high glucose

[mohan739]

I have blood pressure of 140/100 last month and with salt restriction it has come down to 120/88 ,now i have found out that i have fasting blood glucose 174 post food is 300 , fasting lipid pofile .cholestrerol 304 hdl 36 triglyceride 734..i also have a fat around my waist ..so i was thinking i have metatbolic syndrome or  do i have anything else ????.Is it possible for me  to exercise and change my diet and reduce my glucose nad cholesterol at this stage without medication.

[Anita Ramsetty, MD]

HI,
YOu can convert form mg/dl to mMol/L by multiplying by 18 .
Hope this helps.

[Anita Ramsetty, MD]

HI,

It is possible for you to improve all of those numbers with a good diet and exercise program. However at this time I think you need to be started on medication as well because those numbers are quite high. When Triglycerides are above 500 you run the risk of an inflamed pancreas which can be quite dangerous and life threatening. You most definitely have insulin resistance and the metabolic syndrome. From those numbers you already have diabetes.  The medication does not need to be permanent necessarily--if you lose weight etc and the numbers come down to normal you may need minimal medication. However at this time you should be on some medication for your safety. Please speak to your doctor as soon as possible regarding this.

Take care.

[kyalami]

Hi.  Sorry, I didn't realise until it was too late that I could have asked you directly for an answer instead of using the 'Comments' feature.  Feel free to ignore my question if you wish.

[kyalami]

I am a type 2 diabetic and follow closely all comments related to the subject.  However, I see figures being quoted which I don't understand.  In her post sai259, to which you responded, mentions figures of 150 and 200.  My glucometer is in mmol/L and the last reading was in the normal range and was 7.8.  Also, the cholesterol readings I get from my doctor are all below 10.  What scale is being used in sai259's case and is there a converter program I could use?  

[Anita Ramsetty, MD]

HI,
Given how high your cholesterol was in the past,I doubt that you can do without medications altogether. I think it is reasonable to discuss a lower dose with your doctor and between you both decide the course to take.  Your lipid panel right now is excellent, and this is while on medication as well as after dietary changes, so I am sure the medication did play a role in its return to normal.

Your blood sugars are still not normal and now on the borderline: you have impaired fasting glucose and impaired glucose tolerance based on those numbers you  communicated. There is no definite recommendation at this time regarding medication treatment for these levels of abnormal glucose handling, but in many cases where other issues are present(such as high cholesterol, being overweight, family history of diabetes and high blood pressure) some doctors will start a low dose of Metformin. That is something you may consider discussing with your doctor as well.

Take care and keep up the excellent work.

[sai259]

Good Morning Doctor Anita Ramsetty,

Thank you so much for replying to my concern.

I have repeated my cholesterol test (2 weeks on medication,diet and exercise) today morning method of testing finger *****. Readings are as below:
Total Cholesterol  : 117 mg/dl; LDL : 88 mg/dl ; HDL : 16 mg/dl                Triglycerides : 66 mg/dl ; TC/DL Ratio : 7.5
Repeat test also showed similar results.
Current medication : Tricor 145 mg and Simvastine 80 mg/day
The current fasting blood Glucose is at 120 and post food is at 180 (method of testing finger *****)
Can I ask my doctor to reduce the dosage of my medication or skip them altogether? does my blood glucose readings mandate any diabetic medication?

Thank You,

[Anita Ramsetty, MD]

Hi,
Good work starting on exercise routine and changing your diet--that is a necessity.

The starting dose of Zocor is usually lower than the maximum dose, especially when combined with another agent. Your doctor may have felt that your lipids were so high more aggressive action needed to be taken. The risks of side effects are higher with the maximum doses of these medications, especially when used together, so speak to your doctor about perhaps starting at a mid-level dose instead.

It is not always necessary to check the CPK after starting these medications. Often doctors check it only if you have symptoms such as muscle pains or cramps.

Your serum creatinine is not necessary for these medications but it always helpful to know.

You should also speak to your doctor again about diabetes. Fasting value of 150mg/dl is consistent with diabetes.

Take care.

[sai259]

Hi this is mohan739 a few updates: Started using the medication since a week, (ht:5'8" wt:180 lbs, waist 34") current readings: bp:(112/75), glucose pre 150 post below 200, changed the diet completely since 9 daysand started exercising,, it would be great if you could answer my above questions, is the dosage okay? and about AST,SGOT fasting lipid panel but he has not asked for CPK or my blood picture, Do I need to have these tests? or skip them? also do I need my sr.creatinine?

Please advise me.
Thank You

[mohan739]

Hi,

>>"I have blood pressure of 140/100 last month and with salt restriction it has come down to 120/88 ,now i have found out that i have fasting blood glucose 174 post food is 300 , my last year glucose results were post food 80, fasting lipid pofile .cholestrerol 304 hdl 36 triglyceride 734..i also have a fat around my waist ..so i was thinking i have metatbolic syndrome or  do i have anything else ????.Is it possible for me  to exercise and change my diet and reduce my glucose and cholesterol at this stage without medication.">>

Thanks For your valuable advice, I (Age 30 yrs) shown myself to doctor and he diagnosed as Hyperlipidemia-primary, and prescribed
1.)Tricor 145mg/day   ..2.) Zorcor  80mg/day
I felt that the dosage of zorcor 80mg was a bit high, I was expecting to start on a small dose and then increase if necessary, I would like to know if the dosage is appropriate and also for my followup (after 6 weeks) he instructed AST, SGOT fasting lipid panel but he has not asked for CPK or my blood picture but the instructions given to me along with the medication clearly states that these tests(cpk,blood) need to be done so are these tests essential or can i skip them  ?.... Do i need to have my sr.creatinine tested ?

Thank You