How Can High Blood Sugar And HbA1c Levels And Low Vitamin-D Level Be Named Written Diagnosed With Type 2 Diabetes And Chronic Gastritis?

Posted on Fri, 18 May 2018

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 18 May 2018 Answered on

Tue, 6 Feb 2024 Last reviewed on

Question : Hi,
55 Y, F
Major issues currently having are Diabetes (type 2), Chronic Gastritis, OA in knee (3rd stage).

Had following tests done 3 days back (on 15th May 2018):
Liver Function Test, Kidney Function Test, Thyroid Profile, Complete Blood Count, HbA1c, Lipid Profile, Vitamin B12, Vitamin D, Glucose Fasting.
Out of these, following are the deviations found:
Glucose Fasting 269 (70-100)
Vitamin D 27.74 (75-250)
HbA1c 11.1 (< 7)
RDW (Red Cell Distribution Width) 14.9 (11.5 - 14.5)
T4 Total 12.9 (5.01 - 12.45)
Chloride 98 (101 - 109)
Phosphorus 4.9 (2.4 - 4.4)
Alkaline Phosphatase (ALP) 256 (30 - 120)
Triglyceride 149 (for info, at boundary)

All other parameters under the tests carried out, are under normal range.

Want to know:
1. What the parameters are pointing towards.
2. Which should be the top priorities to address.
3. We came to know that CMS Vellore (Endocrine Department) is having excellent treatment for Diabetes. We need to know, should we go for it.
4. For Chronic Gastritis, we are taking treatment from Manipal, XXXXXXX Is it ok for Gastritis to cure in totality, or we need to consider anything else.
5. For 3rd stage knee OA, is there any way to avoid surgery and if exist, what is that way.

Thanks.

Answered by Dr. Dr. (2 hours later)

Brief Answer:
Kindly see detailed answer.

Detailed Answer:

Hello,

I can understand your concern. From your report it is seen that your blood sugar level is on much higher side. HbA1c value also much high. You may require to start insulin injection along with oral diabetic medication, if not on insulin earlier. It is need to correct blood sugar level ASAP, so consult with your diabetologist or any good diabetes care center. It's priority for you.

Vitamin D level is also low. So you can start vitamin D sachets 60000U per week after consultation.

For 3rd stage OA, other than surgery, options available are regular physiotherapy after consultation with physiotherapist, use knee cap, don't sit in squatting position, use commode. For pain you can take tab. Etoricoxib 60mg, tab. Calcium after consultation. Continue treatment for chronic gastritis as advised. Avoid spicy hot food. Drink lot of fluids. Take light food. Kindly follow up if you have any query. Take care.

Regards,
Dr Shyam Kale
Family and general physician.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Dr. (3 hours later)

Hi,

Thank you.

However, we need advise on remaining deviated parameters too i.e.
RDW (Red Cell Distribution Width) 14.9 (11.5 - 14.5)
T4 Total 12.9 (5.01 - 12.45)
Chloride 98 (101 - 109)
Phosphorus 4.9 (2.4 - 4.4)
Alkaline Phosphatase (ALP) 256 (30 - 120)

Also, it would be good to learn about the CMC Vellore (Endocrine Department) - how do Doctors see it for treatment of Diabetes there.

Kindly advise for above.

Answered by Dr. Dr. (6 hours later)

Brief Answer:
Kindly see detailed answer.

Detailed Answer:
Hello and welcome back.

Thank you for your reply. Raised alkaline phoshatase level may be due Chronic osteoarthritis. T4 level is mildly increased, but as TSH level is normal, so nothing to worry. Deranged chloride, phosphorus values may be due uncontrolled diabetes. Raised RDW value may be due to the deficiency of vit B 12 or folate. Regarding CMV vellore endocrine department, kindly look for the reviews and take proper decision. If you kindly follow if you have any query. Take care.

Regards,
Dr Shyam Kale
Family and general physician.

Above answer was peer-reviewed by : Dr. Nagamani Ng