIN 50mg...

doctor1 MD

my husband was prescribed invokana on December 22, along with metformin, januvia, glyburide, and levemir for control of diabetes, along with...

Get personalised answers from verified doctor in minutes across 80+ specialties

136 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Questions Answered By Dr. Abhay A Mali
  • Q - How long does gestational diabetes take to resolve?

  • Q - What causes elevated blood sugar levels?

  • Q - What causes weakness all over body and numbness on left side of chest?

  • Q - What does the following microalbumin report indicate?

  • Q - What does high fluctuation in blood sugar levels indicate?

  • Q - Is there any scope for further improvement in vision of a diabetic patient?

  • Q - Can oral anti-diabetic medicine be taken after LVAD implantation?

  • Q - Suggest medication for elevated blood sugar levels

  • Q - What do my lab test reports indicate?

  • Q - What causes abdominal pain, spasms and frequent sticky stool?

backtotop2