Hello, I am asking for my mother. My mother is diabetic last 4 years. We check her hba1c in april which is 7.6, and fasting around 130-135 and post meal 180-190. Medicines going on in april was - in morning vildagliptin 50 mg+ metformin 500 mg and jardiance 10 mg and in night metformin 500 mg. But in urine test detected uti. So our doctor stopped jardiance 10. And started - in morning glimepiride 1 mg+metformin 500 and in night vildagliptin 50+ metformin 1000. But after stopping jardiance the diabetes level is not coming down, fasting is around 170 and increasing and post meal is 220-230. So please suggest me what to do. How to control the diabetes level.

Dr. Prabhakar Laxman JatharEndocrinologist51yrs exp

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lybrate-user ji, thanks for the query. I have seen the details mentioned. One of the possible side effects of using drugs like sglt -2 inhibitors (like empagliflozin) is development of urinary tract infection. Because that drug excretes more of glucose in the urine, there is a possibility of developing bacterial or fungal infection in vaginal are and lower uti. Patients are asked wash the area clean after passing urine every time or glucose remains locally leading to bacterial or fungal infection. Now since she has been shifted on to glimiperide 1 mg + metformin 500 mg, it is necessary to know following: weight, height, dietary pattern, extent of daily exercise, serum creatinine and urea. On going through all those details I will be able to advise appropriately. Glimiperide is also a very effective drug. Thanks. 

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