Dr. Zulfiqar Ahmed
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My father was recently diagnosed with diabetes type 2. His doctor has him on tablet Trulicity (Dulaglutide) 1.5 mg once a week and tablet Metformin 500 mg (twice a day). He has been reducing his sugar intake, walking a lot more, and has lost a good amount of weight. However, he ate quite a bit of pasta this past week and gained 2 lbs. The previous fasting blood sugar level was 172 mg/dL, which is now 222 mg/dL. Previously, his A1C levels were 8.5 %, now it is 10.5 % (back to the same amount it was six months ago before starting Trulicity). He is very concerned and anxious about this news, and he does not see his doctor until the end of next week. What might be the reason for the increase? Is it possible that it is a medication issue? I appreciate any help you can provide.
Hi,
Welcome to icliniq.com.
It looks like your sugars are increasing along with the weight. The reason may be due to the increased consumption of pasta, a source of carbohydrates. Diabetes is a progressive disease, and with time it worsens. That’s why there may be a need to increase and optimize the medications. How long has your dad been using Trulicity? Trulicity is usually started at 0.75 mg weekly, and after four to six weeks, it is increased to 1.5 mg. After that, if his sugars go up, you can increase it to 3 mg once weekly. Glucophage (Metformin) can be increased to 2 gm as well.
Treatment plan
Patient's Query
Hi doctor,
Thank you for the timely response. I have conveyed this information to my father, and he will be discussing his medication doses with his doctor when he sees her next week. Again, I appreciate your help. Knowing that a medication dose increase can help has eased his mind.
Hi,
Welcome back to icliniq.com.
You are welcome. Let me know if there is anything else I can help you with. Thank you.
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Diabetology
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