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What Causes An Increase In Blood Glucose Level Despite Using Glyciphage?
Question: Dear Doctor, I was diagnosed with impaired glucose sensitivity in 2004. Initially the doctor advised only exercise and elimination of sugary items from diet, My blood sugar remained borderline. Then from 2011 I was prescribed 1gm per day Glyciphage SR. Till 2014 my blood sugar remained normal. But for past six months or so my fasting sugar remains around 130 and PP around 170. There has been no change in exercise, diet or medication. Is it due to my advancing age. I am now 65and half years. Should I increase the dose of Glyciphage?What isthe maximum safe dose for Metformin?
Brief Answer:
You need further evaluation.
Detailed Answer:
Hi,
Thanks for your query.
Diabetes is a life long disease it is due to both insulin resistance (impaired glucose sensitivity) and pancreatic defect in insulin secretion.
As age advances insulin resistance may not fluctuate much but insulin secretion from pancreas decreases significantly.
That's why with advancing age there is increase in blood sugar level for which dose of medicine or number of medicines need to be increased and in many cases there is need for exogenous insulin.
You should do-
1) HbA1c level it will tell blood sugar level over a period of last 3 to 4 months.
2) Renal function test, urinary albumin to creatinine ratio and Creatinine clearance test depending upon it dose of metformin (Glyciphage) need to be titrated also need for other treatment for diabetic nephropathy can be decided.
3) Regular BP check up.
4) Lipid Profile.
5) Screening for other complications of diabetes like fundoscopy for diabetic retinopathy, foot examination for diabetic neuropathy and vasculopathy, ECG and 2DEcho of heart after consultation with your doctor.
If serum creatinine is normal you can increase the dose of Tab Glyciphase SR after discussing with your doctor.
Usually a dose of 1500 to 2000 mg per day is considered as effective dose of metformin.
Metformin act by decreasing the insulin resistance which one of the basic pathology in diabetes.
I would also like to recommend you to take statin (cholesterol lowering drug) even with normal lipid profile only dose will depend on lipid level.
Hope I have answered your query.
I will be happy to answer your follow up queries, if any.
Otherwise close the question and rate the answer.
Regards,
Dr. Abhay Mali.
Diabetologist. XXXXXXX
You need further evaluation.
Detailed Answer:
Hi,
Thanks for your query.
Diabetes is a life long disease it is due to both insulin resistance (impaired glucose sensitivity) and pancreatic defect in insulin secretion.
As age advances insulin resistance may not fluctuate much but insulin secretion from pancreas decreases significantly.
That's why with advancing age there is increase in blood sugar level for which dose of medicine or number of medicines need to be increased and in many cases there is need for exogenous insulin.
You should do-
1) HbA1c level it will tell blood sugar level over a period of last 3 to 4 months.
2) Renal function test, urinary albumin to creatinine ratio and Creatinine clearance test depending upon it dose of metformin (Glyciphage) need to be titrated also need for other treatment for diabetic nephropathy can be decided.
3) Regular BP check up.
4) Lipid Profile.
5) Screening for other complications of diabetes like fundoscopy for diabetic retinopathy, foot examination for diabetic neuropathy and vasculopathy, ECG and 2DEcho of heart after consultation with your doctor.
If serum creatinine is normal you can increase the dose of Tab Glyciphase SR after discussing with your doctor.
Usually a dose of 1500 to 2000 mg per day is considered as effective dose of metformin.
Metformin act by decreasing the insulin resistance which one of the basic pathology in diabetes.
I would also like to recommend you to take statin (cholesterol lowering drug) even with normal lipid profile only dose will depend on lipid level.
Hope I have answered your query.
I will be happy to answer your follow up queries, if any.
Otherwise close the question and rate the answer.
Regards,
Dr. Abhay Mali.
Diabetologist. XXXXXXX
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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