instruction: hello doctor my husband is a type diabetic as he is a hotelier the working hours are stressful for him he has no time for exercise also his meal timings are very odd he takes his lunch at around 30 am in the hotel cafeteria and usually takes his dinner at 12 am 12 30 am at home he takes slimy before breakfast and janumet 50 100 post breakfast and after dinner since his triglycerides are high he has been taking stanlip 145 his sugar levels are fine now with hba1c at 74 but the recent kidney tests show higher levels of serum creatinine at 7 also his amylase and lipase values are significantly high with amylase at 86 and lipase at 98 he is just 32 and has been a diabetic for seven years a general physician says that the elevated levels of creatinine and lipase indicate the risk of the organs malfunction also he says that slimy and janumet are to be blamed for the harm what should we do to protect the vitality of the kidney and pancreas kindly guide
output: hi well I do not think elevated creatinine is due to medications it is most likely due to diabetes itself but elevated lipase is due to high triglycerides apart from high triglycerides alcohol intake can also cause elevated lipase for the protection of pancreas his triglycerides have to be controlled when was his triglyceride tested and what is the value he needs to do exercise daily as of his kidney is concerned his medicine janumet 50 100 has to be stopped and instead he can use tablet galvus 50 my vildagliptin two times a day he should avoid pain killers and inform the doctor that his creatinine his on the higher side before any doctor prescribes any medications repeat serum creatinine after one month and revert back with reports