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When Should The Medication For Diabetes Be Taken?
Question: I was diagnosed with diabetes a year back. Though my sugar level has come down after some change in my life style, it continues to be above normal. I am not taking any medicine for diabetes and my last Ha1Ac result was 7.2. Should I start taking medicines for diabetes? If so, which one. Please advise.
Brief Answer:
It is better to get started on medications
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I had gone through your question and understand your concerns.
The target HbA1C at your age is 6.5%. You have done a great job in bringing it down from 9.2 to 7.2%. Early medications are always better in diabetes. Drugs with lesser side effects can be started early in diabetes - preferred initial treatment includes Metformin or gliptins (Vildagliptin/ saxagliptin etc).
Your liver enzymes are elevated - needs evaluation with an ultrasound abdomen and viral markers. If it has come down with exercise it could be due to fatty liver.
Your cholesterol are normal for a person without diabetes, but when you have diabetes the LDL cholesterol should be less than 100 mg/dl. So if lifestyle modification cannot bring it down, it is better to get started on medications.
Vitamin D levels are low - Need to start on replacement. Vitamin D is available as 60,000 IU sachets or tablets. Weekly dose for 8 weeks is what I recommend for my patients followed by one every 1-2 months.
To sum up my advice is to try hard with lifestyle modifications and if not working it is better to start the medications early before the pancreatic function is affected.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
It is better to get started on medications
Detailed Answer:
Hi XXXXXXX
Welcome to HCM. I had gone through your question and understand your concerns.
The target HbA1C at your age is 6.5%. You have done a great job in bringing it down from 9.2 to 7.2%. Early medications are always better in diabetes. Drugs with lesser side effects can be started early in diabetes - preferred initial treatment includes Metformin or gliptins (Vildagliptin/ saxagliptin etc).
Your liver enzymes are elevated - needs evaluation with an ultrasound abdomen and viral markers. If it has come down with exercise it could be due to fatty liver.
Your cholesterol are normal for a person without diabetes, but when you have diabetes the LDL cholesterol should be less than 100 mg/dl. So if lifestyle modification cannot bring it down, it is better to get started on medications.
Vitamin D levels are low - Need to start on replacement. Vitamin D is available as 60,000 IU sachets or tablets. Weekly dose for 8 weeks is what I recommend for my patients followed by one every 1-2 months.
To sum up my advice is to try hard with lifestyle modifications and if not working it is better to start the medications early before the pancreatic function is affected.
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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