Q. What are the ways to manage fatigue in a patient taking Metformin?

Answered by
Dr. Prabhakar Laxman Jathar
and medically reviewed by Dr. Divya Banu M

Hello doctor,

My father's age is 60 years and is a patient of type 2 DM. He is also a patient of hypertension with an abnormal lipid profile. His RBS is now 360 mg/dl. He is suffering from extreme fatigue although BP is controlled by anti-hypertensive drugs. In this condition, how can we manage fatigue although he is taking Metformin regularly?

Dr. Prabhakar Laxman Jathar

Diabetology General Practitioner

Hello,

Welcome to icliniq.com.

Looking at RBG given (360 mg/100 ml), he has totally uncontrolled diabetes. When this happens there is a lot of glucose lost through urine, leading to excess urination, excess thirst and excess hunger. Plus there is unexplained weight loss and severe tiredness. The remedy for that is to achieve strict glucose control.

Ideally, in a well-controlled patient, fasting glucose should be less than 100 mg, PP 150 to 170 mg and HbA1c % less than 6.8. For his age, it can be around 7 %. It is clear that his current treatment is totally inadequate. There is a need to upgrade the same. Some additional drug or drugs are required. Plus we will have to give a closer look at his present diet, weight, the extent of daily exercise. It is also necessary to check lipid profile, serum creatinine, and urea as well as microalbuminuria. Therefore, it is necessary to consult your local physician and get the necessary treatment initiated. If you are looking for online help, then please come back with all the above details for a consultation. Then I will be able to give specific guidance and even prescribe necessary medication. But please do not neglect. Such high glucose is an invitation for long term complications associated with diabetes. I hope you understand the situation.

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