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Is HbA1c Of 7.3% A Cause For Concern?

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Posted on Wed, 21 Dec 2016
Question: I have been on glipizidexl 2.5mg once a day. it has now been increased to 5mg twice a day. Oct 26 my A1C was 7.3- the highest it has ever been. Oct 28 I had shoulder surgery so have not been active in my garden, etc. When tracking my sugar it seems to be all over the place. My Dr. now wants to add Actos but I don't like the side effects that are listed. This was chosen because it is a XXXXXXX 2 on my drug plan (medicare D). She is really suggesting an injectable like Victoza or Bydureon. I haven't looked them up yet. The other orals were invokana and januvia but they are also XXXXXXX 3 just like the injectable. I am 69 almost 70 yrs old..female. Diabetes type 2 since 1998. This is the first time that I have had these problems. My Dr retired in Feb and I am now with a new Dr. I think I read a study that blood sugar is ok being a little higher in older people. What happens when I am able to get back to walking and exercise? Should I make changes now, wait or ?????I am so confused. Thanks
doctor
Answered by Dr. Mirjeta Guni (46 minutes later)
Brief Answer:
I would suggest some changes.

Detailed Answer:
Welcome and thank you for asking!
I read carefully your concern.
HbA1c 7.3% is slightly increased (under 7% is ideal).
It may be due to lack of physical activity and may be corrected by restarting it.
The best treatment that i would suggest is to reduce the dose of glipizid and add an SGLT 2 inhibitor such as dapagliflozin.
One of the main side effects of glipizid is hypoglicemia that occurs more in high dozes. Dapagliflozin does not cause hypoglycemia and helps in lowering the blood pressure to ( if you are hypertensive).
The only side effect is urinary infection and you should be under monitoring.
Discuss with your treating physician about the above alternative and do not hesitate to ask if you have further questions.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mirjeta Guni (35 minutes later)
What is a dapagliflozin? What would the medication be called?
doctor
Answered by Dr. Mirjeta Guni (6 minutes later)
Brief Answer:
Farxiga.

Detailed Answer:
Hello,
The brand name for dapagliflozin is Farxiga.
Regards,
Dr.Mirjeta
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Is HbA1c Of 7.3% A Cause For Concern?

Brief Answer: I would suggest some changes. Detailed Answer: Welcome and thank you for asking! I read carefully your concern. HbA1c 7.3% is slightly increased (under 7% is ideal). It may be due to lack of physical activity and may be corrected by restarting it. The best treatment that i would suggest is to reduce the dose of glipizid and add an SGLT 2 inhibitor such as dapagliflozin. One of the main side effects of glipizid is hypoglicemia that occurs more in high dozes. Dapagliflozin does not cause hypoglycemia and helps in lowering the blood pressure to ( if you are hypertensive). The only side effect is urinary infection and you should be under monitoring. Discuss with your treating physician about the above alternative and do not hesitate to ask if you have further questions. Kind regards, Dr.Mirjeta