Dear doctor, I am a 75 year old male. I had type 2 diabetes since six years. Since then, I am taking Glycomet 500 mg twice a day. My fasting and PP levels (lab results) are as attached. Kindly go through my case and enlighten me on the following:  How is my control of diabetes? What are latest blood glucose levels for diabetics prescribed by ADA for diabetics? Can I reduce my Glycomet dosage to half, that is, 250 mg twice a day and check my glucose levels at home to know whether there is an improvement? I have yet to go for three months glucose level test.  I am also associated with subclinical hypothyroidism since five years for which I am taking Thyronorm 88 mcg. I observed over this period of six years, I lost much of my fat content and muscle though I did not lose weight. My TSH level is 4.8. My weight 63 kg, BMI 21.7. I never felt any weakness or fatigue. I walk 4 km every day. I am not sedentary. I wish to know that this loss of fat and muscle, is it due to hypothyroidism or Glycomet intake. Please be kind enough to advise me clearly.
Hello. I have gone through the details (attachment removed to protect patient identity). Your sugar control is excellent. As far as target levels are concerned, HbA1c of less than 7 indicates excellent control. So, the target is less than 7. However, since you are elder, slightly higher HbA1c is also acceptable. You may reduce the dose to Glycomet SR 500 mg once a day. Fat loss is due to diabetes itself due to insulin resistance. TSH (thyroid-stimulating hormone) is fine and you should continue the same dose of Thyroxine. Rest, you should continue diet control and exercises. For more information consult an internal medicine physician online -->