Concluded Case

What is treatment of DM

m/52 recent diagnosed with diabetes n HTN had symptoms of headache and dizziness joint pain . patient is on medication for last 1 week i.e METFORMIN500MG SR BD TELMA 40 OD tablet calcium with D3 od. HTN now controlled but FBS IS STILL 260 n PP 2HRS IS 361 . patient headache subsdie but still have dizziness. H/o fast and on off eating of fruits for 10 days during some pooja/worship. is it required to add sulfonylureas with metformin or should I wait.?

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HTN T2 DM HEADACHE DIZZINESS JOINT PAIN -------------------------------------------------- 1 CHOICE OF ORAL HYPOGLYCEMIC DRUGS DEPENDS ON DYRATION OF DIABETES DOSE OF METFORMIN CAN BE INCREASED TO 1000 MG BD PC AT PRESENT ADDITION OF ANOTHER DRUG VOGLIBOSE 0. 2 / 0.3 ONCE OR TWICE WITH FIRST BITE SIDE EFFECTS = HYPOGLYCEMIA LOOSE STOOL METFORMIN IN ADDITION CAN HAVE NAUSEA + VOMITING ---------------------------------------------------- PIOGLITAZONE IF TWO DRUGS CAN NOT CONTROL BLOOD SUGAR ---------------------------------------------------- IF DM IS OF LONG DURATION SECRETAGAGUES WILL HAVE NO EFFECT VILDAGLIPTIN / LINAGLIPTIN SITAGLIPTIN MAY BE CHOSEN ---------------------------------------' EMPAGLIFLOZIN 10 - 25 MG MAY BE GIVEN IN UNCONTTOLLED DM ----------------------------------------------------DIETING EXERCISE ARE IMPORTANT IN DM CONTROL -------------------------------------------------- FASTING SHOULD BE DISCOURAGED
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HTN T2 DM HEADACHE DIZZINESS JOINT PAIN -------------------------------------------------- 1 CHOICE OF ORAL HYPOGLYCEMIC DRUGS DEPENDS ON DYRATION OF DIABETES DOSE OF METFORMIN CAN BE INCREASED TO 1000 MG BD PC AT PRESENT ADDITION OF ANOTHER DRUG VOGLIBOSE 0. 2 / 0.3 ONCE OR TWICE WITH FIRST BITE SIDE EFFECTS = HYPOGLYCEMIA LOOSE STOOL METFORMIN IN ADDITION CAN HAVE NAUSEA + VOMITING ---------------------------------------------------- PIOGLITAZONE IF TWO DRUGS CAN NOT CONTROL BLOOD SUGAR ---------------------------------------------------- IF DM IS OF LONG DURATION SECRETAGAGUES WILL HAVE NO EFFECT VILDAGLIPTIN / LINAGLIPTIN SITAGLIPTIN MAY BE CHOSEN ---------------------------------------' EMPAGLIFLOZIN 10 - 25 MG MAY BE GIVEN IN UNCONTTOLLED DM ----------------------------------------------------DIETING EXERCISE ARE IMPORTANT IN DM CONTROL -------------------------------------------------- FASTING SHOULD BE DISCOURAGED
Need good diet control Tab.diamicron xr mex 500 mg daily 2 times a day Tab.glimipride 2mg daily one after lunch Tab.healthy vit plus daily once Regular exercise
Dear dr Balaram Reddy ?why double sulfonilurea
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Uncontrolled diabetes Definitely need to add sulfonilurea gliclazide 40mg or glimiperide 1mg with metformin Keep monitoring
Thank you doctor
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Please start GLIMY M2 ONE AT 8 AM AND TENLIMAC M 20/500 AT 8 PM REST CONTINUE
Reassessment is required not responding to drugs might require inj insulin
Uncontrolled DM Well said @Shivraj Agarwal sir
Thanx dr
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Pl put him on empa+ linagliptin 5+ 25 along with metformin
Yess need of sulphonylurea like Glimipride 2 mg
Yes, it is required to add sulphonylurea group
Added definitely
Thank you doctor
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