Fasting Blood Sugar And Postprandial Blood Sugar Above Normal Range. Should I Start Medications?
If the fasting blood sugar is >126 mg/dl or the postprandial is >200 mg/dl it is termed as Diabetes Mellitus
Your Husband's fasting sugars is above the normal range The post prandial is also high but in prediabetic range ie 140-200 mg/dl and not in diabetic range. However if the fasting has been high on more than one occasion it is enough to call him a diabetic
I would advice you to get an HbA1c done ie Glycosylated hemoglobin. This report tells us about the average sugar control over last 3 months. If the HbA1c is >6.5 it would confirm our diagnosis
I would also advice you to get a fasting lipid profile and urine microalbumin done. These will tell us about your husbands cholesterol status and kidney status. Dysplipidemia and protein leakage in urine are often seen with diabetes and can easily be prevented. Have his blood pressure also checked. In Diabetics the blood pressure target should be <130/80 mm Hg and not <140/90 mm Hg as it is in normal people.
Diabetics often have retinopathy and I would advice you to get your husband checked with a retinal surgeon for presence of diabetic retinopathy. This screening of the eyes has to be repeated every year
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All in all he may require medications for control of his sugars. We generally started an extended release metformin as the first line therapy. Any local doctor can prescribe you the same. We check the HbA1c every 3 months till it is in control and then every 6 months. If the blood pressure and cholesterol is also high we may require medications for that as well. Low carb diet, atleast 30 min a day excercise and weight loss of about 10-15 percent over 6-12 months would also help in the diabetes management. You can consult a good dietician who would prescribe you a diet chart which would help in diabetes control as well as weight loss
Hope this was helpful.
With Warm regards
Dr Om Lakhani, MD
Diabetologist