Concluded Case

Recurrent Hypoglycaemia

52 F diabetic on OHA presented in hypoglycaemia Blood sugar 45mg% which was corrected in casualty Patients daughter insisted that patient be shown to a senior doctor because of recurrent hypoglycaemia CAREFUL HISTORY TAKING revealed that patent started GLICLAZIDE 80 mg once daily subsequently once to Twice daily BUT AGAIN WHEN normoglycemia was not achieved patient increased to 8 hourly that is b4 bfast, b4 lunch & b4 dinner @@

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Concluded answer
Lesson to be learnt. WE SHOULD EDUCATE THE PATIENT ABOUT THE DRUGS HE USES eg in the case patient was on gliclazide duration of action 12 hrs so he has to b taught that HE. Has to use it in BD
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Sir sulphonylurea are known potent hypoglycemic drugs hence doses suggested 80mg is quite high Recurrent hypoglycemia is more dangerous situation than hyperglycemia Pt needs to adjust doses and diet and to be monitored on time line I feel this pt should be freshly investigated and look for hba1c Better to keep on plain metformin and adjust accordingly It seems reactivation of betalangerhens cells so his diabetic status is to be reconsidered even he may be a c/o reversal of diabetes
Thanx dr Ramesh Kumar Singh
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Gliclazide is a long acting Sulfonuria so switch over on Tab GLIMY-M2 at 8 am and Tab Glycomet SR 500 at 8 pm and control diet and ask for exercise
Thank you doctor
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Gliclazide is a long acting sulfonylurea. There will be persistent hypoglycemia if multiple doses are given . Life style modifications like diabetic diet, exercise, and weight loss are to be stressed. Adding metformin S R and if needed ,a gliptin can control DM. Gliclazide 80 mg, should be kept OD
Thank you doctor
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Lesson to be learnt. WE SHOULD EDUCATE THE PATIENT ABOUT THE DRUGS HE USES eg in the case patient was on gliclazide duration of action 12 hrs so he has to b taught that HE. Has to use it in BD

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