Why is the blood sugar always high despite medication?

Question

Hi doctor,

My husband has diabetes for the last 10 years. He is currently on Amaryl M1. He is living a sedentary lifestyle. For the past few months, the sugar level is always high despite the medication. The fasting blood sugar value was around 169, a week back. His other tests like triglycerides, vitamin D, vitamin B12, etc., were also affected now. His major symptoms are tiredness, unable to do heavy work, frequent half-side headache (back side) mostly when the food time is upset, high BP (140/90), loss of memory, bones seem to be shrunk a bit, short temper, and irritability. Herewith I am attaching his latest blood reports. Kindly check and guide us the treatment plan so that we can treat the root cause. His mother and brother also have diabetes.

Answer 1

Hi,

Welcome to icliniq.com.

I went through your post and investigations (attachment removed to protect patient identity). I would suggest a stepwise approach.

As the blood glucose level is not controlled on Amaryl M 1, increase the dose to Amaryl M 2 (Glimepiride and Metformin), one tablet in the morning and half a tablet in the evening. If the blood glucose is still high, then give the evening dose also as one tablet.

His vitamin D level is very low, so give him vitamin D supplements like capsule Lumia 60K (Cholecalciferol) weekly for eight weeks.

Both his triglycerides and cholesterol levels are high. So he will need treatment. I suggest tablet Rosuvas F at bedtime.

He will need regular BP medicines because high BP (blood pressure) may affect his kidney functions in the future. Presently his kidney functions are good.

His folate level is also low, so supplementing folic acid in the form of tablet Folik 5mg, on an alternate day for few weeks will improve his folate level. Consult your specialist doctor, discuss with him or her and take medicines with their consent.

Regards.

For further queries consult an internal medicine physician online

Answer 2

Hi,

Welcome back to icliniq.com.

Rosuvastatin 10 mg and Fenofibrate 120 mg. It is a combination drug. Consult your specialist doctor, discuss with him or her and take medicine with their consent.

For further queries consult an internal medicine physician online