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Suggest Treatment For Type 2 Diabetes When Suffering From Heart Disease
Question: Hi XXXXXXX I am 63yo male with heart failure level 3 and diabetes 2. The diabetes is the problem as the HF is very well controlled. I have been on Victoza 1.2 for 2 years after trying everything. I had been on Januvia 100, Glimerpiride and have tried Insulin but have a severe Angina attack when it is added to other medications or used in isolation. I have double the amount of insulin in my body (blood test last week) but am very severe insulin resistant. When I try to go to Victoza 1.8 I also get a lot more angina. Metformin is contrainted and also has severe angina problems within 1 day of taking. Any ideas?
Regards,
XXXX
Regards,
XXXX
Brief Answer:
Require more information.
Detailed Answer:
Hello XXXXXXX
Welcome to HCM and thanks for your query.
You have insulin resistance, the basic reason for Type 2 diabetes.
Please let me know your BMI, renal functions, the cardiac out put, heart failure symptoms, echocardiogram findings and the current medicines.
You can reduce your insulin resistance by achieving ideal weight, exercising moderately and use of medicines. Pioglitazone is contraindicated as it would worsen the heart failure.
If your glomerular filtration rate is above 45ml per minute, Metformin in small doses with very careful monitoring may be used to help reduce the insulin resistance.
I shall be able to give my opinion when I have the required information.
Take Care
Require more information.
Detailed Answer:
Hello XXXXXXX
Welcome to HCM and thanks for your query.
You have insulin resistance, the basic reason for Type 2 diabetes.
Please let me know your BMI, renal functions, the cardiac out put, heart failure symptoms, echocardiogram findings and the current medicines.
You can reduce your insulin resistance by achieving ideal weight, exercising moderately and use of medicines. Pioglitazone is contraindicated as it would worsen the heart failure.
If your glomerular filtration rate is above 45ml per minute, Metformin in small doses with very careful monitoring may be used to help reduce the insulin resistance.
I shall be able to give my opinion when I have the required information.
Take Care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Doctor Noble,
My BMI is 130, renal functions are good - stage 2, HF level 3 confirmed and back from level 4 (breathing problems at rest, no tolerance for exercise), had multiple heart attacks and strokes and XXXXXXX strokes. I have a top notch cardiologist and endocrinologist working with me.
I am massively insulin resistant since I have a lot of insulin in my system but it will not be used by my cells... putting in more insulin then creates angina.
Metformin cause me massive angina.
My pituitary gland has ceased functioning and I had thyroid cancer in 1983 and use 125mcg thyroxine per day.
I was hoping for a second opinion that might give some hope. Any ideas are welcome and unfortunately pioglitazone is contraindicated and probably dangerous. If not medicines anything on the natural front?
Regards,
XXXX
My BMI is 130, renal functions are good - stage 2, HF level 3 confirmed and back from level 4 (breathing problems at rest, no tolerance for exercise), had multiple heart attacks and strokes and XXXXXXX strokes. I have a top notch cardiologist and endocrinologist working with me.
I am massively insulin resistant since I have a lot of insulin in my system but it will not be used by my cells... putting in more insulin then creates angina.
Metformin cause me massive angina.
My pituitary gland has ceased functioning and I had thyroid cancer in 1983 and use 125mcg thyroxine per day.
I was hoping for a second opinion that might give some hope. Any ideas are welcome and unfortunately pioglitazone is contraindicated and probably dangerous. If not medicines anything on the natural front?
Regards,
XXXX
Brief Answer:
Discuss SGLT2 inhibitors with your doctors
Detailed Answer:
I appreciate your knowledge and insight.
There is a relatively new class of anti diabetes medicine , SGLT2 inhibitors. These decrease the glucose reabsorption in the kidneys and reduce the blood glucose. They are also beneficial for heart failure by reducing the blood volume.
You could discuss it with your doctors.
On the natural side, Cinnamon and aloe Vera have been found to help my patients.
If you are able to reduce your weight a little and have some exercise training, these would help reduce your insulin resistance.
Take care,
Discuss SGLT2 inhibitors with your doctors
Detailed Answer:
I appreciate your knowledge and insight.
There is a relatively new class of anti diabetes medicine , SGLT2 inhibitors. These decrease the glucose reabsorption in the kidneys and reduce the blood glucose. They are also beneficial for heart failure by reducing the blood volume.
You could discuss it with your doctors.
On the natural side, Cinnamon and aloe Vera have been found to help my patients.
If you are able to reduce your weight a little and have some exercise training, these would help reduce your insulin resistance.
Take care,
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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