Sir my mother has been suffering from long standing diabetes and hypertension. Her lipid is normal. Hba1c is 6.1.fbs 104 ppbs 134. Serum creatinine 0.76.spot urine microalbumin 4.9 and creatinine urine 22.54.microalbumin/creatinine ratio 21.74.she has been on gemer 1 one tablet daily for fifteen years, telista 80. And stator 10 my for 10 years. Please suggest whether she will continue gemer 1 and other medicine as she faces hypos or it is good to tapper Glimepiride or to other medicine. Is it good for her age. She is frail and weak.

Dr. Prabhakar Laxman JatharEndocrinologist52yrs exp

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Hello, thanks for the query. I have seen the details mentioned. Please clarify what is the patient's age? Because in the information male, 72 years, ht 5.5 ft & 54 kg etc is mentioned. Because generally in old age (above 70 years) glimiperide tends to cause hypoglycemic episodes when there is strict glucose control. The reason for that is its action lasts for almost 16 hours. So if such instances are noticed as in her case, it is better to shift to either gliclazide or to a dpp iv inhibitor with metformin like tenelegliptin, sitagliptin or vildagliptin. So you might talk to her consultant and ask if he can suggest the necessary change. Her glucose control seems to be quite good, that is the reason for such episodes. In this communication we are supposed to give only general guidelines, no drugs can be prescribed. If you want prescription then please come in a private conversation (paid consultation) so that I can do the necessary action. Otherwise please talk to your local physician and get necessary change done. Thanks.  

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