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Chronic rhinitis, high BP, headaches, diabetic, hyperlipidemia, high LDL, high HDL. Treatment?

Scenerio: You had a 48 year old female patient that you have treated for the last 14 years. She originally presented with chronic rhinitis , high blood pressure and headaches. Her yearly labs including thyroid function were completely normal. In the 7th year her labs came back that she had very high fasting glucose levels, high LDL and HDLs, and was diagnosed with Type II diabetes and hyperlipidemia . Changes in her blood pressure medicine seemed to help the headaches. She had normal metabolic labs including TSH panel every year for 14 years, headaches, chronic rhinitis, diabetes type II, and had a hard time controlling the blood sugar levels. She has followed the diet and cut out the sugars. How would you continue treatment with this patient?
Asked On : Fri, 13 Apr 2012
Answers:  2 Views:  68
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Diabetologist 's  Response
I like to give direct treatment options:
Better to start basal insulin along with proper orlhypoglycemics according to her blood sugar,life style modifications like daily walking,meditation,strict diabetic diet and also medications for hypertension and dyslipidemia and allied problems.
With Regards'
Answered: Sun, 15 Apr 2012
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General & Family Physician Dr. Sourav Ganguly's  Response
Thanks for posting query.
Continue the oral hypoglycemic drugs for diabetes and if not controlled then I may have to shift to insulin. For dyslipidemia I need to add a hypolipidemic drugs like statin, and to control BP hypertensive should be added.
Other problem like rhinitis can be treated with antibiotics, decongestant nasal drop and antihistaminic.
Consult with physician to choose correct drug and doses.
Wish you a speedy recovery.
Dr Sourav Ganguly
Answered: Mon, 30 Jul 2012
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