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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for uncontrolled blood sugar levels

Answered by
Dr. Binu Parameswaran Pillai


Practicing since :2003

Answered : 1414 Questions

Posted on Wed, 20 Aug 2014 in Diabetes
Question: I am diabetic since 5 years,for the last 5 years my fasting blood glucose in between 125-134 mg/dL and my blood sugar level two hours after eating is less than 200 mg/dL and A1c between 6.5 - 6.7 percent , Iam using Januvia 50 ml/ per day ,but in last month I suffered a problem and pressure so my fasting blood glucose became in between 145-160 mg/dL and my blood sugar level two hours after eating is less than 270 mg/d suddenly . I have also cholesterol 217, triglycerides 270 i would like to ask is that the beginning of the use of insulin injections or my current blood glucose related to the my psychological state and then it will go down and please advice me what shall I do . Best regards
Answered by Dr. Binu Parameswaran Pillai 11 minutes later
Brief Answer:

Detailed Answer:
Good day.
Noted your points and understand your concerns.
Noted that you are using januvia 50 my. Are you using twice daily?. Have you ever used metformin?
What other medicines are you using. What is your height and Weight? Could you please answer my above questions? I will be able to guide you better.
Anyway looking at your HbA1c levels I don't think you need insulin now. Are you using any Blood pressure medicines?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Binu Parameswaran Pillai 35 minutes later

Thanks a lot for your prompt reply .

I am using Januvia 50ml only one time per day not twice and I never use metformin.

the medicines iam using now is:

Isoptin SR 240 mg ( half tablet daily ) for blood pressure

my height is 189 and Weight is 92 ( I lost 4 kg last month )

Thanks in advance and waiting for your reply .
Best regards

Lopid 600 ( tablet daily ) for triglycerides

Answered by Dr. Binu Parameswaran Pillai 1 hour later
Brief Answer:

Detailed Answer:

Looking at your weight and height, Metformin is a very good option. Even the dose of Januvia is not optimum in you. The optimum dose is 100 mg. Dose reduction is required only in kidney failure.

Metformin and Januvia is an excellent combination. Helps to lose weight too.
The current increase in blood glucose may be secondary to your stress from high Blood pressure. Please do not worry. It may settle down in due course.
Regarding optimising your diabetic medicines , you will have to discuss with your GP.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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