 
                            When Should The Medication For Diabetes Be Taken?
 
 
                                    
                                     Tue, 30 Dec 2014
                                                
                                            
                                                Answered on
                                                
                                                Tue, 30 Dec 2014
                                                
                                            
                                                Answered on
                                             
                                             Tue, 27 Jan 2015
                                                
                                                
                                                Last reviewed on
                                                
                                                Tue, 27 Jan 2015
                                                
                                                
                                                Last reviewed on
                                             
                                            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
 
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