What Do My Sugar Levels Indicate?

Posted on Sat, 6 Dec 2014

Question: Dr I am diabetic since 20 years . Until yesterday day I used Janumet 50/500 two times a day. Now my sugar levels are like this Fasting Plasma Glucose 243 mg Post Lunch Plasma glucose is 320. HBA1C 9.6. My Dr advised Janumet 50/1000 ( 2 times ) Volix 0.3 MG in the Morning, after Dinner Ecosprin 75 + Rosuvas 10 MG + Pregabalin M 75 MG. I want XXXXXXX Endocrinologist advise

Answered by Dr. Anshul Varshney (37 minutes later)

Brief Answer:
You need drug modification

Detailed Answer:
Welcome To HCM. I am Dr Anshul Varshney.
I understand your concern.
What I have got from your query is that your current blood sugar levels that you have mentioned are "On Medications". If I have understood right, you need a strong dose modification.
Before I can advise you that,I need a few more details:
1. Since when you are on Janumet?
2. What were your initial blood sugar levels when you were diagnosed to have Diabetes?
3. How about your Kidney functions and cardiac status?
4. Have you been ever on any other medication like Glimiperide?
5. Have you ever been advised for insulin?
Revert with these details for a better help.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (15 minutes later)

Since 6 months I am using Janumet. Initial stage I had 150 and 170 sugar levels. Kidney and cardiac functioning well. Dr advise some time I used the medicines Prelin 75 + Stanlip. 4 days back one Dr advised insulin. Advise me correctly

Answered by Dr. Anshul Varshney (13 minutes later)

Brief Answer:
You should ideally take insult.

Detailed Answer:
Dear Friend.
Since you are already on very high dose of oral anti diabetic agents , you should start on insulin now.
This high blood sugar is unlikely to respond with safe dosage of oral Diabetes drugs.
See, its important to keep blood sugar under control to prevent complications of diabetes.
My sincere advise for you is to start on insulin as advised by your doctor. Insulin use initially looks troublesome but it is the best modality of blood sugar control.
I would advise in such scenario to start with a combination insulin containing long acting and short acting preparation that is commonly known as Human Mixtard 30:70.
There is no point in waiting and giving your body more exposure to high blood sugar.
In most cases, person gets controlled just on twice daily schedule of this variant of insulin. And if not, oral drugs are simultaneously added.
Anyhow , we have to control the blood sugars.
Apart from this follow strictly the diabetic diet and also exercise regularly.
I hope this information helps.
If you have any further query please ask me.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (26 minutes later)

Dr I am very much fear of taking Insulin. Just 3 days back I icreased Janumet dosage from 500 to 1000. can I wait for one month. If the same continues I will go to insulin. Advise me ? thanks.

Answered by Dr. Anshul Varshney (5 minutes later)

Brief Answer:
Addition of Glimiperide is required.

Detailed Answer:
Dear Friend.
I understand your concern.
But its just a worry of a few days. After that it comes into your routine practice like you brush, eat!!
However, if you still want to try further on oral drugs, increasing the dose of Metformin alone won't help much.
Discuss with your doctor about adding Glimiperide to your regimen. This might help you.
Get prescription from your doctor, try for 15 days, get back to me after your fresh blood sugar levels.
We will take a final decision what you should be doing.
You have last 15 days to try your luck my friend!!
I wish your luck works!!
If you have any further query please ask me, else you may close the discussion and rate it.
Stay Healthy.

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar