Diabetic patient with fasting blood sugar decreased than normal .......
Pt aged 50 years taking metformin, voglibose and glimepride combination since 1and half year with which der was no change in bld sugar levels thereforen pioglitazone was added to the regimen since 3months but his bld sugar level has not changed, can you give any suggestions or explaination for why only der is decrease in fasting bld sugar and not post prandial
glimepiride should be omitted. And follow the patient.
I think it's because of fasting duration at night. When the PPBS has been checked?
He uses glimepride and metformin twice daily before food and pioglitazone morning after breakfast
What is the patient eating? Reduce the meal carbs by 15 grams, unless they are consuming low fat versions of foods. Have them switch back to regular versions. Low fat foods often are high in carbs. Also get rid of the glimepride.
