Following one high fasting glucose test several years ago I have been taking 15mg Actos daily, "prophylactically" per the original prescriber, my GP. My a1c is below 6, my fasting glucose is below 100, I exercise regularly and vigorously, and I am overweight (can't shed that 15 lbs) but not obese. The endocrinologist I began to see, who kept me on Actos and agreed with the prophylactic strategy has left the practice, and his successor wants to switch me to 1000mg metformin. I have no contraindications for either. Metformin's cheaper (and bigger!!), but other than that, what is the benefit of switching?
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another issue is what should be prevented- i recently heard an endocrine md quip that diabetes should be called heart disease with high sugar- the joke is that diabetes isn't what kills you, it's the heart disease- and there may be more effective preventative factors for heart disease than for insulin resistance (as the post says, the verdict is still out)- my guess is that the syndrome will be very difficult to prevent by aiming at different numbers (preventing high GLC or high ox-LDL)- the shotgun approach might be better via lifestyle modification (diet, exercise, stress relief, etc.) rather than a more potent drug that controls one number, while assuredly disturbing some other number
I'm 64 and have had type 2 diabetes for 11 years. I am the only person in my family to have it.
There is a long history of cardio-vascular disease on my mom's side of the family. Her dad died of a heart attack when he was about 65. Her mom had several strokes when she was around 80. My mom died of CHF when she was 83. Her brother was diagnosed with type 2 diabetes in his 70's, after his second bypass surgery. I've always wondered if perhaps they had insulin resistance or chronically "just a little high" blood sugar levels, and if this perhaps caused their CV problems.