Based on the details provided:
• Your
diabetes is very well controlled (
HbA1c 5.6, fasting 88).
•
Thyroid seems controlled, but unintentional weight loss despite good appetite needs evaluation.
• Pioglitazone does NOT cause weight loss; it usually causes weight gain, so it is unlikely to be the reason.
• Glibenclamide (Glucobay/acarbose) can cause loose stools, bloating, and hunger, which explains your symptoms.
• Anxiety, panic symptoms, and antidepressant/antipsychotic medicines (sertraline, olanzapine) can also alter appetite and weight.
•
Vitamin D is low and should be corrected.
• Persistent weight loss with loose stools raises concern for malabsorption, anxiety-related hyperphagia, or over-treatment of thyroid
Next Steps
1. Repeat
thyroid profile (
TSH, FT4) to rule out over-replacement.
2. Stop acarbose (Glucobay) temporarily after consulting your doctor if loose stools persist.
3. Stool examination (routine + fat) if diarrhea continues.
4. CBC, ESR,
CRP, and LFTs to rule out systemic causes.
5. Start
Vitamin D3 supplementation (e.g., 60,000 IU once weekly for 6–8 weeks).
6. Review psychiatric medicines with your psychiatrist—dose adjustment may help anxiety and appetite issues.
7. Monitor weekly weight, not daily.
Health Tips
• Do not panic—your
sugar control is excellent.
• Avoid frequent weighing; anxiety can worsen symptoms.
• Maintain balanced meals with adequate protein.
• Seek urgent care only if you develop severe diarrhea, blood in stool, fever, or rapid weight loss (>2 kg/month).