Dr. Raveendran S R
Sexology
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Patient's Query
Hello doctor,
The patient is a 47-year-old female. She has diabetes for eight years and has been diagnosed with hypothyroidism (about four years ago). She is on Levothyroxine (Euthyrox) for her hypothyroidism and Sita-Met for diabetes. Her problems are sleeplessness. This is her biggest problem over the last four years. She would go to bed at 10 PM and go up to 3 or 4 AM in the night without a minute of sleep. We have tried to ask medical practitioners around, but none seem to understand why. The problem is so severe that the patient has come to believe that she has been bewitched. Is her sleeplessness caused by any of the medications (see attachment)? Please advise. She also has a high blood glucose level. She tries to do sports every day, avoid any foods supposed to increase her blood glucose, and takes medication daily as indicated, but her blood glucose is always high (fasting glucose 144 mg/dL to 180 mg/dL). She has tremendous weight loss. Is anyone of the drugs (attached) contributing to her weight loss? If you need any further information, please let me know.
Hi,
Welcome to icliniq.com.
I have checked the reports (attachment removed to protect patient identity). Sleeplessness is common in diabetic patients due to neuropathic issues. Even with increased blood sugar, the patient can have sleeplessness. She is already doing her regular exercise, which is good, she needs to continue it. You can get her sedation pills like Clonazepam 0.25 mg once at night as a temporary solution so that she can get good sleep. If she gets adequate sleep, her stress will reduce, and sugar will also decrease. Regarding high blood glucose, I have checked the report the medication she is on is not enough. We need to add some medicines to bring down the blood sugar levels. She is already on Sita-Met (Sitagliptin, Metformin) think she is taking it once a day. You can add Glimepiride 1 mg twice a day and recheck the blood sugar after five days to manage further and reduce the blood sugar within a month. Regarding weight loss, yes, you are right. Decreased sleep will increase stress and cause weight loss. Sita-met contains Metformin, which causes weight loss. Also, you need to add multivitamins.
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Sexology
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