T-20 M Tablet belongs to the group of medications called ‘antidiabetic agents’ used to treat Type 2 diabetes mellitus. This medication improves glycaemic control in diabetic patients who do not react well to Metformin alone.  Type 2 diabetes mellitus is a chronic or life-long condition in which blood sugar or glucose levels rise more than normal. It occurs when the body does not produce enough insulin (metabolizes glucose), or if produced, it cannot function properly in the body.

T-20 M Tablet is a combination of two medicines, namely: Metformin and Teneligliptin. Metformin comes into the category of medications known as 'biguanides', and it acts by decreasing liver glucose production and intestinal glucose uptake. On the other side, Teneligliptin works by stopping the action of the dipeptidyl Peptidase 4 enzyme, which in turn increases the insulin levels in the body and reduces the glucagon levels. All of these actions reduce sugar levels in the body.

You should take this medicine as prescribed by your doctor. You may experience side-effects of such as nausea (feeling sick), vomiting (falling sick), diarrhoea, headache, stomach ache, respiratory infection, weight gain, sweating, palpitations, and vision problems. Some patients experience decline in blood sugar levels lower than normal (hypoglycemia), resulting in sweating, dizziness, headache, confusion, feeling hungry, temporary changes in vision, uneasiness, irritability, and weakness. In such cases, seek medical attention immediately.

Do not take T-20 M Tablet if you are allergic to any of its contents. Do not use this medicine if you have heart failure, bladder cancer, or diabetic ketoacidosis (a complication of diabetes). T-20 M Tablet may cause ‘lactic acidosis’ (accumulation of lactic acid in the blood), which requires immediate medical attention. The risk increases if you are previously diagnosed with kidney or liver diseases. Do not consume alcohol (risk of lactic acidosis) or fast for prolonged periods (risk of hypoglycemia). Also, inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding.

T-20 M Tablet is suggested for the management of type 2 diabetes to be followed with the right diet and exercise. T-20 M Tablet is given in combination in patients whose diabetes is not effectively controlled with Metformin alone.  This medicine makes the body more responsive to insulin and helps the body to a normal state.  Metformin tablets are especially advised to release the drug at a slow rate in the body from time to time.

• Nausea (feeling sick)

• Vomiting (falling sick)

• Diarrhea

• Headache

• Stomach ache

• Respiratory infection

• Weight gain

• Sweating

• Palpitations

• Numbness

• Vision problems

T-20 M Tablet should be used with caution in patients with heart diseases as it increases the risk of heart failure. T-20 M Tablet may cause ‘lactic acidosis’ (buildup of lactic acid in the blood), characterized by abdominal pain, muscle cramps, vomiting, severe fatigue, and difficulty breathing. It is a life-threatening condition that requires immediate medical attention. Inform your doctor if you have any severe liver or kidney problems as their normal functioning is required to eliminate excess lactic acid from the body.  Do not consume excess alcohol as it increases the risk of lactic acidosis.  T-20 M Tablet may lower vitamin B12 levels, so it is recommended to take blood tests regularly to identify any vitamin deficiencies.

Drug-Drug Interactions: T-20 M Tablet may have an interaction with medicines used to treat bacterial infections (rifampicin, tetracycline, Clarithromycin), a medicine used to treat fungal infections (fluconazole), other oral antidiabetics, medicines used to treat gout (probenecid).

Drug-Food interactions: Intake of excess alcohol may increase the chance of a life-threatening condition known as lactic acidosis.

Drug-Disease Interactions: T-20 M Tablet should be avoided in patients with heart diseases (congestive heart failure and myocardial infarction), vitamin B12 deficiency, alcoholism, type I diabetes, bladder cancer, oedema (fluid retention), liver disease, premenopausal anovulation, obesity (weight gain), anaemia should avoid intake of T-20 M Tablet .

• RIFAMPICIN
• TETRACYCLINE
• CLARITHROMYCIN
• FLUCONAZOLE
• PROBENECID

• Fill your half plate with starchy veggies, a quarter with proteins, and a quarter with whole grain.

• Eat at regular intervals. Do not take the long gap between a meal or snack.

• Monitor your blood sugar level regularly, especially when there are a lot of fluctuations.

• Invest at least 150 min of moderate-intensity physical activity and 15 minutes of high-intensity exercise every week.

• Lose weight gradually to achieve a healthy body mass index (18.5 to 24.9).

• Replace refined carbohydrates-containing foods with whole grain foods and increase fruits and veggies and other fiber-enriched foods.

• Reduce saturated fat intake (or hidden fats) in food like chips, crisps, pastries, biscuits, and samosas. Choose omega 3 fatty acid-containing oils for daily cooking. You may use palm oil, mustard oil, groundnut oil, rice bran oil, and safflower oil for frying.

• Do not take stress as it may elevate your blood sugar level. You may adopt stress management techniques like mindfulness, yoga, or meditation to control stress-related blood sugar changes.

• Opt for low-fat dairy products (low-fat yogurt, fat-free milk, and cheese, etc.).

• Keep your blood pressure as normal (120/80) as possible as it reduces the risk of heart diseases in diabetes patients.

• T-20 M Tablet shows optimum effects when you follow healthy lifestyle changes like weight loss, regular exercise, healthy diet, etc.

• Keep taking the drug even if you think your blood sugar levels are under control. If you miss a dose, do not take a larger dose; consult your treating physician for advice.

• Take short, frequent meals, avoid prolonged fasting when taking this drug. Beware of hypoglycemia symptoms include sweating, dizziness, palpitations, shivering, intense thirst, dry mouth, dry skin, frequent urination, etc. Whenever you experience the above-mentioned symptoms, immediately consume 5-6 candies or 3 glucose biscuits or 3 teaspoons of honey/sugar and also get in touch with your physician. Make sure to carry these with you at all times, especially for long travels.

• Avoid drinking alcohol while on this drug as it increases the risk of hypoglycemia (decrease in blood sugar which might be fatal in some cases) and lactic acidosis (when the lactic acid increases in the body, which impacts various organs in the body).

• Try to quit smoking and reduce intake of carbohydrate-rich food like potato, rice, mangoes, bread, sugar, etc.

Type 2 diabetes mellitus: It is a chronic condition in which blood glucose levels are elevated in the body. Insulin is responsible for the utilization of glucose by the cells. In type 2 diabetes, the body cells do not respond to insulin, or in later stages, your body may not produce enough insulin. Symptoms include excessive thirst, excessive hunger, fatigue, increased appetite and dry mouth. This condition may worsen over time and cause toxic effects if not properly treated.