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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Uncontrolled Diabetes

Hi Doctor, My mother, 70 a sugar patient had a knee lock problem about 3 months back. Since then she has been complaining of severe pain in left leg, espicially knee. MRI is also done of LS Spine which says Lumbar spodylosis and mild diffuse annular and posterolateral bulges of L3-4,L4-5 & L5-SA disc casuing mild impingement of bilateral intervertebral neural foraminae without neural compression. Orthopaedician says nothing serious but no one is able to treat her pain. With physio pain increases. 2nd problem, she was initially on Mistard (30:70), Azulix 2MF forte and Glimy 2 and Pioglar 15 (twice). Her sugar was under control with PP 160. Only complication was she was gaining weight due to Pioglar. We shifted to new doctor with new line of treatment, with Novorapid and lantus and Januvia 100 and now changed to Janumet 1000 her sugar level has shot up to 360 and not coming down. Kindly help
Wed, 17 Sep 2014
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Internal Medicine Specialist 's  Response
Hi,

Thank you for your query. I can understand your concerns.
Your mother has post-prandial hyperglycemia.I suggest to add repaglinide 1 mg orally before each meal in addition to novorapid and lantus as prescribed. If post-prandial blood sugar still remains >140 mg/dl ,you have to add voglibose 0.2 to 0.3 mg before each meal in addition;her PP will come down. Reduce janumet to 50/500 mg twice a day instead of single dose of 1000. Of course ,you can have fresh consultation with your diabetologist.







Regards

Dr. T.K. Biswas M.D.
Mumbai
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Suggest Treatment For Uncontrolled Diabetes

Hi, Thank you for your query. I can understand your concerns. Your mother has post-prandial hyperglycemia.I suggest to add repaglinide 1 mg orally before each meal in addition to novorapid and lantus as prescribed. If post-prandial blood sugar still remains 140 mg/dl ,you have to add voglibose 0.2 to 0.3 mg before each meal in addition;her PP will come down. Reduce janumet to 50/500 mg twice a day instead of single dose of 1000. Of course ,you can have fresh consultation with your diabetologist. Regards Dr. T.K. Biswas M.D. Mumbai