Endocrinology-Diabetes Questions Diabetes

When does medication start for diabetes?

I am 37 years old and my recent blood tests indicated that I may be borderline diabetes as I have fasting sugar levels of 140. At what levels is one started out on diabetes medication?

4 Answers

If diet and exercise not helping to lower fasting blood sugar < 110.
Medications like Metformin along with Diet and Exercise are shown in studies to slow down progression of DM
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It is a discussion that needs to happen between you and your doctor. If you are someone who is at high risk for type 2 diabetes and diabetes related complications depending on your family history or life style .. medical therapy should be initiated as a means of prevention. Metfomin is the best drug of choice. Of course the main stay is always the diet and life style changes. Data is clear that with 5-7% of weight loss one can prevent progression of Pre diabetes to diabetes without medical therapy.
Well the good news is you don't have "borderline" diabetes. The bad news is you have Diabetes. First of all "borderline diabetes" is an obsolete term we don't use anymore. The term for an early state of diabetes today is Pre-diabetes. Here are the criteria FBS <100 normal, FBS 100-126 Pre-diabetes, FBS >126 Diabetes Mellitus. So with a FBS of 140 you are beyond pre-diabetes and have diabetes. Start treatment now. 1) get advice on diet and exercise (we call it life style change 2) start medication. 3) Get a good education course on diabetes 4) get a HbA1c test if not already done. At this level of blood sugar, most physicians would just start Life Style change. I would do that but add the medication metformin. This drug has been in use for decades and has few side effects, control BS, & is generic so is very cheap. Its time to start so see your Dr. & get going before it gets worse as it will without working to keep blood sugar as near normal as possible.