What are the possible measures to control diabetes?

Question

Hi doctor,

I am taking the following medicines for my diabetes, Amaryl 2 mg 1-0-1, Onglyza 5 mg 0-1-0, Losar A 1-0-0 and Hosit-L 0-0-1. I would like to know if these medicines can control and regulate my diabetes? If not, please advise me some tablet to bring my sugar level down and get better control of my diabetes.

Answer 1

Hi,

Welcome to icliniq.com.

I saw your blood reports (attachment removed to protect patient identity) and medications as well. We diabetologists usually give Amaryl (Glimepiride) to young people and Amaryl Plus (combination of Glimepiride and Metformin) for people with long-standing diabetes. I do not understand why you are still in Amaryl. Insulin resistance can be overcome only by Metformin. So please stop tablet Amaryl and start Amaryl-M 2 mg twice a day before food. Pioglitazone can be added. This will further reduce almost 30 points of blood sugar. Please start tablet Pioz 15 mg one tablet after food in afternoon. The tablet Pioz can be increased up to 45 mg once a day. Check fasting blood sugar and PP (postprandial) blood sugar after 15 days and increase tablet Pioz to 30 mg and then after 15 days to 45 mg once a day. Please start these drugs and continue other drugs. Even then if blood sugar is not controlled, we can start tablet Prandial (Voglibose) 0.3 mg in afternoon and night during food. That will prevent absorption of glucose from the food we eat. What measures are you taking to control your diabetes? Are you on strict diet for diabetes and doing regular exercises? As you are overweight, it will cause less effectiveness of tablets you take. So, please start strict diet (no sugar at all, stop having milk based food like coffee, tea, curd, stop taking oil based food, reduce tubers like potato and complete quitting of alcohol). Also vigorous walking for 40 minutes in early morning in empty stomach is strictly needed. Summary: Stop tablet Amaryl 2 mg. Continue other drugs. Start tablet Amaryl-M2 1-0-1 before food. Start tablet Pioz 15 mg 0-1-0 after food. Please do FBS (fasting blood sugar) and PPBS (postprandial blood sugar) after 15 days and contact me.

Answer 2

Hi,

Welcome back to icliniq.com.

We have almost saturated oral drugs. If your blood sugar does not reduce after taking following drugs for 15 days, we start with insulin. Continue Onglyza and Stop Amaryl-M2 Forte. Start tablet Diapride M3 Forte before breakfast and dinner. It is Glimepiride 3 mg plus Metformin combination. If it is not available similar brands like Euglim M3 or Amaryl-M3 Forte can be used. Take tablet Pioz 45 mg instead of 15 mg. Let us hope for a reduction in blood glucose level. But long time diabetes causes complete loss of function of pancreas whereas oral drugs will not work and we have to go for insulin. Please take above drugs and do fasting blood glucose and postprandial blood glucose and contact.