Important

Hi...I hope this is the right place because it is about the most important person in my life.My mother is a type 2 diabetic since the last 4 yrs, shes 45 yrs old. Shes already on zoryl-3 (glimepiride 3mg),piodart-15(pioglitazone 15mg), X-met( metformin 500 mg) besides that she is on antihypertensives( ramipril and hydroclorthiazide), allopurinol, hypolipidemic (atorvastatin). Her blood sugar is still high in the range of 240-270 mg/dl. I request you, and Sir/Maam please do take this message into consideration to inform me about the treatment options. Should insulin be started, her glycosylated hbA1c level was 8. And any other treatment options.I shall be highly thankful.

[Anita Ramsetty, MD]

Hi,
Thank you for writing in on behalf of your mother.
You are right, she does need a medication change if her sugars are still in the 200 range. Is your mother also following dietary changes that may help? If she has not met with a diabetes nutritionist, I think that may help as well.
Otherwise there are some options. Her oral doses may be adjusted upwards if not at the maximum dose(and her kidneys, heart function etc are not contraindications). A new medication called Byetta has shown good results in persons struggling to get their sugars down when already on several oral medications. It is an injectable medication taken twice daily.
Insulin would otherwise be my next suggestion, starting with one or two injections per day.
Please speak to your mothers doctor soon about having her regimen adjusted and meeting with a nutritionist if necessary. While her current range is not immediately dangerous in general, it certainly will lead to further damage if it continues for much longer.
Good luck and take care.