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Suggest Treatment For Mildly High Blood Sugar

Posted on Fri, 25 Apr 2014

Question: Hi I sent you a question early this year /i have got your good reply I have repeated my a1c but seems to go up from 6,4to6,6. I have noticed at the same time that my fasting blood sugar was 113/ And the insulin at the same moment was 26,4 /i am still not taking any Medicin/and still cheking my blood sugar 2hours after eating and always Under 140 / My problem seems to be in the morning when i wake up i am always 105/115. And than start to go up to 140 /am making 5/7 days 1hour of jogging And 40 min of swiming my b/s is 100/ to 115 imdtly after my sport The breakfast comes after my sport and here i would tell you if i eat even a moderate carbs (bread and honey) i see the level of 190 but it goes back to 140 after 2hours /i dont see this high levels on lunch or dinner even with much more Carbs/i am eating too much vegetables an grilled fish , red meat very very I am too much exagerating in testing my b/s because i am concern /but In the same time i feel that my metabolism is working very well and that The 6,6 could be a normal range for A1c for some poeple What shall i do /shall i take some medicin Tks in advance

Answered by Dr. Minal Mohit (1 hour later)

Brief Answer: We can think of adding metformin. Detailed Answer: Dear Sir, Hi! you are really doing very very good. maintaining HbA1c still <7% with dietary restrictions and regular exercise. A1c has gone up by 0.2 % and sugars are touching somewhere 190mg/dl. As oer American guidelines this is time to add drug like metformin along with life style modification. any brand of metformin 500 mg twice a day, one after breakfast and one after dinner can be added. rest all to continue same. recheck your blood glucose on once a week basis and A1c every 3 months and do let me know. Regards!

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

Follow up: Dr. Minal Mohit (14 hours later)

Hi I was mentioning the 190 bs only for for a very short time And only in the morning .. Since yesterday i have started with Januvia 50/ and my BS after breakfast did not go over 135 To go down to low levels all the day after the lunch and the dinner To remain between 80 and 110... I would try for 1 week januvia bcs i think my problem Could be a insulin resistence only in the morning because i was Since more than 35 years eating only one time in the evening! I changed my life style since abt 2years Regards

Answered by Dr. Minal Mohit (6 hours later)

Brief Answer: januvia 50 mg can be taken. Detailed Answer: Dear Sir, Hi! tab januvia 50 mg /d in the morning with breakfast can be taken. but as per international guidelines metformin still enjoys the position of first line drug with life style changes. you are right that in the initial phase insulin resistance is the reason for sugars going up. metformin is the insulin sensitizer and helps the insulin produced inside our body to work better. you are getting high sugars post breakfast because your metabolism was tuned to handling carb load only at night . now when you have started breakfast as well you are finding post breakfast high glucose. that does not mean you should stop breakfast. you must take all three meals a day and also in between snacks. the idea is to eat small frequent meals. healthy meals small proportion. you can continue januvia 50 mg a day. but if you find sugars going low by evening you can switch over to metformin. Regards!

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

Follow up: Dr. Minal Mohit (54 minutes later)

Thanks a lot Well answered and well understood Regards

Answered by Dr. Minal Mohit (8 hours later)

Brief Answer: You are most welcome. Detailed Answer: Dear sir, pleasure is mine to help you through medical problems. you are always welcome. regards!

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