How to deal with my mom's sugar and her low Hb levels?

Question

Hello doctor,

I am writing this query on behalf of my mother, who is a teacher and is 47 years old. Her demanding and stressful work environment might be affecting her health.

She has been managing multiple health conditions for some years now. She was diagnosed with diabetes four years ago, thyroid issues 7 years ago, and hypertension also seven years ago. Her body mass index (BMI) is 24.04, and she is on regular medication for all these conditions.

Recently, we found that her hemoglobin levels had dropped significantly to 7.8 g/dL. After consulting a local physician, she started taking iron supplements. However, we are still concerned, as her blood sugar levels and hemoglobin continue to fluctuate despite her being compliant with medications.

To provide a complete picture, I am attaching the latest reports, which include the following:

Blood sugar levels, along with hemoglobin.
CBC and lipid profile.
Urine culture.
Thyroid panel.

I would be grateful if you could suggest steps to manage her diabetes better and improve her hemoglobin levels. Please guide us on the types of medications, dietary changes, or lifestyle modifications that may help stabilize her condition.

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your mother, at 47, is managing several chronic conditions under a stressful work environment, and, understandably, you are concerned. As per her test results, she is anemic (having a lower than normal level of hemoglobin or red blood cells), with a hemoglobin level of 7.8 g/dL, which is quite low. I recommend a capsule of Vitcofol (a hematinic supplement), one capsule at night after food for a week, then increase to one capsule twice daily (morning and night) if she tolerates it well. Continue this for at least three months, then recheck her hemoglobin.

Her TSH (thyroid-stimulating hormone) is well-controlled, and if she has no symptoms of hypothyroidism (a condition where the thyroid gland produces too little thyroid hormone), there is no cause for concern. Her lipid profile is mostly normal, except for slightly raised triglycerides. No extra medication is needed at this level if she is already on Atorvastatin; just continue it. Lifestyle changes like a healthy diet and daily exercise will help.

Her HbA1c (hemoglobin A1c) is 7.8, which is a little high. Ideally, it should be under seven percent. She is on Glycomet GP 1, but the names of the other two medicines were unclear. Please send the correct names. If she is not already on a Gliptin, I suggest starting a tablet of Trajenta (Linagliptin) 5 mg once daily with breakfast or lunch.

Diet-wise, avoid sweets, fried, and processed foods. Include more leafy vegetables, salads, and fruits (excluding bananas, mangoes, grapes, and chikkoo). Daily walking for 45 to 60 minutes is highly recommended. Also, kindly update me on her BP (blood pressure) readings.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

I read your query and can understand your concern.

Thank you for sharing the details. I will review your mother’s current prescription and her treatment history. Since her hemoglobin levels have been unstable and her medications were recently changed, it would be helpful if you could also share her past treatment records and any recent test reports.

Once I go through them, I can guide you on whether any revisions in her medications are needed.

I hope this helps.

Please revert in case of further queries.

Thank you.