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Multiple drug therapy for type II diabetes

Q: I have been a Type II diabetic for last 7 years. The condition has deteriorated over the years but I have been able to change medicine to control it. These days my blood sugar ranges between 5 and 9 mmol/l. I am 55 years old and have a good weight and diet control. I am taking the following medicines daily: Metformin 1000 mg twice, Glyburide 10 mg twice and Pioblitazone (Actos) 30 mg once. I am looking for a brand being manufactured in India which covers combines these drugs or some other single drug to control my diabetes. I have heard that the latest theory is to give multiple drugs instead of one single to control. Is it correct. If possible give me a substitute name being sold in India.

A:You have been correctly informed that treatment with multiple drugs is preferred these days: multiple points of action are tackled, increasing efficacy, while the risk of side effects is less. All these drugs are freely available in India, eg. Metformin and Glyburide are manufactured singly and in combination by over 20 companies; Pioglitazone is also available in several formulations. There are many companies making combinations of 500 mg Metformin with 5 mg Glyburide, so that would reduce intake from 4 to 2 tabs per day. However, it would be better if you got your local doctor to prescribe a product he/she is comfortable with. If you are uncomfortable with the number of tablets you are taking, one possible way to reduce the burden, as you yourself have realized, is to increase exercise. This would give you multiple benefits and not just reduce the dose of medicines you need.

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