Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Needs To Be Done About Deranged HbA1c Level, Very High FBS And PPBS Levels?
Question: My Glucose Fasting is 242 mg/dl and Glucose PP is 256 mg/dl
My Microalubumin , Random Urine is 71.4 mg/dl
My Creatinine Urine, Random is 124.0 mg/dl
My Albumin Creatine Ratio is 58.0 mg/dl
My Glycated Hemoglobin (HBA1C) is 11.1 %
Kindly advice me how I can bring it back to normal
Please note that , the above results are as per the Lab report taken yesterday
My Microalubumin , Random Urine is 71.4 mg/dl
My Creatinine Urine, Random is 124.0 mg/dl
My Albumin Creatine Ratio is 58.0 mg/dl
My Glycated Hemoglobin (HBA1C) is 11.1 %
Kindly advice me how I can bring it back to normal
Please note that , the above results are as per the Lab report taken yesterday
Brief Answer:
You need to start on insulin
Detailed Answer:
Hi,
Thanks for posting your query
Firstly you have taken combination of glimepride + metformin + teneligliptin.
Next you have taken combination of glimepride + dapagliflozin.
Your HbA1C is also out of range.
How was your sugar control on first regime that included metformin?
Since your sugar levels have been raised for some time and the oral medicines are being ineffective, its time that we consider insulin. Consult a diabetlogist to start you on appropriate insulin regime for you. Also a combination of metformin and acarbose can be continued. But insulin seems necessary (atleast for sometime).
Urine report is fortunately in normal range.
Hope you are following diet control (avoid high glycemic index foods) and regular exercise of atleast 30 min a day.
Hope it helps. Let me know if I can assist you further.
Dr Vaishalee
You need to start on insulin
Detailed Answer:
Hi,
Thanks for posting your query
Firstly you have taken combination of glimepride + metformin + teneligliptin.
Next you have taken combination of glimepride + dapagliflozin.
Your HbA1C is also out of range.
How was your sugar control on first regime that included metformin?
Since your sugar levels have been raised for some time and the oral medicines are being ineffective, its time that we consider insulin. Consult a diabetlogist to start you on appropriate insulin regime for you. Also a combination of metformin and acarbose can be continued. But insulin seems necessary (atleast for sometime).
Urine report is fortunately in normal range.
Hope you are following diet control (avoid high glycemic index foods) and regular exercise of atleast 30 min a day.
Hope it helps. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Doctor Madam,
Since end January 2017 I have stopped all the medicines and was only relying on diet and exercise. If necessary I can further control my diet with morning
and evening walking as well. I am very sorry that I have forgotten to inform you in the first instance.
Also I am being very religious ly following my diet and regular walking.
Hence , please suggest me the right medicine accordingly.
Yours truly,
S XXXXXXX
Since end January 2017 I have stopped all the medicines and was only relying on diet and exercise. If necessary I can further control my diet with morning
and evening walking as well. I am very sorry that I have forgotten to inform you in the first instance.
Also I am being very religious ly following my diet and regular walking.
Hence , please suggest me the right medicine accordingly.
Yours truly,
S XXXXXXX
Brief Answer:
Start on metformin
Detailed Answer:
Hi again
So you were off medicine since 6 months.
Yes please continue your diet and exercise. Also take cleaner water from RO system. This will help avoid any infections. Karela-Jamun juice or Karela juice are also considered good.
How was your sugar control on previous medicines? Newer medicine will depend on the response previously. If there was good response to Metformin, then that will be my first drug of choice for you. You can start with Tab Gluconorm-SR 500 mg once daily. Keep monitoring your fasting blood glucose levels with a glucometer.
Dr Vaishalee
Start on metformin
Detailed Answer:
Hi again
So you were off medicine since 6 months.
Yes please continue your diet and exercise. Also take cleaner water from RO system. This will help avoid any infections. Karela-Jamun juice or Karela juice are also considered good.
How was your sugar control on previous medicines? Newer medicine will depend on the response previously. If there was good response to Metformin, then that will be my first drug of choice for you. You can start with Tab Gluconorm-SR 500 mg once daily. Keep monitoring your fasting blood glucose levels with a glucometer.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Madam, thank you for the advice.
For your kind information , when took Tivolib 1mg along with Teneza 20 mg morning and evening initially for 4 days , my blood glucose level came down to 59 .
Immediately my doctor asked me to stop Tivolib 1 and continue only Teneza 20mg during March 2016.
After that what ever medicine prescribed by him didn't bring my sugar level in place.
Then I stopped all the medicine and had normal diet with regular walking without taking any sweets strictly.
I found to my XXXXXXX that it worked well and my sugar came nearby to the level when I was on medicine.
But my concern is mainly to bring down the glycated Hemoglobin level, which is now 11.1%.
Yours truly,
S XXXXXXX
For your kind information , when took Tivolib 1mg along with Teneza 20 mg morning and evening initially for 4 days , my blood glucose level came down to 59 .
Immediately my doctor asked me to stop Tivolib 1 and continue only Teneza 20mg during March 2016.
After that what ever medicine prescribed by him didn't bring my sugar level in place.
Then I stopped all the medicine and had normal diet with regular walking without taking any sweets strictly.
I found to my XXXXXXX that it worked well and my sugar came nearby to the level when I was on medicine.
But my concern is mainly to bring down the glycated Hemoglobin level, which is now 11.1%.
Yours truly,
S XXXXXXX
Brief Answer:
Diet and exercise are first line of management
Detailed Answer:
Hi
Diet and exercise should be prescribed first for atleast 3 months.
I have reviewed your medicine intake. I think Glimepiride, teneligliptin, dapagliflozin were ineffective in your case. The only medicine that was bringing down your sugar in past was metformin and/or voglibose. Metformin is known to not cause low blood sugar. So probably Voglibose was causing low blood sugar in your case. Overall Voglibose is most safe as er side effects. It has only local action.
You can start on metformin for now. It will help bring down your glycated hemoglobin. You can start with Tab Gluconorm-SR 500 mg once daily.
Dr Vaishalee
Diet and exercise are first line of management
Detailed Answer:
Hi
Diet and exercise should be prescribed first for atleast 3 months.
I have reviewed your medicine intake. I think Glimepiride, teneligliptin, dapagliflozin were ineffective in your case. The only medicine that was bringing down your sugar in past was metformin and/or voglibose. Metformin is known to not cause low blood sugar. So probably Voglibose was causing low blood sugar in your case. Overall Voglibose is most safe as er side effects. It has only local action.
You can start on metformin for now. It will help bring down your glycated hemoglobin. You can start with Tab Gluconorm-SR 500 mg once daily.
Dr Vaishalee
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
