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I have been diagnosed with three things over the past year: Type 2 diabetes, interstitial cystitis, and fibromyalgia. I know that two are autoimmune diseases and that researcher are now working to determine whether or not Type 2 diabetes can be added to the autoimmune disease category.

I am 60 years old patientold, previously healthy, but slightly overweight at 146 pounds. My cholesterol and triglycerides are high, and we are now investigating some out of value thyroid tests. I have begun regular exercise.

My specific question is this: I take multiple medications and am told I need to eat a specific diet for each of my issues. Some of my physicians tell me to take supplements of various kinds, and other's say not to. How can I know what to eat and what to take? Is there one type of physician, pharmacist, herbal specialist, nutritionist, or anyone who can help me look at the entire picture and know the right things to do and not to do manage my multiple disease state?

Category: Internal Medicine Specialist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at DoctorSpring.com
I understand your concern.
Interstitial cystitis is indeed of unknown etiology, and some patients with IC also present simultaneously with fibromyalgia, showing the auto-immune component. Type 2 DM can be attributed to some genetic factors, but it is not really autoimmune and develops more as a result of peripheral resistance to insulin. Can be due to obesity, lack of exercise, sedentary lifestyle, e.t.c
Regular exercise is definitely one positive thing that you have done.
I want you to give me a complete list of medications you're on currently and also what are the various diets that you have been suggested? Dietary changes while being very effective in Type 2 DM, the evidence of it having an impact on IC/fibromyalgia is doubtful and is lacking. So for the time being you should stick to a diet that reduces your blood glucose in general and invariably will also reduce cholesterol and triglycerides in due time. The problems you have come under multiple specialities, that is true, but i will try my best to give you a second opinion on what drugs to be used, so that it is easier for you to follow the guidelines.
Hope this was helpful,

Patient replied :

Thank you for your answer, and request for more information.
I have hypertension that is corrected to almost normal with Losartan Potassium 50 mg, 1 per day.
For the diabetes I take 1,000 mg Metformin ER per day.
For interstitial cystitis I take CystoProtek, a dietary supplement meant to help keep the bladder lining healthy. One capsule twice per day unless I have a flare and then I take two capsulres twice a day. So far it is working and I have not had a bad IC flare for some months. If you are not familiar with it it contains Hyaluronate Sodium, Chondroitin, Glucosamine, Quercetin, Rutin, and Olive Kernel Oil. It is manufactured by Meda Consumer Healthcare, Inc. under license from Algonot, LLC, Marietta, GA 30062. 1-800-328-0503.
I currently have an eye-infection and my opthamologist has prescribed amoxicillin TR-KCLV 500-125 (I don't understand this, but I take one per day.
For the fibromyalgia pain I take one Aleve per day and since one of my fibro symptoms is an inability to sleep, 20 mg anatriptyline and 5 mb zolidem. The anatriptyline also seems to help some with the body pain.
I have just been prescribed Dexilant 60 mgs per day. This is for a sick stomach and heartburned caused by some of the other drugs.
I do not drink or smoke. My father developed adult onset diabetes when he was just about my age.

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Thank you for additional information.
Based on that, this is my line of action for you :
1) Good blood glucose control and HBA1C in normal range is the most important priority. So follow the diet accordingly with exercise.
2)Aerobic exercise will be helpful in your case, along with moderate 30-45 minute walking everyday.
3) Continue all the medicines, except for Amoxicilllin. Once you are done with the course of amoxy, you can stop it. If doctor asks you to continue, ask him to tell the diagnosis.
4) All the drugs Losar, metformin, aleve, Anatryptiline, Zobidem are safe and effective. So you can continue.
5) Continue with Cystro Protec since it has been so effective.
6) Can you provide your cholesterol values/ Triglyceride values. You may need medication for that. If you haven't checked recently you can get lipid profile donw.
7) You can also take Omega 3 fish oil capsules. It can be considered after your cholesterol values.
8) Fiber rich diet, green leafy vegetables, fruits are better than any isolated supplements. So make sure your diet has adequate quantities.
The best doctor for you will be a family physician who can keep a track of all the medicines you're taking and monitor your progress.
Hope this was helpful,

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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