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What Causes Pre Diabetes?

Posted on Mon, 23 Jun 2014

Question: I have generally been prediabetic, taking 1/2 to 1/4 of a 5 mgm glipizide tablet every evening with morning glucose levels of 100 or less. my AC1 has been 5.8 or 5.9, sometimes 6.1. Two nights ago, my glucose was 191. It was unexpected. I took 1/3 tab of glipizide. In the morning, my glucose level was 176. I checked it again; it was 175. I got a new battery for my true result meter; still 176. Had breakfast of two eggs, sausage, 1/4 cup of hash browns, and w/w toast with small amounts of jam, 2 cups coffee. bought a new meter, and several hours later got a 226 reading. Checked it again without eating about two hours later, reading about 176. Had supper with 1/2 a calzone pizza, a cup of oranges, bananas, and about 1oz. wine. At bedtime 4 hours later, my glucose read 256. I took 1/2 tablet glipizide and retired. At 6 the following morning, my glucose read 148. Took 1/2 tablet glipizide. Back to sleep for 2.8 hours, reading of 141. Then had breakfast of 2 prunes, egg white omelet with chopped peppers, one w/w toast with benecol, 1/2 grapefruit, and 1 cup cojjee. Took a one mile walk and reading taken after breakfast and walk: 175. Question: why the sudden change? is glipizide no longer effective? why not? how do i get back to where I was. My usual routine then was a regular breakfast (1/4 grapefruit, 2 eggs, 1 slice bacon, toast with bon mamman preserves, 1+ cups of coffee), a cup of coffee with 2 cookies as a snack before lunch, lunch (almost always 4 oz. low fat cottage cheese, l w/w slice with benecol and peanut butter, coffee with 1 or two cookies); supper (3-4 oz. meat, veg. serving, no potatoes and light or no dessert), sometimes a flavored yogurt before bedtime. If I had had dessert or yogurt, I would take 1/4 tab giipizide. And in the morning would expect a glucose reading of 100, or 90 or 87 or 103; rarely, 112 or 123.

Answered by Dr. Pavan Kumar Gupta (5 hours later)

Brief answer....It is natural course of progression of Pre diabetes stage to XXXXXXX diabetes.
Detailed answer....
Hello,
Thanks for the query.
I have read your query and feel that you have not been properly advised regarding Pre diabetes and diabetes.
Pre diabetes is a stage where fasting blood sugar levels are between 100-126 and PP sugar levels are between 140-200.
If proper care is not taken during Pre diabetes stage,in form of diet control,regular aerobic exercises and shedding of weight,then most of the people go into XXXXXXX diabetes stage sooner or later.This is what happened to you.
Reason for this is gradual destruction of beta cells of pancreas.As the age advances the mass of functioning beta cells gradually starts dwindling and this results in precipitation of XXXXXXX diabetes.These beta cells are responsible for production of insulin which helps in controlling blood sugar levels.
GLIPIZIDE acts by stimulating beta cells and when the mass of beta cells becomes less,the effect of GLIPIZIDE in the same dose also gets reduced.
There is no point taking haphazard treatment now.
Although at your age,a very aggressive Control of sugar levels is not required but still care must be taken so as to keep Your fasting levels below 120-130 and PP levels below 200.
You must consult a diabetologist or an internal medicine specialist and get a proper prescription of medicine which should be taken regularly.
Along with this,you have to start taking dietary precautions and do some regular exercises like walking regularly.
Similarly due care should be given for your lipid profile as well as blood pressure.
Avoid sweets XXXXXXX cookies,junk foods,colas,fruit juices etc.
I hope it helps,however you are most welcome to revert to me for any further query.
Best of luck
Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Pavan Kumar Gupta (17 hours later)

Dr. XXXXXXX yesterday, I remained on a diabetic diet, having no sugar and only cottage cheese, fruit (dried unsweetened cranberries) nuts (almost entirely almonds) and spaghetti with meatballs, the spaghetti was white flour. I also took small unsweetened apple sauce. Before supper, I read 161. At bedtime my reading was 261; so i took 1/2 tab+ glipizide. At 5:30 a.m. my reading was 103 and at 8 a.m., having taken only a little water, was 99. I was much encouraged. My breakfast: 1/4 grapefruit, 2 oz. orange juice, oatmeal, w/w toast with benecol and, taking a chance, a small amount of jam. 1 cup coffee, 6 oz. water. Reading at 11:00: 190. I had also brushed my teeth before breakfast with Colgate Total toothpaste. Las night while checking on the net, I had noted an article on glipizide and Total but had not read it. This morning I did read more but was unable to find anything definite. I think, but do not know, that there may be a connection. I am going to change toothpaste and if you would like to know more, give me a way to reach you and I will keep in touch. XXXXXXX

Answered by Dr. Pavan Kumar Gupta (10 hours later)

Hello,
Very frankly speaking I don't think that changing the toothpaste would make any difference,however it would better if you observe about it yourself.
In my opinion,your primary problem is post prandial HYPERGLYCEMIA ( after food ).
Taking 1/2 tablet glipizide won't make any difference and it can be dangerous to increase its dose as it can cause hypoglycemia anytime.A sulfonylurea drug like glipizide can cause hypoglycemia specially in old age.
The best for you would be take medicines from alphaglucosidase inhibitor class like VOGLIBOSE .3 mg thrice a day.This drug doesn't result in any hypoglycemic attack and works best for post prandial HYPERGLYCEMIA.
Another thing you can do is to avoid sugar,sweets XXXXXXX fruit juices and fruits like XXXXXXX banana,grapefruit etc.
You can discuss about VOGLIBOSE with your treating doctor.
In case you need to discuss anything in future,you can contact this healthcare magic site and address the query in my name.Your query would be sent to me by the forum.
I hope it helps.
You can consult me any time,if you wish.
Thanks

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar