Thursday, March 21, 2013

Episodes of high and low blood sugar

Today is  March 7, 2013 last week ago  another episode of increase high blood sugar happened again to my better-half.. As she described  her blood sugar increase to 145. I want to chat with her but she said she's feeling dizzy and weak. She said that the increase of high blood sugar is probably cause of his overwork because she transfered to another place where she could have some time doing eatery business and also to make herself busy while waiting for her application   To  remedy her situation she double her dose of metformin in the morning and  evening. She also had to watch for her diet to counter act the high blood sugar.

After a week we had a chat again and now she had reported that her glucose level had lowered to as much as 60 and she had no appetite for food.  I theorized that doubling the dose of metformin and not eating much affects the glucose it lowered. She also mentioned that she had to consult again the doctor because of too low blood glucose.  She also is suffering from back headache and dizziness.  So all in all she is taking 6 medicines (metamorfin, gemfibrozil, and epirisone  and 1 vitamin supplement which became very expensive almost P150/day. On discussing further her situation she mentioned that pain on her legs and backbone pain is also troubling her. 

I tried to research on her situation and recommended some changes on her medicine and food intake;

The first thing i research on were the additional  medicines that were prescribed to her and this are the results of the online research; 

Eperizone -  this was recommended for her back headache . 
     This medication is a muscle relaxant, prescribed for muscle spasms. 

How it should be taken : 

It comes as a tablet to take by mouth, with food.

Warnings and Precautions :
* Caution should be exercised in patients with history of liver impairment, any allergy, during pregnancy and breastfeeding. 

* It may cause dizziness or drowsiness, do not drive a car or operate machinery while taking this medication.

Side Effects :
Central Nervous System - Weakness, dizziness, sleeplessness, drowsiness, numbness or trembling in the extremities. 

Miscellaneous - Liver, kidney dysfunction; changes in blood counts, skin rashes, itching, gastrointestinal disturbances and urinary disorders.

Other Precautions : 
* Avoid excess dosage.

 * I wondered why a muscle relaxant drugs was recommended when her complaint was back headache. 

From: Wikipedia :

Eperisone   acts by relaxing both skeletal muscles and vascular smooth muscles, and demonstrates a variety of effects such as reduction of myotonia, improvement of circulation, and suppression of the pain reflex. The drug inhibits the vicious cycle of myotonia by decreasing pain, ischaemia, and hypertonia in skeletal muscles, thus alleviating stiffness and spasticity, and facilitating muscle movement[1]
Eperisone also improves dizziness and tinnitus associated with cerebrovascular disorders or cervical spondylosis.
Eperisone has a relatively low incidence of sedation when compared with other antispasmodic drugs; this simplifies the clinical application of the drug and makes it an attractive choice for patients

Gemfibrozil - this was recommended for her cholesterol 
Gemfibrozil is the generic name for an oral drug used to lower lipid levels. It belongs to a group of drugs known asfibrates. It is most commonly sold as the brand name, Lopid. Other brand names include Jezil and Gen-Fibro.[citation needed]

Therapeutic effects

spasmodic therapy without a reduction in alertness.
Eperisone also facilitates voluntary movement of the upper and lower extremities without reducing muscle power; it is therefore useful during the initial stage of rehabilitation and as a supporting drug during subsequent rehabilitativetherapy

Nontherapeutic effects and toxicities

Metformin (BP, pronounced /mɛtˈfɔrmɨn/met-fawr-min; originally sold as Glucophage) is an oral antidiabetic drug in the biguanide class. It is the first-line drug of choice for the treatment of type 2 diabetes, in particular, inoverweight and obese people and those with normal kidney function.[1][2][3] Its use in gestational diabetes has been limited by safety concerns. It is also used in the treatment of polycystic ovary syndrome, and has been investigated for other diseases where insulin resistance may be an important factor. Metformin works by suppressing glucose production by the liver.
Metformin is the only antidiabetic drug that has been conclusively shown to prevent the cardiovascular complications of diabetes. It helps reduce LDL cholesterol and triglyceride levels, and is not associated with weight gain. As of 2010, metformin is one of only two oral antidiabetics in the World Health Organization Model List of Essential Medicines (the other being glibenclamide).[4]
When prescribed appropriately, metformin causes few adverse effects (the most common is gastrointestinal upset) and is associated with a low risk of hypoglycemiaLactic acidosis (a buildup of lactate in the blood) can be a serious concern in overdose and when it is prescribed to people with contraindications, but otherwise, there is no significantrisk.
First synthesized and found to reduce blood sugar in the 1920s, metformin was forgotten for the next two decades as research shifted to insulin and other antidiabetic drugs. Interest in metformin was rekindled in the late 1940s after several reports that it could reduce blood sugar levels in people, and in 1957, French physician Jean Sterne published the first clinical trial of metformin as a treatment for diabetes. It was introduced to the United Kingdom in 1958, Canada in 1972, and the United States in 1995. Metformin is now believed to be the most widely prescribed antidiabetic drug in the world; in the United States alone, more than 48 million prescriptions were filled in 2010 for its generic formulations.[5][6]
Metformin is contraindicated in people with any condition that could increase the risk of lactic acidosis, including kidney disorders (creatinine levels over 150 μmol/l (1.7 mg/dL),[47] although this is an arbitrary limit), lung disease and liver disease. According to the prescribing informationheart failure, in particular, unstable or acute congestive heart failure, increases risk of lactic acidosis with metformin.[48] A 2007 systematic review of controlled trials, however, suggested metformin is the only antidiabetic drug not associated with any measurable harm in people with heart failure, and that it may reduce mortality in comparison with other antidiabetic agents.[49]
Metformin is recommended to be temporarily discontinued before any radiographic study involving iodinated contrast agents, (such as a contrast-enhanced CT scanor angiogram), as the contrast dye may temporarily impair kidney function, indirectly leading to lactic acidosis by causing retention of metformin in the body.[50][51]Metformin can be resumed after two days, assuming kidney function is normal.[50][51]

[edit]Adverse effects

The most common adverse effect of metformin is gastrointestinal upset, including diarrhea, cramps, nausea, vomiting and increased flatulence; metformin is more commonly associated with gastrointestinal side effects than most other antidiabetic drugs.[17] The most serious potential side effect of metformin use is lactic acidosis; this complication is very rare, and the vast majority of these cases seem to be related to comorbid conditions, such as impaired liver or kidney function, rather than to the metformin itself.[52]
Metformin has also been reported to decrease the blood levels of thyroid-stimulating hormone in people with hypothyroidism,[53] and, in men, testosterone.[54][55]The clinical significance of these changes is still unknown.

Discussing and informing  the researches  above with my better-half  she decided to now take the Gemfibrozil which was prescribed for the lower backhead ache. But metformin she had to take it daily and she conformed that she had to eat more and not be on diet. 

After almost a few days , her "glucose reading" increase to 110 and the pain on her head, legs, and back had gradually gone. She had a good appetite and begin to make a menu daily for her meals and snacks.