Love this website and hope to get some advise from the wonderful people here. I have done a medical examination recently and found to have Prediabetes. The doctor asked me to start diabetes medication (half tablet of Januvia 100mg per day). The doctor said that the risk of getting cardiovacular disease for prediabetes is of no diffrence from a diabetes patient. Starting the diabetic treatment now will help delaying diabetes type II too. Hence he recommended for diabetic medication. I was somehow not comfortable with his advise. The following are some of my personal infor and test results: (1) 47 yo male, Height (173cm) and Weight (71kg), non smoker and non drinker, do regular exercise. (2) HBA1C - 5.5% (Under non diabetic range) (3) GTT result: Blood Glucose Fasting (0 hr) - 5.2 MMOL/L Blood Glucose (1 hr) - 8.5 MMOL/L Blood Glucose (2 hr) - 9.8 MMOL/L (4) Total Cholesterol - 6.0 MMOL/L (normal < 5.2) HDL Cholesterol - 1.46 MMOL/L (normal > 1.03) LDL Cholesterol - 4.11 MMOL/L (normal < 2.58) Triglyceride - 0.94 MMOL/L (normal < 1.70) My questions is: (a) Do I really need to start the diabetic medication? I read that for newly diagnosed diabetes patients, the doctor normally will advise them to go for diet change and also exercise first before recommending medication. In my case (pre-diabetic) with HBA1C shown normal result (indicating good glucose control for the past few months), do I really need to start medication? Why this conservative (diet and exercise) treatment plan is excluded? (b) For diabetes patient, one of the important tests to monitor the blood glucose control is HBA1C. But for my case if I started my prediabetic medication, how do I monitor the effectiveness of my treatment? Do I still look at HBA1C (which most likely will be normal) or to look at GTT and observe the improvement of Blood Glucose at 2 hr. My diabetes knowledge is limited, how I get some help and advise. Thank you.