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Daughter's GP seems to be in two minds

JohnEGreen

Master
Messages
14,002
Location
Nottinghamshire
Type of diabetes
Other
Treatment type
Diet only
Dislikes
Tripe and Onions
Daughter had a HbA1c test a while ago went to the doctors the other day and he told her she has nothing to worry about as it was 39 mmol/l then he said well you could be approaching pre diabetes levels then added no that's not possible as there is no such thing as pre diabetes. Doh.
 
Well he's right in a way. It isn't a recognised illness/disease. It is considered normal until it hits 48. It is just a range that means you need to be doing something positive to halt the progress. That's why I balk at doctors who say "it's fine" because it just may not be.
 
Yes I perfectly understand that it was just that the doctor seemed to be confused himself. I also know that some "pre diabetics" have been put on metformin occasionally or so I believe.
 
I'm not at all sure, but I don't think Metformin is actually licensed for non-diabetics other than as an appetite suppressant for those needing to lose a lot of weight. (It started out life as an appetite suppressant back in the 50s I believe) Certainly at my Practice it isn't generally prescribed if the diagnosis HbA1c is 53 or less.
 
Is fasting blood sugar of 6.4 - 7 too high.
I have been at this range for 1 month now. Next appointment with my gp will be next month.. Shoul I go now to see my gp or to wait for my next appointment?

I was put off met sr because my creatin has gone up to 100.

What shall I do?
 
After my gp stopped my met sr1000 my fbg has gone up from 6 to 7.
The reason to stop my met sr is the rise in my creatin to 100..
Next appointment is next month.
What shall I do?
 
6.4 to 7 is in the normal range so I personally would not be overly concerned. I think your best option is to wait for the appointment and discuss your concerns with your doctor.
 
I must admit that metformin has been prescribed for pre diabetics mainly in the USA
Prediabetes is, for many people, a confusing condition. It’s not quite Type 2 diabetes — but it’s not quite nothing, either. So how concerned should you be about it?

For years, the jargon-filled names given to this condition — impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) — may have made the task of taking it seriously more difficult. But in 2002, the American Diabetes Association (ADA), along with the U.S. Department of Health and Human Services, inaugurated the term “prediabetes” to convey the likely result of not making diet or lifestyle changes in response to this diagnosis. In 2003, the threshold for prediabetes was lowered from a fasting glucose level of 110 mg/dl to one of 100 mg/dl.


Then, in 2008, the American Diabetes Association (ADA) began recommending the drug metformin for some cases of prediabetes — specifically, for people under age 60 with a very high risk of developing diabetes, for people who are very obese (with a body-mass index, or BMI, of 35 or higher), and for women with a history of gestational diabetes. The ADA also said that health-care professionals could consider metformin for anyone with prediabetes or an HbA1c level (a measure of long-term blood glucose control) between 5.7% and 6.4%.

But according to a recent study, metformin is still rarely prescribed for prediabetes. The study, published in April in the journal Annals of Internal Medicine, found that only 3.7% of people with prediabetes were prescribed metformin over a three-year period, based on data from a large national sample of adults ages 19 to 58. According to a Medscape article on the study, 7.8% of people with prediabetes with a BMI of 35 or higher or a history of gestational diabetes were prescribed metformin — still a very low rate for the highest-risk groups, in which evidence for the benefits of metformin is strongest. It appears that most doctors simply aren’t following the ADA’s guidelines or aren’t aware of them, as they relate to prediabetes.

http://www.diabetesselfmanagement.com/blog/metformin-for-prediabetes/

Edit to add this link'

http://link.springer.com/article/10.1007/s40265-015-0416-8
 
Last edited by a moderator:
JohnEGreen said:
6.4 to 7 is in the normal range so I personally would not be overly concerned. I think your best option is to wait for the appointment and discuss your concerns with your doctor.
Click to expand...
The cut off for full blown diabetes is 7. Normal is up to 5.6. In between is classed as pre diabetic.
 
I tend to think of pre diabetes as just being a possible future diabetes early warning no mans land rather than an actual condition, so I'd agree with @Bluetit1802 and quite understand the doctor's bit of a dither. But perhaps being identified as a pre diabetic makes people take things just that bit more seriously?

Robbity
 
I look at it quite differently.
42 or above is the start of diabetes and should be treated as such (treated by education and addressing diet and exercise). Better halt it dead at that point (not always possible, but worth a try), than ignore it and develop T2 decades earlier than necessary.

I am always delighted when we get prediabetics posting to say they are taking it seriously.

Diabetes T2 is progressive unless handled with care. If someone's hba1c is rising out of normal, then that progression has already begun.
 
Different nhs areas have different policies. Some prescribe metformin for PCOS because it reduces insulin resistance.
 
How I wish my morning fasting blood glucose can come down to 4.
Can someone give me some advice?
My medication - 2 gliclacide 1 efore breakfast and 1 before dinner + 1 linagliptin (5 mg)

Sent from my SM-T810 using Diabetes.co.uk Forum mobile app
 
evelygtc said:
How I wish my morning fasting blood glucose can come down to 4.
Can someone give me some advice?
My medication - 2 gliclacide 1 efore breakfast and 1 before dinner + 1 linagliptin (5 mg)

Sent from my SM-T810 using Diabetes.co.uk Forum mobile app
Click to expand...
Hi. I wouldn't aim for a fasting level of 4 as that is entering hypo territory. Anything between 5 and 7 is fine. The overnight liver dump of glucose can affect the reading so better to test 2 hours after typical meals and also use the HBa1C measure if your GP has done this blood test.
 
It's an interesting term isn't it "pre diabetic". Almost as annoying as "slightly diabetic", "slightly pregnant"? This is slightly tongue in cheek, so I hope nobody takes offense.
It's only my opinion, but an HbA1c of 39 mmol/l isn't really a sure sign of anything. In that previous 8 - 12 weeks they say an HbA1c is good for, you have no idea what's been going on, if it was 60 mmol/l that's different. Surely the thing about diabetes is the inability to deal with the sugar that ends up in your blood after consuming carbs which as we all know includes sugar, not what the picture after 8 - 12 weeks is looking like.
 
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