My almost 81 year old husband has congestive heart failure for which he takes several medications, and he also has diabetes for which he was taking Amaryl, but since his blood sugars have been 240-290 mg/dl [13.3-16.1 mmol/L], his doctor added Glucophage. We walk daily and stay on a strict diet, but I am concerned because he seems to be getting very weak. His doctor said that in some future time my husband’s sugar will come down.What do you advise?

Your husband’s blood sugar levels of 240-290 mg/dl [13.3-16.1 mmol/L] are definitely not at goal. Daily walking and a strict diet are excellent steps your husband is taking to help reduce these blood sugar levels. He does probably need something in addition to the Amaryl [glimepiride] (if he is at the maximum dose) for his diabetes, but the use of Glucophage [metformin] may not be an ideal choice of medications and should be further discussed with your husband’s health care provider.

Glucophage is not recommended for use in patients with congestive heart failure if they are taking other medications for their congestive heart failure. It is also not recommended routinely in people over age 80 unless a specific test (creatinine clearance) is done to assure that his kidneys are functioning well. Depending on the degree of your husband’s congestive heart failure, he might do well with another type of pill in addition to his Amaryl or he may need to start taking insulin. Again, I would recommend discussing these issues with his health care provider.

TB