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Pre-Diabetic with good control: Continue exercises and diet or start medication?

Dr Chandrakant Lahariya | Answer |Ask -Follow

Diabetologist, Consultant Physician, Vaccine Expert - Answered on Nov 15, 2024

Dr Chandrakant Lahariya is a diabetologist, an infectious diseases and public health specialist and a vaccine expert.
The Delhi-based senior physician also has over 20 years of experience in hypertension, thyroid disorders and respiratory illnesses.
An expert on common health issues and the preventive aspects of medicine, he has co-authored the book, Till We Win: India's Fight Against The Covid-19 Pandemic.
Dr Chandrakant completed his MBBS from the Maulana Azad Medical College, New Delhi, and his MD from the Lady Hardinge Medical College, New Delhi.
He has a DNB (National Board of Examination, 2009) certification and a diploma in vaccinology from Institut Pasteur, Paris.... more

Question by Suvendra on Nov 15, 2024Hindi

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I was diagnosed with diabetes with HB1AC 8.3. Three months later by proper exercise and right food i controlled it to 6.3. I am doing regular exercise and taking proper food . My diabetes is controlled with normal level . Fasting sugar 105-113 and after taking food it is within 140. Is it advisable to take medications or I will do regular exercises and take proper food.

Ans: I think you should be congratulated for the efforts you have made.

The blood sugar levels are still in range of pre-diabetic. Therefore, it is advisable that while you continue the lifestyle modifications, it will be useful if you take atleast metformin, which works as insulin sensitiser. Once your HbA1c is below 6 and fasting sugar below 100, you can discuss with a physician and stop medications.

However, one of the key factor to determine blood sugar levels is going to be your age. So, if you are younger than 60, remission is a good target.

Dr Chandrakant Lahariya
Centre for Health: The Specialty Practice,
Safdarjung Enclave, New Delhi

DISCLAIMER: The answer provided by rediffGURUS is for informational and general awareness purposes only. It is not a substitute for professional medical diagnosis or treatment.

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Hi Komal ji. I am 61 years and diabetic for the past 12 years. My HbA1C today is 6.4 and it was 5.1 in November 2022. Fasting and PP is 90 and 84 respectively. I am on medication with Janumet 50/500 twice a day morning and night and Cardace 2.5 mg in the morning for BP. My weight is 60 kgs and height is 167cm. My diet includes millets, vegetables, fruits, dry fruits, chese, butter, ghee and cold pressed oils. Fully stopped eating maida, white rice and sugar. Please advice (1) how to bring HbA1c within 4.6 to 5.5. (2) If HbA1c is brought within 4.6 to 5.5, can I stop taking diabetes medicines ?. Thanks & Regards.

Ans: You are already on maximum diet. Exercise of 30 to 45 minutes everyday for at least 5 days in a week would help to control the HBA1c well. Once your sugar levels are consistently in the normal range, you can probably reduce the tablet to once daily. Possibility of completely stopping the medicine is less. It is a very stiff target of keeping HbA1c of 4.6 to 5.5, which is difficult to achieve. Keeping it less than 6.4 is fair enough.

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I am 43 years and 5 years back when I had my test for blood glucose level fasting was around 140 and pp was little over 200. HbA1C was around 6.7. As that’s the first time I was diagnosed as diabetic my doctor advised life style corrections and within 3-4 months I brought my weight down from 89 to around 80. Then the reading came to pre-diabetic range HbA1C less than 6.5 and fasting and pp was less than 125 and 140. I tried to continue the routine like 4-5 days per week physical activity and avoided direct sugars as much as possible. Now for past 1 year my fasting level is less than 125 but HbA1C has increased to 7.2. I am still thinking of not taking medication and want to be diet controlled diabetic. But my cardiologist suggesting to start with tablets as HbA1C is not in control. Question is the HbA1C less than 8 says fair control, need advice on how to postpone taking medication.

Ans: Hello. For your age, Hba1C should be around 6.5 to prevent any long term damage to the eyes, heart arteries, kidneys and nerves. Sometimes fasting sugars maybe ok but post meal sugars can spike due to the inefficient secretion/ action of insulin to keep it controlled. If you don't want to take medications, you may choose to completely avoid eating foods that spike your sugars. One way to check is to wear a CGM (continuous glucose monitor ) for 2 weeks and closely observe which foods are increasing your sugars and avoid those. This may help in avoiding medications altogether.

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I am 65 yrs old and diabetic since last 21 yrs. I am on medication ie Metformin SR 1gm, Glimpirde 2mg, and sitaglyptin 50mg. with some multivit. Sugar level remain always around 150 to 190 ( F & PP )latest diagnostic for Hb1AC is 7.6 and creatinine 1.1 . these 2 reading never fall below this level. My Physician has not prescribed any more medicine. Is it OK or anything is better suggestive at your end.

Ans: We should aim for a better HbA1c. Diet and exercise are the key. Medications may be adjusted as per the doctor to optimise glucose levels further. Need to watch for low glucose levels also, if caused by medicines.

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Im 46 yeras just now 15 days back came to know my hba1c is 8.5 took second opinions of blood tests too...almost same.. Doctor has prescribes medicine for morning n afternoon... Now my confusion is at this stage can I control my sugar levels only with diet exercise weight management or should i compulsorily take tablet. I have got this through genetic.. Tablets mandatory or lifestyle management is reversible.. Please help

Ans: Type 2 Diabetes is a lifestyle disorder. Genetic component need to be tackled through epigenetics that is living over the genetics with a lifestyle modification. Looking at your HbA1C as 8.5 you need work hard to bring in the dietary discipline and moderate intensity exercices
Give it all your try for three months. Meet a functional nutrition. Parallel keep checking your sugar levels

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