Momma Day's Girl

Q:

I can't seem to get my glucose under control. I am taking 850 mg of metformin twice daily, 500 mg of metformin once daily 6mg glimepiride once daily and once daily lisinop-HCTZ 20-12.5 tab and one 40mg pravastinb sodium daily. I have talked to my doctor and she recommended that I keep taking the meds as prescribed and make sure I eat the same time every day, not more than four hours a day. I am retired, so that is easy, but no results. My blood sugar stays from 140-228 — too high!

Dr. David Erani

A:

Metformin and glimepiride are diabetes medicines. They will help control your blood glucose. Lisinopril and HCTZ (hydrochlorothiazide) are blood pressure medicines. Lisinopril is an ACE-inhibitor. ACE-inhibitors can protect your kidneys from diabetic kidney disease. Pravastatin is a “statin.”a drug which lowers cholesterol. There is strong evidence that lowering LDL-cholesterol with statins reduces cardiovascular risk, especially in people with diabetes. There is evidence that statins can raise blood glucose levels, but this modest negative effect does not outweigh the cardiovascular benefit. The blood glucose range you report may be higher than ideal, but depending on when you are checking, it may not be so bad. Blood glucose levels in this range two hours after meals are not far from where they should be, especially if most are in the 140 – 180 mg/dL range. In order to assess your glycemic control, we should focus on your A1C. Why is it important to control your blood glucose? By doing so, you can prevent symptoms and decrease the risk of the complications of diabetes. As far as we know, the A1C is the best indication of your risk of complications of diabetes. If your A1C is at goal (your A1C goal depends on several factors including your overall health) and you are not having problems with hypoglycemia, your diabetes is well-controlled. If your A1C is higher than it should be, there is a lot that can be done. Eating in a healthy way can do a lot to keep blood glucose levels under control. Regular physical activity is also beneficial. A diabetes educator can help you with these. You should talk to your doctor before starting an exercise program. If you are already doing these things and your A1C is still too high, there are other medicines which can be taken along with metformin and glimepiride to help lower your blood glucose further.

May 20, 2013 at 2:31 pm