DM

Male patient of age 45 Chief Complaints Rise in blood sugar Diagnose 2 years ago Weight lose Body pain Excessive Appetite Non healing wound with itching History History of taking medication since two years from different hospital but not relief Vitals Bp:110/74 Pulse:100 Physical Examination Weak Investigations Dated 10/11/2020 Cbc: hb11 Platelates:1.80 Esr:35 Hb1ac 9.2 Bs pp:250 Fasting:340 Diagnosis Dm 2 Management He had taken Galvas met 500/50 one bd Plus Glim 2 one bd On present Rx after blood reports Tab:Glycomet gp2 850/2 one bd Tab:Galvas 50 one bd Cap:meganeuron pg one hs Blood sugar in control after 2 weeks of rx Body pain relief But He suffers loose stools since medication start What to do to maintain body fluid and control loose stool by maintaing tight glycemic control?? Is insulin therepy should advice or not???

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Review the line of treatment Both vildagliptin and pioglitazone are insulin sensitisers iwill prefer either of two As you have stepup glimiperide to 2mg Add tab dapagliflozin 10mg 1od So far loose motions are concerned known side effects of metformin hence lower the dose to 500mg Add racecordil or Rifaximin for loose motions with vit b12 and pre/probiotics Keep electrolyte balance

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Loose motions are caused due to over dise of Networking. Just reduce to 500mg. Check Thyroid profile. Dapagliflozin 10 mg OD with any dise with Glimperide w mg . Vitamin supplements

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Diabetic debility due to uncontrolled diabetes. Needs diabetic dietary supplements and antioxidant regularly. Physical activity or exercise for mental health and physical health. INSULIN ??? CONSULT WITH AN ENDOCRINOLOGIST FOR THE BETTER TREATMENT AND MANAGEMENT.

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