 |
 |
A question for the diabetic experts: We have a 62 year old type 2 DM patient who is well controlled with a 500mg/d dose of metformin (in divided doses). His blood glucoses are never above 10 mmol/L and HbA1c is always <7.0%. Whilst his diabetes is well controlled, he does suffer from debilitating nocturia, typically having to get up 6-8 times during the night. This is obviously becoming a real nuisance for him. His urine glucoses (measured on the night samples) are typically 30-40 mmol/L, even when his blood glucose is only between 7-8 mmol/L. It is likely that he also suffers from renal glycosuria and a lower renal threshold for glucose reabsorption. This may confer him some benefit in terms of cardiovascular disease and other long term complications of DM, but is proving to be a real issue as he is chronically sleep deprived. The questions that have arisen is that how should such patients with dual pathologies be managed? Should taking more of the metformin dose in the evening be beneficial? Should he be advised to have a big meal late afternoon but only a small meal in the evening? Any other suggestions would be most appreciated. Regards, Rafaq Azad Clinical Biochemist. Your Hospital needs YOU! We need you to register as a Public, Patient or Staff member and help shape the future of your healthcare. Call 0800 280 2581 to register by phone or you can email [log in to unmask] and ask to be registered as a new member. For more information about our hospitals and Foundation Trust Membership please visit www.bradfordhospitals.nhs.uk This message is confidential. It may also contain privileged information. The contents of this e-mail and any attachments are intended for the named addressee only. Unless you are the named addressee or authorised to receive the e-mail of the named addressee you may not disclose, use or copy the contents of the e-mail. If you are not the person for whom the message was intended, please notify the sender immediately at Bradford Teaching Hospitals NHS Foundation Trust and delete the material from your computer. You must not use the message for any other purpose, nor disclose its contents to any person other than the intended recipient. Bradford Teaching Hospitals NHS Foundation Trust does not accept responsibility for this message and any views or opinions contained in this e-mail are solely those of the author unless expressly stated otherwise. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/