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Suggest treatment for insomnia and dizziness in a hypertensive person

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Posted on Mon, 11 Jul 2016
Question: Hi,My dad has Hypertension and he was op.erated for aneurysym 13 years ago,He used to take alcohol once on daily basis.Now he had a check up where sugar levels 241 and I have attached the report for other reference.The endocrinologist has prescribed medicine and K bind powder to be taken along with the meals.For the past 9 days he is not taking alcohol.He is experiencing insomnia and he is mentally depressed and feels tiered and dizzy all the time.Is it because of medications or his sugar levels has decreased rapidly.He has the urge to urinate or pass stools but he is severely constipated .Please help.
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Answered by Dr. Mirjeta Guni (1 hour later)
Brief Answer:
Please help with further examinations.

Detailed Answer:
Welcome and thank you for asking!
I have gone through your query.

Before giving you a proper treatment for your father i would recommend to attach me some more detailed examinations (i can see attached only the prescription of the doctor), because first :

-Only one value of the glycemia is not a good indicator to start or change the treatment and second:

- A person diagnosed with diabetes needs to do some more controls in order to see if diabetes has done any complication until now. So i would recommend to do:

-HbA1c
-Full blood count
-Lipid profile
-AST,ALT,GGT.
-Urea and creatine level estimation
-Urine examination and a 24 hour urine collection to check for proteinuria.
-Fundus occuli to check for retinopatia
-ECG, heart ultrasound and stress test.
-Ultrasound of the carotids arteries.

It will be a pleasure to give you further information regarding treatment and chronic complications of the diabetes after having the above results.

Kind regards,
Dr.Mirjeta



Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Mirjeta Guni (1 hour later)
PFA


really worried about his condition,For the past 1 week he is in low protein diet and away from alcohol consumption.will sudden alcohol withdrawal cause any problems
doctor
Answered by Dr. Mirjeta Guni (16 minutes later)
Brief Answer:
Continue with the treatment

Detailed Answer:
Hello again,

I have gone carefully through the exams you send.

Actually there are some identified problems most of them probably caused by alcohol consumption.

I agree with treatment recommended, but i would suggest to be very careful because there is an altered renal function (both metformine and galvus should be given in reduced dose, XXXXXXX 50 mg galvus/day and 1000 mg of metformine) and a high GGT due to alcohol consumption. Except of the treatment for diabetes start a low protein diet because of the altered renal function.

I strongly recommend to check the other blood vessels (carotids, coronaries and peripheral arteries), because there are many factors that may have damaged them: diabetes, high lipids, alcohol consumption).

AN ophthalmologist for the evaluation of the eyes and a 24 hour urine collection would complete the check up for chronic complications of diabetes.
Regarding to high Kalium and low natrium level i also recommend to recheck them.
Continue monitoring the diabetes and blood pressure and keep in contact for the outcome with this treatment.
Feel free to ask more questions if you have still queries.
Kind regards,
Dr,Mirjeta

Brief Answer:
Brief answer

Detailed Answer:
I would say that sudden withdrawal does not cause any problem rather than symptoms, the sudden correction of the glucose can also cause fatigue, tiredness, visual problems, but these are symptoms that to not last to long (max 2-3 weeks). Of course it is not easy and needs lots of will, but at this point it is very important to stop the risk factors(alcohol) for preventing further damages.

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2322 Questions

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Suggest treatment for insomnia and dizziness in a hypertensive person

Brief Answer: Please help with further examinations. Detailed Answer: Welcome and thank you for asking! I have gone through your query. Before giving you a proper treatment for your father i would recommend to attach me some more detailed examinations (i can see attached only the prescription of the doctor), because first : -Only one value of the glycemia is not a good indicator to start or change the treatment and second: - A person diagnosed with diabetes needs to do some more controls in order to see if diabetes has done any complication until now. So i would recommend to do: -HbA1c -Full blood count -Lipid profile -AST,ALT,GGT. -Urea and creatine level estimation -Urine examination and a 24 hour urine collection to check for proteinuria. -Fundus occuli to check for retinopatia -ECG, heart ultrasound and stress test. -Ultrasound of the carotids arteries. It will be a pleasure to give you further information regarding treatment and chronic complications of the diabetes after having the above results. Kind regards, Dr.Mirjeta