My mother is having type 2 diabetes from past 7 years. From last 1 years her fasting glucose is always high (more than 200). She is taking glimepiride 4 mg +metformin 1000 mg BD & vildagliptin OD for last 20 days but still today her Fasting was 240 PP was 262. Now doctor has prescribed insulin 30/70 - 15 units in night. Also glimepiride 4 mg in morning along with Sitagliptin+metformin 500 mg. Also metformin 1000 mg in night. Why her fasting glucose is so much high while PP usually under 200 mg/dl? Is the medication ok?

Dr. Prabhakar Laxman JatharEndocrinologist46yrs exp

92% (11091 ratings)

Ask Free Question

Mr. lybrate-user, Thanks for the query. From the given information it is clear that she is already on very high dose of Glimepiride 4 X 2 tabs. Usually there is no benefit in giving such a high dose of glimepiride. Plus she is on Vildagliptin also. It is essential to bring blood glucose level to: FBG <100 mg & PP 150 to 170 mg & HbA1c%<6.8, in order to prevent long term complications of diabetes. Therefore, it is necessary to use Insulin injection like Glargine once a day along with the oral drugs (with a reduction in Glimepiride dose). If you are keen on getting a better control, please come in a private conversation, with following details: current FBG, PP levels, HbA1c%, her dietary pattern and extent of daily exercise. Then I will be able to guide. Please understand it is absolutely essential to reduce the glucose levels. If not with me please do consult your local doctor and take necessary steps. Thanks. 

2 person found this helpful