Thursday, October 23, 2014

Saturday, September 18, 2010 Deb628, Community Member, asks

Q: What is your opinion of a 51 year old female with a recent a1c level of 6.59%?

Should she be on medication? When do doctors usually start you on medication? She was dxed 9 years ago via the O.G.T.T. (not pregnant), but has had fasting levels between 90 and 97 all this time. She has also had a1c's in the 5's all this time, until the recent one in July. Opinions, advice will be greatly appreciated! Thanks! Also: I'm on blood pressure meds. I'm on cholesterol meds. I've lost 30 pounds since diagnosis and eat healthier. I'm menopausal (going on 2 years).
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Answers (1)
Ann Bartlett, Health Guide
9/21/10 11:09am

Fasting blood sugar is in good range, but clearly something is off and most likely the time to check the blood sugar is 1 hour to 2 hours after a meal.  I have a feeling you will find a spike.  She may need medication if the pre diabetes has moved to type 2, but she needs to make a doc appt to review and if she can have a record of blood sugar tests to show they will probably be able to help her better understand what she needs to do.

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Deb628, Community Member
9/22/10 11:15pm

Thanks for the reply.  Do you think I should be on medication at this point?  My doctor will do a re-check in November (another a1c) and told me if it wasn't lower, she'd put me on Glucophage.  She told me quite a few years ago that if my fasting was consistently 105 or more, she'd put me on Glucophage.

 

I have had a few slightly higher fastings off and on (a few up to 108), but like I said, they're usually around 97 most mornings.  I do know I can feel different after meals (heart seems to beat faster, or I feel "off," or kind of sleepy), and can find my bs over 200 at one  hour.  Most times, it's under 140 at the two hour mark.

 

I don't know if going lower carb will help, or if I'm now showing progression of the disease?  Any advise or information would be appreciated.

 

Thanks,

Deb.

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Ann Bartlett, Health Guide
9/26/10 5:55pm

You said, " I do know I can feel different after meals (heart seems to beat faster, or I feel "off," or kind of sleepy), and can find my bs over 200 at one  hour.  Most times, it's under 140 at the two hour mark."

 

These are symptoms of high blood glucose, but you need to test when you feel that way.  It's the only conclusive way to know.  If test strips are pricey, check out Amazon, they are generally half the price of a pharmacy.  Do a weeks worth of checks and write it all down.  Test, before eating, then 1 hour after and two hours after each meal.  This will give your doc critical information to determine if you need meds.   

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Deb628, Community Member
9/26/10 11:14pm

Hi Ann,

 

Thanks for writing back again.  When I left my appointment with my doctor after finding out about my 6.59% a1c, I commented to her about maybe it was higher because sometimes I can check at one hour and find it over 200.  She kind of agreed with me, but then repeated that I should be checking fastings and at 2 hours after meals.

 

I was very shocked a day or two after that apppointment when I had some KFC.  About an hour aftering eating, I really felt different, and my heart was really pounding.  I checked my bs and it was at 284!!  That scared me! I've never seen it that high!  I was down to 177 at two hours.

 

I assume lowering the carbs will help, but I wish I knew if I am progressing, or if really watching my eating will help even without meds?  Too bad we don't have a crystal ball to see the future, huh?

 

Thanks again,

Deb.

 

P.S.

I'm not sure if I already sent this or not?  The board asked me to sign in again? Hmmm?

 

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Ann Bartlett, Health Guide
9/27/10 7:31am

Hi Deb,

I got it so the site was having a hiccup!

 

It does sound to me like you are moving from pre diabetes into type 2.  Your blood sugar is consistently too high after meals.  A type 2 in good control will have an A1c between 4.5-5.5 to give you some idea.  

 

KFC would definitely be a problem, as are most fast foods, because there is a lot of hidden sugar.  Read some of David Mendosa's blogs on low carb to get your feet wet and check out the book The Diabetes Solution, by Dr. Richard Bernstein

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Deb628, Community Member
9/27/10 11:25pm

Hi Ann,

 

Thanks for another reply.  Someone in good control would have an a1c between 4.5-5.5?  That seems so low, esp. the ones in the 4's!

 

I stayed in the 5's for all this time, without a whole lot of effort.  I think I was just lucky. But now with the 6.5 a1c, I better work a little  harder at it.

 

Thanks for recommending D.Mendoza's blogs and Dr. Bernstein's book.

 

---Deb.

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By Deb628, Community Member— Last Modified: 12/27/10, First Published: 09/18/10