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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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85 Years Old, High BP And Cholesterol. Had Lost Memory For Coma. Taking Volix, Glynase, Fenacor. Correct Medication?

Hi, My father is 85 yrs of age (height 5 8 , Weight 59 Kg) has been a diabetic for 30 - 35 yrs, and went into Hypoglycemic coma 20 yrs ago. Due to the coma, he lost some memory . The current problem is that his BS fasting is around 85-90 mg/dl and PP is varying between 142 to 200. His Cholestrol has been slightly high and also his BP is around 150/70 range. He is on the following medication: Volix 0.2 mg twice a day, Glynase MF twice a day, Fenacor 67 mg once a day, Tazloc 40 mg once a day with a multi vitamin tab. Since last month, he had swelling in his right leg ankle with slightly reddish blue color and an xray and doppler was done and no DVT was found but has inconsistent blood flow in the arteries. A doctor suggested the possibility of arteosclerosis and prescribed lisinopril 10 mg. Can this be taken along with Tazloc 40 mg, as i understand that this is also used for BP?
Mon, 18 Feb 2013
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General & Family Physician 's  Response
Hello,
Because postprandial glucose elevations tend to be higher in elderly diabetic patients, intensive efforts to reduce blood sugar levels  to normal or near-normal levels may greatly increase the risk of hypoglycemic events. 
following are the factors which may cause problems...

1...Poor or erratic nutritional intake
2...,Changes in mental status that impair the perception or response to hypoglycemia
3...Increased polypharmacy and noncompliance with medications
4...Dependence or isolation that limits receipt of early treatment for hypoglycemia
5...Impaired renal or hepatic metabolism

Hiwever as far as aggressive  control of blood pressure is concerned ,beneficial effects on microvascular complications equal to or greater than that of tight glycemic control.Further, the beneficial effects of improved blood pressure control extended to cardiovascular and stroke events, which occur with much greater frequency (and with greater morbidity and mortality) than microvascular complications in elderly diabetic patients. 
So, aggressive control of blood pressure should be a high priority in the management of older hypertensive diabetic patients.

So that is the reason your doctor has added LISINOPRIL to TAZOLAC to achieve a better blood pressure control.

So the levels of FASTING around 120 and PP between 180 to 200 are acceptable.
Thanks
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85 Years Old, High BP And Cholesterol. Had Lost Memory For Coma. Taking Volix, Glynase, Fenacor. Correct Medication?

Hello, Because postprandial glucose elevations tend to be higher in elderly diabetic patients, intensive efforts to reduce blood sugar levels  to normal or near-normal levels may greatly increase the risk of hypoglycemic events.  following are the factors which may cause problems... 1...Poor or erratic nutritional intake 2...,Changes in mental status that impair the perception or response to hypoglycemia 3...Increased polypharmacy and noncompliance with medications 4...Dependence or isolation that limits receipt of early treatment for hypoglycemia 5...Impaired renal or hepatic metabolism Hiwever as far as aggressive  control of blood pressure is concerned ,beneficial effects on microvascular complications equal to or greater than that of tight glycemic control.Further, the beneficial effects of improved blood pressure control extended to cardiovascular and stroke events, which occur with much greater frequency (and with greater morbidity and mortality) than microvascular complications in elderly diabetic patients.  So, aggressive control of blood pressure should be a high priority in the management of older hypertensive diabetic patients. So that is the reason your doctor has added LISINOPRIL to TAZOLAC to achieve a better blood pressure control. So the levels of FASTING around 120 and PP between 180 to 200 are acceptable. Thanks