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What is your opinion on the medication and reports attached?

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Practicing since : 2000
Answered : 103 Questions
need an opinion om my mothers's present medication. reports and medication detailed attached to the query raised on 28th October 2013
Posted Thu, 5 Dec 2013 in Diabetes
Answered by Dr. Amit Rajput 22 hours later
Brief Answer: Need strict sugar control for neuropathy. Detailed Answer: Hello XXXXXXX Thank you for posting on XXXXXXX I just went through all the records you have attached. However, you have not enclosed your mother's current blood sugar levels and Hba1c reports, so it is hard to assess her current blood glucose control. If I assess indirectly, she is suffering from diabetic neuropathy (probably because of inadequate control of blood sugars). She is consuling three medications for the same - Tryptomer, Pregabalin and Neurobion. She is consuming Codeine syrup for cough but her physician must rule out whether the cause of the cough is Tablet Cardace or not. Few people on Cardace could get cough. Her heart seem to be functioning fine, especially the pumping. She has mild leaky heart valve (Mild mitral regurgitation), which is quite common for her age. Rest of her reports are alright and I would not worry about them. To conclude - Her blood sugars and hba1c values (last three months average blood glucose control indicator) should be normal. That should reduce her neuropathy. For that she needs change in her oral diabetic medications and Insulin. I would also like to advice to do her Thyroid function testing. Hope I have answered your query. I will be available to answer your follow up queries, if any. Regards The name of Insulin is not written so I cannot comment on the same.
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Follow-up: What is your opinion on the medication and reports attached? 1 hour later
Thank you doctor Her blood sugar levels are checked on a periodic level and always within the range. The codine is given to treat IBS and not cough, she's on codine for over 5 yrs now. Insulin is novamix 30/70 We are scheduled to get her 3 months sugar levels within the coming week and I shall share the details of the same. The diabetic neuropathy medication was initiated about 6 months back when she was complaining of food getting stuck in the gums, while there was no dental issues. This was started and it did help to a certain degree and hence need an opinion if it's actually diabetic neuropathy or may be due to something else. I shall share the reports with you shortly.
Answered by Dr. Amit Rajput 20 minutes later
Brief Answer: Suggesting thyroid profile too Detailed Answer: Hello and thanks again, Food getting stuck in her gums could be a feeling due to neuropathy, if there are no dental issues. If there is problem in swallowing and digestion (IBS) - it could also be due to neuropathy. Along with Hba1c, I'd also suggest to check her thyroid profile. Hope my answer was adequate and helpful to you. Please accept my answer if you do not have further queries. Wishing her a good health. Regards.
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Follow-up: What is your opinion on the medication and reports attached? 3 minutes later
Recent thyroid profiling was within the range aswell. Do you suggest any additional medication or assessments for neuropathy.
Answered by Dr. Amit Rajput 11 minutes later
Brief Answer: Advised review by a diabetologist Detailed Answer: Additional medications doesn't seem to be necessary at this point of time. For assessment of neuropathy, I'd suggest to get her re-examined by a diabetologist or an endocrinologist, if already not done so. Neuropathy assessment is mostly done on clinical examination. Regards.
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