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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Sugar, BP High. Blood Test Shows Uric Acid, Pus Cells In Urine, Cholesterol High. How To Control?

Hello Doctor, My mother is having high BP problem and high sugar also... she was taking losar H tablet for BP and diet control for high sugar. few days back doctor changed the BP tablet to Olmat-H 40 mg. after 8 days my mother was not responding properly and we was feeling very weak. right now we have stopped all the medicine and went for all body test. In test report her sugar is 120 fasting and 152 PP. Uria, uric acid , PUS cell in urine, ESR (Westergren) and cholesterol is also high. She always want to sleep and little memory loss . So kindly guide me what should be the first step. Regards, Nitin
Sat, 30 Mar 2013
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General & Family Physician 's  Response
HI, thanks for using healthcare magic

It is possible, with the presence of pus cells in the urine, that she has a urinary tract infection that is requiring treatment. It would contribute to the weakness that she is experiencing. The ESR is a non specific indicator of infection or inflammation in the body, it does not say where the problem is, just that a problem exists and further investigations may be needed. If a urinary tract infection is present , the ESR may be in response to that infection.

The fasting and post prandial blood sugars are both within the control range for a diabetic.

With a history of high blood pressure and diabetes, it is important that all her risk factors for heart disease be under control. This would include her cholesterol. This can be controlled by using a diet high in fiber from fruits, vegetables, whole wheat or whole grain, oats, barley. Other dietary measures are: reduction in the use of fried foods, reducing the use of fat on meats, using low fat products such as low fat cheeses or milk.In addition medication may be needed to help reduce the cholesterol.

I hope this helps
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Cardiologist Dr. Hemant Kumar's  Response
pus cell in urine, increase urea, drowsiness ( always want to sleep), high ESR- highly suspicious of urinary tract infection ( which is very common in old diabetic females) , so investigate and take treatment for UTI
after controlling of infection reassess sugar levels , if still elevated start oral hypoglycemic medicines.
olmet-H is very good antihypertensive medicine , YOUR BP GOAL IS LESS THEN 130/80 MMHG, if remain elevated add other medicines
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Internal Medicine Specialist Dr. Maruti Karale's  Response

Hello!

Thanks for writing to us.

Problems that your mother is suffering from are high Uric acid,pus cells in urine,high ESR,high Cholesterol,high blood pressure,high sugar,little Memory loss(Could be altered sensorium).Hence present problem i would like to consider to be urinary tract infection.

Blood sugar of Fasting 120 and Post meal 152 is normal,hence you need not worry about.Just continue the same medicines or diet control for high sugar.

Blood pressure keeps fluctuating depending on stress,any acute medical illness hence it needs regular check up as usual and keep blood pressure to less than 130/80 mm of Hg.

High cholesterol can be dealt with hypertension and sugar control.She needs statins or other lipid lowering agents as per the recent lipid profile.

Now,new problem that should be urgently needs attention is high ESR and Pus cells in urine.
pus cell in urine, high ESR- highly suspicious of urinary tract infection so get investigated for UTI.

High uric acid can be due to decreased renal function secondary to urinary tract infection or hypertension and high sugar.

I would like to suggest to get a physician opinion and get Hb,CBC, USG KUB,Renal function test,Urine examination for micro-albuminuria,culture sensitivity tests done.

Hope this could help you.
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Orthopaedic Surgeon Dr. Sunil Kumar Srivastava's  Response
in view of pus cells, urine culture/sensitivity and suitable anti biotic treatment needed.
If losar-H was giving initial response and now BP rising then probably your doc. should modify dose of same drug instead of starting a new one.For cholesterol,atorva 20 mg once a day after breakfast shall be okay
Blood sugar , I believe can still be managed on diet and activity.
Please consult a senior physician in a hospital or check again with your doc. and ask him if earlier treatment on losar with modification of dose would that work?
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Sugar, BP High. Blood Test Shows Uric Acid, Pus Cells In Urine, Cholesterol High. How To Control?

HI, thanks for using healthcare magic It is possible, with the presence of pus cells in the urine, that she has a urinary tract infection that is requiring treatment. It would contribute to the weakness that she is experiencing. The ESR is a non specific indicator of infection or inflammation in the body, it does not say where the problem is, just that a problem exists and further investigations may be needed. If a urinary tract infection is present , the ESR may be in response to that infection. The fasting and post prandial blood sugars are both within the control range for a diabetic. With a history of high blood pressure and diabetes, it is important that all her risk factors for heart disease be under control. This would include her cholesterol. This can be controlled by using a diet high in fiber from fruits, vegetables, whole wheat or whole grain, oats, barley. Other dietary measures are: reduction in the use of fried foods, reducing the use of fat on meats, using low fat products such as low fat cheeses or milk.In addition medication may be needed to help reduce the cholesterol. I hope this helps