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Hello,I am Dr. Aren and i will help with your query.Glipizide can be taken once before breakfast instead of twice daily with meals.An Extended Release (ER) tablet will release the drug slowly reducing the chances of sudden lowering of blood sugar.You can give him one of the old 2.5 mgm tablets now and start the 10 mgm ER tablets from the morning.This drug can initially be started in divided doses initially and later be given as a single morning dose.Giving him a 10 mgm dose now and repeating it in the morning may cause double dose effects in the morning increasing risk of hypoglycaemia.
If you give no antidiabetes drug tonight,no harm will come to him.You can then start the drug in 10 mgm Er dose from the morning.
The blood sugar levels are high but not very high,thie bloos sugar will soon be controlled by the increased dose of the drug.KIt is best to avoid night time dosing of Antidiabetes drugs as night time hypoglycaemia can be very dangerous.
The blood sugar range which would be acceptable would be 90- 120mgm fasting blood sugar,Post prandial blood sugar can range from 130-180mgms.So both would appear to be right in their own way.
Ideally the blood sugar control should be good and the blood sugar after meals should not exceed 160-170mgm,occasional reading above the mark can be excused .Uncontrolled blood sugar peaks for longer periods persistently will cause rapid microvascular damage to the eyes,heart and kidneys apart from damage to other organs.THe type of foods which are unhealthy like simple carbohydrates and sugars can cause the most harm.
Glipizide 10 mgm can be taken once a day as it will perform as well as the lower dose taken thrice daily.Ideally it should be taken before breakfast if a single dose needs to be used.This has been confirmed by various trials.
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A balanced diet would be the best,preferably low fat and low in simple carbohydrate will be fine.Kindly rate my answer as 4 or 5 stars thank you.I will be available to answer any follow up queries after that.