Q: I am 56 years old male weighing 110 kg. I am suffering from high blood pressure and taking Tenormin 100, Losartan 100, Amlodepine (10 mg) and HCTZ 25. I have been taking the medicines for quite some time and now my blood pressure is under control. A year back, I was diagnosed with impaired glucose tolerance (IGT) and the doctor asked to undergo tests. The prescribed tests showed my fasting blood glucose as 120 mg/dl, HbA1c 6.6%, lipid profile, thyroid and creatinine normal. The doctor advised to follow a strict diet and do brisk walking. After nine months of strict diet and regular walk, my fasting blood sugar was 115 mg/dl and HbA1c 7.09%. Recently, I underwent a test where my fasting blood sugar was 103 mg/dl, post lunch glucose was 86 mg/dl and HbA1c was 7.09%. The doctor has prescribed Metformin (500 mg). I am so frustrated that despite my vigorous walk and diet control, there is not much change in my blood glucose level. My mother was diabetic and sister is diabetic. How can my blood glucose be controlled?

A:You have IGT and hypertension. Your physician is right in advising you to take Metformin 500 mg twice daily. Metformin will help you not only in controlling your blood glucose but also in reducing weight to a certain extent. All obese subjects do not respond to diet and exercise and need medications or surgery. I would suggest you to take Sibutramine under physician supervision to start with and then please get back to us after 3 months for further advice. Please note that you are overweight by 20 kg and if weight is reduced both IGT and hypertension will improve or might disappear even.