Sir. I am diabetic and 37 years old and overweight too. Earlier I was taking glycomet 1000 and vildagliptin 50 twice a day after food and udapa 10 mg once a day .invokana 100 1 hr before breakfast. But recent my doctor prescribed tenepride instead of vildagliptin and after having that for 2 weeks, I started gaming weight. used to have a lot of stress earlier due to work pressure and that resulted in weight gain (dr told. I used to crave for junk food like bun etc and also would snack on oily food every day. So as per the instruction of my endocrinologist I consulted a psychiatrist and he prescribed desevren tablet (earlier paxidep. Now changed) and risperidone. 50.actually Dr. told me to take motyvyst 300 and took it for 20 days. But I couldn't afford it. Also.weight wasn't reduced even after having that. But 5 years ago when I started having jardiance 25 .weight started reducing. My hbai1c is 8.4 .ppbs 210 and fasting (varies. All other tests r normal. Kidney. Liver etc. Is medi slim good option for wright reduction? I am 6 foot tall and 97 kg. But I don't look that fat. Is orlistat a good option? Reeshape or lipophage 60 mg for first 2 weeks and 120 mg for the remaining 2 weeks?

Dr. Prabhakar Laxman JatharEndocrinologist52yrs exp

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Hello, thanks for the query. I have gone through the details given. However, I did not see any mention of important info like fasting & pp glucose and current hba1c%, dietary details, extent of daily physical exercise and bp as well as lipid profile. Another aspect is that drugs like udupa (dapagliflozin), invokana (canagliflozin) tablet motyvyst 300 (canagliflozin 300 mg) & jardiance (empagliflozin) all these are similar drugs, known as sglt - 2 inhibitors, which act by excreting extra glucose through urine and also do help in some weight reduction. Usually only one of these is given not two together. (like invokana & udupa). I am a bit surprised to see such a prescription. Another important aspect is your bmi (body mass index) which is 29 kg/sq meter (normal < 23 kg/sq meter). Your ideal body weight has to be 77 kg. Which means there is an excess of over 20 kg. Looking all these aspects there is a need to look at your over all treatment which includes your diet, extent of exercise, hba1c%, drugs to control glucose and over all lifestyle. If you have any questions please do come back. I am sure you are aware that in a well controlled diabetes patient fb should be < 100 mg, pp 150 to 160 mg & hba1c% < 6.5%. Achieving such strict control ensures either the prevention of or postponement of long term consequences of diabetes. Thanks.  

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