Brief Answer:
Consider the following....

Detailed Answer:
Hi XXXX,

I have gone through your medical history carefully and understood your concerns.

Having high uric acid levels are always associated with high diabetes risk. You are already a diabetic, and I'd like to know if you had high uric acid levels even before you've been diagnosed with diabetes or not? Diabetes itself can also cause uric acid to be high.

High uric acid levels (hyperuricemia) are due to overproduction or decreased excretion of uric acid. Diet is important in managing hyperuricemia and preventing gout. However, conditions like exercising, fasting or even crash diets can cause uric acid to get temporary high in blood.

As you are taking insulin, if I was your caring doctor would advise to monitor your blood sugar (bs) levels in order to see if they get decreased at point of hypoglycemia.

Next, watch your diet, increase water intake as it will help flush the excessive uric acid out of your system; avoid foods high in proteins (e.g. lean meat, poultry, fish), include more complex carb foods and low fat dairy/foods.

Furthermore, you started to take the combination pill containing hydrochlorothiazide and olmesartan. You are right, there are studies confirming this combination will cause uric acid get higher. Can discuss with your doctor about this as side effect of this combination pill in order to reconsider your treatment strategy.

Snoring problems could be related to being overweight? or possible hypoglycemia attacks you might go through at night. It is common to get hypoglycemia at night especially if the dose of insulin is high, and if you consume a low carb/low calorie meal at bedtime.

ENT problems should be ruled out by ENT specialist.

Feeling sleepy might be due to dehydration and oscillations in blood sugar levels. A complete blood count is recommended to exclude anemia; continuous monitoring of bs and electrolytes levels.

Hope it was of help.
Dr.Albana

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