My aunt is a known case of diabetes since 20 yrs. And she was prescribed with jardiance 25 mg. And she already suffering from urinary inconvenience and itching in the pelvic area. Where as jardiance side effects include these two. How come it is possible to prescribe a medicine with out any intervention with the patient. Already patient is in insulin n metformin. Prescribing jardiance may cause hypoglycemia. What is the justification for this prescription?

Dr. Ganesan, P.R.Diabetologist32yrs exp

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Yes you right in your comments on Jardiance, if the patient is suffering from recurrent UTI, withdraw the drug for time being and treat with topical as well as systemic antifungal, control of blood sugars by adjusting dosage of insulin, mostly in this pt low sugar may be due to insulin over dosage or poor intake and delayed intake, not because of Jardiance. After complete recovery from fungal infection restart Jardiance with minimal dose of 10 mg, to minimise the requirement of total dose of insulin and added benefits of Jardiance. Even if you get recurrent UTI, then stop and can switch over other medications. Finally I like to mention timely recommended food and regular physical activity and avoiding sugary, fatty items, along with regular meditation or yoga which may help to reduce stress direct or indirect one which is also contributing for optimal blood sugar levels. All the best take care of the fundamentals.  

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