Dr. M V Srinivas (Emergency Medicine) needs a second opinion on this medical case.
54 Female weighing 90kg known HTN came with a c/o intermittent fever with chills on and off.
Test for Malaria under microscope negative. Salmonella negative.
H/o Burning micturition 3weeks back and having vaginitis as i understood by her words.
Complete urine analysis - lot many pus cells.
Urine sent for culture.
Immediately she was started on Glevo 500 daily once for 1 week and Niftas 100 mg twice daily for 7days
blood investigations further revealed
FBG 260 PPBG 330
S URIC ACID - 6.3
BLOOD UREA AND S CREATININE WITHIN NORMAL LIMITS
FASTING LIPID PROFILE - TGL 360 Total Cholesterol - 214 VLDL 72 HbA1c 12.4
Thyroid profile and urine for ketones - Waiting
As this is freshly diagnosed dm case whats the next step of management?
Apart from lipid lowering agents Shall we start with metformin and sitagliptin/Glimepiride or
Insulin have to be started immediately with the above drugs combination ?