question-icon

Suggest treatment for type 2 diabetes

default
Posted on Tue, 13 Dec 2016
Question: Hi,
want to get better medicines for type2 diabities; currently using (a) triglycomet (b) onglyza (c) oxycent lyco and (d) ecosprin-AV75; a patient from last 20-25 years; not now convinced with the current medicines being used for >5 years; can you help me in finding better pills
doctor
Answered by Dr. Abhay A Mali (53 minutes later)
Brief Answer:
Need evaluation.

Detailed Answer:
Hi,

Thanks for your question.
Noted your concern.

Before giving any opinion I may suggest following evaluation-
Complete Blood Count.
Fasting and Post-prandial blood sugar level.
HbA1c
Lipid Profile.
Renal function test (Urea, Creatinine, Electrolytes).
Liver Function Test.
Urine examination.
ECG and 2DEcho of heart.

Before commenting on any changes in medicine one should know complete prescription (including frequency and dose of medicines), the current blood sugar control, any impact of long lasting diabetes on various organs in body which may prevent the use of certain medicines.

Hope this helps you.

Regards,
Dr. Abhay Mali.
Diabetologsit.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
default
Follow up: Dr. Abhay A Mali (3 hours later)
LIPID PROFILE: 100,72,31,61
S. CREATININE: 0.85; SGPT: 39; TSH: 6-39; FB SUGAR-207; PP SUGAR-358
URIC ACID: 4.7; CBC: Hb13.6; Weight: 61Kgs
Prescription:
TRIGLYCOMET: 1 tab before b/f and 1 tab before dinner
ONGLYZA: 1 tab after b/f
ECOSPRIN: 1 capsule before sleep
OXYCENT: 1 capsule after meal/lunch



doctor
Answered by Dr. Abhay A Mali (4 hours later)
Brief Answer:
I may suggest insulin.

Detailed Answer:
You are already on 4 different types of anti-diabetic medicines in almost maximal doses.
Triglycomet contains glibenclamide 5mg, metformin 500mg, pioglitazone 15mg
Onglyza contains Saxagliptin.

Despite of these 4 effective medicines your blood sugar are not controlled.
In such scenario I may suggest use of insulin (at least to start with night dose of long acting insulin like Glargine or Degludec) for blood sugar control.

I may suggest you to consult your diabetologist as insulin treatment requires education of insulin injection techniques, hypoglycemia early detection, prevention and its management.

Hope this helps you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Abhay A Mali (35 hours later)
it was partially answered, attaching hereby the various reports and prescription to form a considered opinion.
doctor
Answered by Dr. Abhay A Mali (33 minutes later)
Brief Answer:
Regular follow up with your treating doctor is important.

Detailed Answer:
Went through your previous record.
Your blood sugars are uncontrolled since 2012 (HbA1c above 11 persistently).
Also there is no regular follow up with your treating doctor which is not advisable.

Considering all these points I may suggest use of insulin (as suggested previously) along with your current oral medicines.
I cannot give detailed prescription without assessing patient physically.

Better to consult your treating doctor and follow him regularly.

Hope this helps you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
Answered by
Dr.
Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 807 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for type 2 diabetes

Brief Answer: Need evaluation. Detailed Answer: Hi, Thanks for your question. Noted your concern. Before giving any opinion I may suggest following evaluation- Complete Blood Count. Fasting and Post-prandial blood sugar level. HbA1c Lipid Profile. Renal function test (Urea, Creatinine, Electrolytes). Liver Function Test. Urine examination. ECG and 2DEcho of heart. Before commenting on any changes in medicine one should know complete prescription (including frequency and dose of medicines), the current blood sugar control, any impact of long lasting diabetes on various organs in body which may prevent the use of certain medicines. Hope this helps you. Regards, Dr. Abhay Mali. Diabetologsit.