I am diabetic for the last 34 years and on medication. I am 73 years old now. Taking following medication: 1) glycomet gp 2 forte. 2 tabs/ day 2) jalra 50 mg .2 tabs / day 3) volix 0.3 mg .2 tabs / day recently I consulted a doctor and he advised me to stop jalra 50 mg and instead take under .one per day my fasting blood sugar remains in between 135-160 and pp 250/260. But the hba1c remains 8.0-8.2 can you please advise as to what I should do to control hba1c.

Dr. Prabhakar Laxman JatharEndocrinologist49yrs exp

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Hello, thanks for the query. I have seen the details given. You are already on 4 mg of glimiperide, with 2000 mg of metformin, 60 mg of vildagliptin, & 0.6 mg of voglibose. In spite of these drugs glucose levels are not in good control. One of the reasons for this is the beta cells capacity to secrete insulin even on regular stimulation progressively goes down. So the glucose control is not adequate. So there is a need to look at your dietary intake, daily physical activity, weight and height, plus serum creatinine and urea. There is no information given on these aspects. Invariably in this situation patient has to be given a small dose of insulin along with oral drugs. Plus we will have to look your egfr to see how the kidney function is. So please come back with all the necessary details, preferably in a private conversation, then I iwll be able to give specific instructions and even prescribe drugs if needed. Thanks. 

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