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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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I am 41 yrs old and a diabetic (type-2) since

Answered by
Dr.
Dr. Minal Mohit

Endocrinologist

Practicing since :1998

Answered : 834 Questions

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Posted on Fri, 22 Feb 2019 in Diabetes
Question: I am 41 yrs old and a diabetic (type-2) since 2011. Initially I was taking Glimet DS (Glipizide 5mg+ metformin 500mg) and was maintaining controlled levels. During the period 2015 until mid 2017, with strict diet control, I was off this medicine. My hba1c was 6 and regular fasting readings of 90-110.
I was in Goa during all this while. But in mid-2017 I had to move to Sikkim (job transfer). Slowly my fasting readings started going up like 130-140. So I started with half dose of my previous medicine. Then back to same 1 tab Glynase MF twice a day. Initially was able to control but after a few months again I got fasting readings of 130-150.
Now during the last month or so, my fasting readings are sometimes going over 200 (range 135-240). I still control my diet as before and taking 1 tab Glynase MF twice a day.
Is this happening due to the extreme cold weather here?
Please advise if I should change my medication.
doctor
Answered by Dr. Minal Mohit 9 hours later
Brief Answer:
Change of food habits , weather, climate, exercise all will affect

Detailed Answer:
dear sir, Hi! welcome to Ask A Doctor. diabetes worsening slowly is due to many reasons. one is, disease itself is progressive in nature. second of course your life style. so change of place, work culture, sleep pattern, food quality, exercise ROUTINE, all will show cumulative effect.
as you have already started tab glynase MF, please add tab istamet 50/500 mg Twice a day. Continue exercise plan, increase time or speed which ever is feasible . follow strict diet plan. and recheck your sugars after 7 days and let me know . also please check it hba1c, lipids, thyroid, and renal function and do let me know
regards!
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Minal Mohit 4 days later
Hi Doctor...As per your advice, started Istamet 50/500 along with Glynase MF 1 tab twice a day. My FBS on Wed was 129. But last night after taking medication and light meal (2 boiled eggs and some sev farsan) I was feeling very uneasy. So I checked my random sugar and it was 64. So then I ate some more food (noodles and 2 apples) then I felt better. Today my FBS is 122. Please advise if I continue same dose of tablets or reduce. All the blood test reports as asked by you are done, attaching the copies.
doctor
Answered by Dr. Minal Mohit 43 minutes later
Brief Answer:
hba1c, renal function and thyroid report is good, lipids need correction.

Detailed Answer:
Dear sir, all are good, but LDL is high. Need to add Rosuvastatin 20 mg at night.
sugars are doing good. one hypo because you changed your meal plan. I would suggest make glynase MF once a day and continue istamet twice a day.
regards!
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Minal Mohit 8 days later
Hello Doctor, My BP is showing higher readings recently. Sys range 135-154 and Dias range 85-103. Today was 154/99. I don't smoke a lot also now, only two sticks a day. Are my new medicines affecting my BP? And how long should I continue with the rosuvastatin 20mg? Or reduce dosage after a while? FBS is currently around 130-135.
doctor
Answered by Dr. Minal Mohit 2 minutes later
Brief Answer:
Are you on some medicine for hypertension?

Detailed Answer:
Dear sir,

The statin is the recommended molecule for cholesterol, heart issues. So it will not increase the BP nor will it reduce it.

But high fasting sugars are not good. We need to add tab Vobose-M at night before dinner. For BP you may add tab Telmisartan 40 mg once a day after breakfast (after discussing with your treating doctor).

Regards!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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