Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Is An INR Reading Of 1.00 In A Diabetic Patient Normal?
Question: My mother is 79 and partially bed-ridden due to a right side paralytic stroke in May, 2011. She also has BP, Sugar, Thyroid, an auto-immune skin condition called pemphigoid, constant UTI, thyroid and low sodium problem. She takes following medicines:
1. Tab Thyronorm 50 mcg. Before bed tea – 8 am
2. Cap. Razo D (20 mg) Before bed tea – 8 am
3. Tab. Cardace - 5mg. 10 am
4. Tab. Glycomet - 1 g 10 am
5. Tab. Trazalon - 25 mg 10 am+10 pm
6. Cap. Amantrel 100mg 10 am +10 pm
7. Ulgel - A Suspension (for Acidity) 10 am+10 pm
8. Dapsone 4mg 11 am
9. Tab. Clopitas 75 mg (Clopidogrel) 2 pm
10. Cap. Gemcal 2 pm
11. Tab. Evion LC 2 pm
12. Tab. Nebistar -SA ( for BP) 7 pm
13. 14. Tab. Pexep CR - 12.5 mg 10 pm
15. Storvas 10 pm
16. Cremaffin Plus (SOS) At Bedtime
17. 1 Uprise D Capsule ( 60000 IU) to be given once a month
• For Urine E-coli or enterobacter clocae infections, we have to often give antibiotics like Martifur, LCin, Feronom etc.
Due to appearance of 2 bruises ( on wrist and upper arm) recently, we had her blood tested. Her Clotting and Bleeding Time was OK, Platelets were 1.59 lacs ( With clumps), TLC was 10.5, Hb was 8.8, Prothrombin time was 13.2, Prothrombin Ratio was 1.00 and INR Ratio was also 1.00. As per some internet sites, INR 1.00 is considered dangerous for people on Warfarin therapy for whom it should be 2.00-4.5. My mother is on Clopitas 75 mg with INR 1.00 and our Doctor has not increased or added something else. Is this Ok? I am a little worried and confused and will appreciate your help.
Her BP is OK but sugar is 220 approx. at both fasting and random Thanks a Lot & Regards,
Vandana
1. Tab Thyronorm 50 mcg. Before bed tea – 8 am
2. Cap. Razo D (20 mg) Before bed tea – 8 am
3. Tab. Cardace - 5mg. 10 am
4. Tab. Glycomet - 1 g 10 am
5. Tab. Trazalon - 25 mg 10 am+10 pm
6. Cap. Amantrel 100mg 10 am +10 pm
7. Ulgel - A Suspension (for Acidity) 10 am+10 pm
8. Dapsone 4mg 11 am
9. Tab. Clopitas 75 mg (Clopidogrel) 2 pm
10. Cap. Gemcal 2 pm
11. Tab. Evion LC 2 pm
12. Tab. Nebistar -SA ( for BP) 7 pm
13. 14. Tab. Pexep CR - 12.5 mg 10 pm
15. Storvas 10 pm
16. Cremaffin Plus (SOS) At Bedtime
17. 1 Uprise D Capsule ( 60000 IU) to be given once a month
• For Urine E-coli or enterobacter clocae infections, we have to often give antibiotics like Martifur, LCin, Feronom etc.
Due to appearance of 2 bruises ( on wrist and upper arm) recently, we had her blood tested. Her Clotting and Bleeding Time was OK, Platelets were 1.59 lacs ( With clumps), TLC was 10.5, Hb was 8.8, Prothrombin time was 13.2, Prothrombin Ratio was 1.00 and INR Ratio was also 1.00. As per some internet sites, INR 1.00 is considered dangerous for people on Warfarin therapy for whom it should be 2.00-4.5. My mother is on Clopitas 75 mg with INR 1.00 and our Doctor has not increased or added something else. Is this Ok? I am a little worried and confused and will appreciate your help.
Her BP is OK but sugar is 220 approx. at both fasting and random Thanks a Lot & Regards,
Vandana
Brief Answer:
Nothing to worry about INR, Increase diabetes medication
Detailed Answer:
Hello XXXXXXX
I have gone through your question and all reports.
Only blood sugar fasting is abnormal requiring increase in diabetes medication. Medications will be changed after regular monitoring of her blood glucose levels.
Clumped platelet may be fallaciously low and needs repeat measurement.
Clopidogrel is an anti platelet agent and is not monitored with INR.
The bruising in old age may be due to vitamin K deficiency or age related increased vascular fragility.
Handle and hold your mother with care and less pressure, avoid any trauma.
Vit k supplementation may be given after consultation with your doctor.
Continue rest medications.
Hope she get well soon.
Wishing her good health ahead.
Regards
Dr N Kumar
Neurologist
Nothing to worry about INR, Increase diabetes medication
Detailed Answer:
Hello XXXXXXX
I have gone through your question and all reports.
Only blood sugar fasting is abnormal requiring increase in diabetes medication. Medications will be changed after regular monitoring of her blood glucose levels.
Clumped platelet may be fallaciously low and needs repeat measurement.
Clopidogrel is an anti platelet agent and is not monitored with INR.
The bruising in old age may be due to vitamin K deficiency or age related increased vascular fragility.
Handle and hold your mother with care and less pressure, avoid any trauma.
Vit k supplementation may be given after consultation with your doctor.
Continue rest medications.
Hope she get well soon.
Wishing her good health ahead.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Sonia Raina
Thanks a lot.
Last blood test was on 7th February, 4 days ago. When should I get the platelets and CBC tested again.
She has to take Dapsone for Pemphigoid and the dermatologist had said we should be careful of her blood count with this medicine. This meant her Hb or her platelets?
I will consult our Doctor about Diabetes medication and Vitamin K as advised by you. We started Martifur yesterday due to UTI. Last Course was given in early January last month.
Any information or tip would be helpful.
I appreciate the clarity with which you have replied Sir.
Last blood test was on 7th February, 4 days ago. When should I get the platelets and CBC tested again.
She has to take Dapsone for Pemphigoid and the dermatologist had said we should be careful of her blood count with this medicine. This meant her Hb or her platelets?
I will consult our Doctor about Diabetes medication and Vitamin K as advised by you. We started Martifur yesterday due to UTI. Last Course was given in early January last month.
Any information or tip would be helpful.
I appreciate the clarity with which you have replied Sir.
Brief Answer:
Get investigated as advised
Detailed Answer:
Hello,
The steroid leads to increase in total cell count but decrease in platelet may occur. Even hb may decrease if there is bleeding ulcers in stomach due to steroid use.
You should repeat it after 1-2 weeks.
For repeated UTI with diabetes at this age you should get her examined for any uterine prolapse. Urine culture sensitivity should be done and good control of diabetes should also be done.
Vitamin K injection can be taken.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist
Get investigated as advised
Detailed Answer:
Hello,
The steroid leads to increase in total cell count but decrease in platelet may occur. Even hb may decrease if there is bleeding ulcers in stomach due to steroid use.
You should repeat it after 1-2 weeks.
For repeated UTI with diabetes at this age you should get her examined for any uterine prolapse. Urine culture sensitivity should be done and good control of diabetes should also be done.
Vitamin K injection can be taken.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
