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Suggest Treatment For Uncontrollable Sugar Levels

Posted on Thu, 18 Sep 2014

Question: I checked my fasting it reads as 210 . I am right now taking metformin 500 mg in the morning only, Earlier I use to take metformin 500 with glimipride 1 mg . I have been hearing jalra 50 is very effective Can I take jalra 50 with metformin 500 in the morning and just metformin in the night I am poor eater and have moderate exercise

Answered by Dr. Nishad BN (1 hour later)

Brief Answer:
Treatment for Diabetes.

Detailed Answer:
Hi
Thank you for writing to us.
Your blood sugar level is not controlled now. You should atleast increase the metformin dose to 1000grams per day which can be taken in 2 times or 1 time as extended release tablets.Glimepride is a sulphonylurea which is not recommended by most of physicians now.
Jalra is vildagliptin which is a dpp4 inhibitor preferred over glimepride. Most people are well tolerated and better controlled their blood sugar levels by this drug. So you discuss with your nearest physician or treating doctor for prescription of it. Combination of metformin and jalra therapy will make you better.
Hope this may help you.
Let me know about your follow up or further queries. I am happy to help you.
Thanks

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Nishad BN (24 minutes later)

Thanks Dr XXXXXXX for your advice.

Local physicians is not aware of vildagliptin. I live in a rural village in Tamilnadu and hence I posted the query through web. I run a XXXXXXX kiln and I am always on my feet for 8 to 10 hours a day. I get completely drained by 8.00 pm and I am unable to be awake beyond 9.00 pm . Most of the days I skip my dinner and hence not taking tablet in the night before sleep. my experience with glimiperide that I get hungry quite often and requires eating frequently if I take glimiperide.'

Can you please suggest me now . As you hv suggested I will increase the metformin to 1000 mg from today. I want to completey avoid the medicines. Will it be really possible

thanks and regards XXXXXXX

Answered by Dr. Nishad BN (37 minutes later)

Brief Answer:
therapy for diabetes with vildagliptin

Detailed Answer:
Hi
thank you for your follow up query.
Skipping whole dinner is not a good idea. You can have it early like before 7pm. Vildagliptin has low potential for hypoglycaemia while considering with glimepride.
If I were treating doctor I would increase dosage of metformin initially for that to a duration of 1 or 2 weeks.Those who have already started sulfonylurea there is comparatively less chance of achieving glyceimic control alone with metformin. So after high dose metformin therapy if you are not achieving the normal blood sugar levels then it is better to start vildagliptin.
I also suggest you get HbA1c blood test to know about your three months blood sugar levels.
Hence I would suggest you visit your treating doctor and discuss all bout this with your treating doctor before increase dosage of metformin. Meantime continue same treatment.
And also discuss about vildagliptin and another dpp4 inhibitors like sitagliptin (januvia) with doctor. Thit is the 1st generation one. If your creatine and urea is normal level which means your kidney function is good then metformin therapy won't be causing any harm.

Hope this may help you.
Let me know if you have any follow up or further queries.
Thanks

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Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju