Medication - when?

[smitha48]

Hi all,

I often browse the :?: s and threads on here, and have one to raise myself.

quite often you get people diagnosed with a HBA1C of 7 or less some cases they are 6.5, and they are put on Metformin.

At my diagnosis of 7.0 it was clearly stated that there was no requirement fro me to go on meds and D & E was the way ahead. I followed a suitable regime and next test was 6.4

Again congratulated and no meds

The question is this......Is there a 'cut off' at which metformin will be prescribed as from what i have noted on here it seems to be haphazard.

I don't want to go on any more meds if i can help it, just wondering.

Thanks

Tony

 

[Osidge]

Hi Tony

I was put on Metformin almost immediately from diagnosis. Apart from keeping my HbA1c in the fives for many years it also gave me free prescriptions!! That was important as I also needed treatment for hypertension and high cholesterol as well - and latterly for Parkinson's Disease. For someone like yourself, one of the benefits of early Metformin is that it appears to be cardioprotective: http://www.battlediabetes.com/news/scie ... ects-heart and http://www.diabetes.org.uk/Guide-to-dia ... iguanide-/

Hope this helps

Doug

 

[smitha48]

Hi Doug,

Thats interesting.....However i note that your HCP diagnose Metformin when your HBA1C is below 7, and i presume was somewhere around there at diagnosis, but mine don't.

I am wondering what the cut off is?

As i said i don't particularly want any more meds (i take 13 pills a day for the CAD) i just have a burning question in my head, and unfortunately my mind won't settle till i have what i consider the full answer.....i'm a bit strange like that!

Cheers for the link :thumbup:

tony

 

[jumbleannie1VDJQ]

If there is a cut off point my doctor obviously has not heard of it as my past two Hba1c have been 6.9 and 6.5. Told by the nurse last time that I had a normal Hba1c. (I acctually had to ask for the scores on the doors, and inform her that was not normal) :? Still not been offered any meds, but not in any rush to start as Bp and Chol both ok. (had to ask for those too). Good question though and I would love to hear the answer. Some of my collegues have a lower result than me an have been put on Met, so maybe it depends on who your DR is.

 

[Grazer]

There is no "cut-off"
Different practices will prescribe differently. It will also depend on the weight of the individual, not just the HbA1c. An obese person will probably be prescribed it earlier because it helps with weight loss which lowers insulin resistance. In some states in USA, it's prescribed to pre-diabetics even because it's considered a good preventative. So it's all down to individual circumstances and the Doctor's views.

 

[Daibell]

Hi. The ultimate references that GPs are supposed to follow are the NICE/NHS Diabetes Guidelines available for download from the NICE and/or NHS Diabetes web pages. The Quick Ref Guide for Type 2 May 2009 for example says an Hba1C greater than 6.5 should suggest Metformin but the notes say 'or individually agreed target' hence it's' rough guideline. The thing is that as Metformin is such a safe proven drug that does help, GPs do prescribe it quite freely. The standard version is also very low cost. The slow release SR version does cost a bit more and does help some people with any stomach upset.