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Suggest Treatment For Diabetes In An Elderly Person
Question: Dear Sir,
My Mother is having Diabetes from past 15 year.Current Reading is 190 Before Breakfast and 280 after Breakfast .She is on Medication listed in Current medication Tab.
Could you please suggest that those Medications are good to Control Diabetes ?
She is also having Osteoarthritis on Left Leg on left leg which has reached at last Satge.Doctor suggeted
To Undergo Knee Replacment surgery.So Could you please let us know When is it Safe to UnderGo Knee Replacment Surgery with Current Readings.
Does Knee replacement would cause any issue since my mother is having Diabetes.
Do we have any alternative ways other than knee replacement
My Mother is having Diabetes from past 15 year.Current Reading is 190 Before Breakfast and 280 after Breakfast .She is on Medication listed in Current medication Tab.
Could you please suggest that those Medications are good to Control Diabetes ?
She is also having Osteoarthritis on Left Leg on left leg which has reached at last Satge.Doctor suggeted
To Undergo Knee Replacment surgery.So Could you please let us know When is it Safe to UnderGo Knee Replacment Surgery with Current Readings.
Does Knee replacement would cause any issue since my mother is having Diabetes.
Do we have any alternative ways other than knee replacement
Brief Answer:
Insulin is a better option if surgery is indicated earliest.
Detailed Answer:
Hi,
Thanks for your question.
Noted your concern.
Considering 15 year of Diabetes and age, I may suggest following evaluation -
- HbA1c.
- Lipid Profile.
- Renal Function Test including Urea, creatinine, electrolytes.
- Liver Function Test including Bilirubin, liver enzymes.
- Complete Blood Count.
- Urine examination including ketone.
- Chest x-ray.
- ECG and 2DEcho of heart.
All these investigation required for pre operative fitness.
Regarding blood sugar control:
If knee replacement is suggested earliest it can be done with rapid blood sugar control using insulin.
Modification in oral medicine can be tried, though it may take some time for blood sugar control.
Regarding oral medicine considering her normal kidney & heart function, I may suggest
- To continue Glycomet GP1 (Glimepiride 1mg + Metaformin 500mg) twice a day.
- Add Tablet containing Metaformin 500mg and Sitagliptin 50mg (like Janumet) before breakfast.
Recheck Fasting & post-prandial blood sugar levels after 10 to 15 days and accordingly if needed dose of Sitagliptin can be increased to 50mg twice a day.
Along with this she should follow diabetic diet.
Hope this helps.
Regards,
Dr Abhay Mali.
Diabetologist.
Insulin is a better option if surgery is indicated earliest.
Detailed Answer:
Hi,
Thanks for your question.
Noted your concern.
Considering 15 year of Diabetes and age, I may suggest following evaluation -
- HbA1c.
- Lipid Profile.
- Renal Function Test including Urea, creatinine, electrolytes.
- Liver Function Test including Bilirubin, liver enzymes.
- Complete Blood Count.
- Urine examination including ketone.
- Chest x-ray.
- ECG and 2DEcho of heart.
All these investigation required for pre operative fitness.
Regarding blood sugar control:
If knee replacement is suggested earliest it can be done with rapid blood sugar control using insulin.
Modification in oral medicine can be tried, though it may take some time for blood sugar control.
Regarding oral medicine considering her normal kidney & heart function, I may suggest
- To continue Glycomet GP1 (Glimepiride 1mg + Metaformin 500mg) twice a day.
- Add Tablet containing Metaformin 500mg and Sitagliptin 50mg (like Janumet) before breakfast.
Recheck Fasting & post-prandial blood sugar levels after 10 to 15 days and accordingly if needed dose of Sitagliptin can be increased to 50mg twice a day.
Along with this she should follow diabetic diet.
Hope this helps.
Regards,
Dr Abhay Mali.
Diabetologist.
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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