Essentially medicines like Metformin, Sitagliptin, Vildagliptin, Saxagliptin and Linagliptin do not produce significant hypoglycemia (low blood sugars) by itself. Metformin acts by utilizing the existing insulin in the body and gliptins by stimulating the pancreatic beta cells in phased manner.
However if this is combined with Insulin or other diabetic medications, they may result in low blood sugars. Do not change or stop medications without meeting your doctor.
High blood sugars during fasting can happen if the subject had a high blood sugar to start with or if some medicines are reduced or discontinued. If sugars are beyond 300 mg/dl, there is a risk of diabetic ketoacidosis. Further you can experience increased urination, excessive tiredness, fatigue and infections if sugars increase beyond 300 mg/dl.
Low blood sugar values below 70 mg/dl can result in dizziness, drowsiness, hunger, perspiration and convulsions. If your sugars are found to be below 70 mg/dl or above 300 mg/dl, it is preferable to break the fast and contact your health care provider. If the blood sugars are below 70 mg/dl, consume 150 ml of fruit juice or 2 glucose tablets and top it up with a snack.
Subjects with heart disease including angina and heart failure may have regular medicines to take during the day. It is preferable not to fast if it seems to interfere with normal consumption of medicines or lifestyle changes. Similar with stroke and kidney disease, a medical opinion should be strictly sought before attempting to fast. If you happen to experience any new symptoms suggestive of your disease, you need to consult your doctor as soon as possible.
These medications have high risk of hypoglycemia (low blood sugars) during prolonged fasting. You could still fast while being on these medications but your physician will help you time the doses of medications. The doses may need to be reduced or replaced by tablets that do not produce hypoglycemia.
Hypoglycemia during fasting is quite dangerous. You should be breaking the fast if you see blood sugar values below 70 mg/dl or see falling blood sugar values on monitoring.
We see parents coming to us at 16 or 17 years asking if there is any chance of increasing the child’s height. Most days, we give a clinical check and few investigations and end up saying that your child is short but nothing can be done at this stage. With the ever expanding indications of Growth Hormone, there is an option of increasing the child’s stature if used for the right child at the right time.
Check out this list and see if your child needs any help
1. Is your child one among the shortest 5 in the class? It is high time that you seriously measure his height every 6 months. 90 % he may be normal, but 10 % he may require help.
2. Is your child looking funny or awkward (we call it FLK: Funny Looking KID) : he needs a check
3. Was he born small? (less than 2.8 kg at birth). Yes he needs follow up.
4. Did he have low blood sugars at birth or prolonged jaundice?
5. Did he have both testes descended to the scrotum?
6. Does he have a cleft lip /cleft palate or depressed nose?
7. Has he stopped outgrowing his shoes or uniforms in 1-1.5 years?
8. Does he have any chronic medical illness?
Or just, to see if he is OK, a height monitoring would do. Check his height every 6 months with your doctor and find out if he is growing well?
Parental height is a determinant of the child height. You need to see if your child is in keeping with his genetic height potential. Please see our next post on that.
