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What causes increased blood sugar levels despite taking medication?

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Posted on Mon, 23 Nov 2015
Question: I am a diabetic, dependent on insulin, basal insulin is 20 units of lantus to be taken in the night, secondary insulin is insulin aspart 10 units to be taken before Lunch. Even after this dosage my Sugar is not normal , fasting fluctuates wetween 130 to 160 and post lunch after 2 hours of lunch is nearly 220 to 280.
I take two Glyclizide 80 mg tablets two times a day.
For Hypertension I am taking Clinidipine 20 mg once in the night and Olmin 40 in the morning. BP is controlled
As prophylactic I am taking Clopridagel 20 mg with 75 MG of aspirin.
Atorvostatin 10 for cholesterol although my Cholesterol readings are very normal.
Please advise me.
My Weight is 94 kgs, Heiight 169 cm.
I am advised walking as exercise to reduce insulin resistance but due to Knee pain I am unable to walk much, only walk for some time as is needed for work
doctor
Answered by Dr. Abhay A Mali (1 hour later)
Brief Answer:
You need evaluation to start medicines for lowering insulin resistance.

Detailed Answer:
Hi XXXX,

Thanks for your question.
Noted your concern.

Considering your height and weight your BMI is >32 (Grade I obesity).

There are many options that can be considered in your case for better sugar control and decreasing insulin resistance depending upon your detailed clinical examination and base line blood work.

In such case I may have advised following investigations-
- Complete Blood Count.
- Renal Function Test - Urea, Creatinine, Electrolytes, Uric acid.
- Liver Function Test.
- Vitamin D3, B12.
- Calcium profile.
- ECG, 2DEcho.
- Urine albumin creatinine ratio.
- T3, T4, TSH.
- Xray of both knee joints.
- Lipid profile that you have already done (as mentioned normal in your question)

Depending upon clinical examination and above test results use of medicines like Metformin, DPP4 inhibitors, GLP1 agonists like Exenatide, Liraglutide and some more medicines can be considered.

Considering your scenario I will advise you-
- To consult nearby Endocrinologist/ Diabetologist for better opinion considering your clinical evaluation.
- Consult dietitian who can plan diet for you considering your BMI and food habits.
- Also consult orthopedician and physiotherapist for knee joint pain so that appropriate type of exercise can be followed.
- Continue current medicines for Hypertension and cholesterol.
- For prophylactic purpose I may have suggested Ecosprin alone rather than combination of ecosprin and clopidogrel, if there is no evidence of past or present vascular disease like Coronary artery Disease, Sroke or Peripheral Vascular Disease.


Hope this helps you.
I will be happy to answer your future questions.

Regards,
Dr. Abhay Mali.
Diabetologist.

You can directly ask question to me on following link -
http://www.HealthcareMagic.com/doctors/dr-abhay-a-mali/69954
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Abhay A Mali

Diabetologist

Practicing since :2006

Answered : 807 Questions

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What causes increased blood sugar levels despite taking medication?

Brief Answer: You need evaluation to start medicines for lowering insulin resistance. Detailed Answer: Hi XXXX, Thanks for your question. Noted your concern. Considering your height and weight your BMI is >32 (Grade I obesity). There are many options that can be considered in your case for better sugar control and decreasing insulin resistance depending upon your detailed clinical examination and base line blood work. In such case I may have advised following investigations- - Complete Blood Count. - Renal Function Test - Urea, Creatinine, Electrolytes, Uric acid. - Liver Function Test. - Vitamin D3, B12. - Calcium profile. - ECG, 2DEcho. - Urine albumin creatinine ratio. - T3, T4, TSH. - Xray of both knee joints. - Lipid profile that you have already done (as mentioned normal in your question) Depending upon clinical examination and above test results use of medicines like Metformin, DPP4 inhibitors, GLP1 agonists like Exenatide, Liraglutide and some more medicines can be considered. Considering your scenario I will advise you- - To consult nearby Endocrinologist/ Diabetologist for better opinion considering your clinical evaluation. - Consult dietitian who can plan diet for you considering your BMI and food habits. - Also consult orthopedician and physiotherapist for knee joint pain so that appropriate type of exercise can be followed. - Continue current medicines for Hypertension and cholesterol. - For prophylactic purpose I may have suggested Ecosprin alone rather than combination of ecosprin and clopidogrel, if there is no evidence of past or present vascular disease like Coronary artery Disease, Sroke or Peripheral Vascular Disease. Hope this helps you. I will be happy to answer your future questions. Regards, Dr. Abhay Mali. Diabetologist. You can directly ask question to me on following link - http://www.HealthcareMagic.com/doctors/dr-abhay-a-mali/69954