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Should my medicines for type2 diabetes be revised inspite of fasting sugar levels?

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Practicing since : 2001
Answered : 1663 Questions
I am on medicine for type2 sugar problem from 01/07/2011. My doctor revised my doses to current from 17/01/2014, on that day my sugar levels were fasting 140 & PP 270. But today i checked my sugar levels on Gulucometer , and found the same levels i.e. fasting 150 & PP 270. Should my medicines be revised.
Posted Mon, 10 Mar 2014 in Diabetes
Answered by Dr. Shehzad Topiwala 3 hours later
Brief Answer: Yes Detailed Answer: The latest guidelines by Diabetes Endocrine experts worldwide call for A1c goal of 6.5 % to 7 %. If less than 6.5 % can be achieved safely without any treatment burden, it should be pursued especially in a young person like you. An A1c in this range can be accomplished with fasting glucoses close to 100 most of the time. There is no need to check after meals, as long as you check before each meal and sometimes at bedtime, it is sufficient. However if your fasting and before meal glucoses are in the range of 80 to 120 and despite that your A1c is more than 7 % then you may wish to check 1 to 2 hours after the beginning of the meal. It has been shown in well published studies that if glucoses are kept as close to normal, the chances of diabetes related complications are minimized, and consequently people tend to live longer and healthier.
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Follow-up: Should my medicines for type2 diabetes be revised inspite of fasting sugar levels? 3 hours later
Presently i am taking following medicines:-1) Before Breakfast: Tab Gemer-2DS 2)with breakfast: tab Volibo 0.3 3) After Dinner: Tab Jalra M 50-500 & Roseday 5mg my glucose levels are a) before meal : 150, b) 2 hours after meal : 270 Please advice me medicines in your opinion.
Answered by Dr. Shehzad Topiwala 23 minutes later
Brief Answer: Follow up Detailed Answer: When I see a patient like you, I generally prescribe the following: Sitagliptin 50 mg / Metformin 1000 mg twice daily with food, along with Glimepiride 4 mg once daily in the morning, as long as there are no contra indications to the use of these 3 medicines. Contra indications means medical reasons not to use a given medication. These are assessed in person thoroughly by an Endocrinologist who also undertakes comprehensive laboratory testing to ensure the choice of medications is safe and effective Then the response to these agents is evaluated by monitoring the blood glucose readings using a glucometer
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