Taking diabetes medication early.

Because...quite frankly....you're not a diabetic (at least not yet). Also, at those levels I'd be extremely surprised (although not impossible I suppose) if your vision issues had any relation to your blood sugar.

Diabetic complications are ultimately caused by high blood sugar, and nothing you mentioned is sufficient evidence to suggest you have consistently high blood sugar. I can also think of tons of reasons (liability, cost, slippery-slope, etc) why I agree with the doctor in this case.

Is there a reason you're so eager to get on medication? What else are you trying in the mean time?

Hi Abri. I progressed (unfortunately) from being pre diabetic about a year ago to Type 2 recently. I get where you're coming from and that you want to take control of potentially developing diabetes by intervening quickly. My fasting blood test results put me in diabetic range but weren't excessively high (under 9). So, I'm currently diet controlled and no medication was offered for my diabetes. My Dr does not feel it necessary. So, even if you are diabetic the first route is diet only. If this is not enough then it would likely progress to metformin and finally injecting insulin.

Of course, we are all individuals and one person's experience of diabetes may not be the same as another's.

Have a browse through the pre diabetes forum. Also, have a look at the diet and low carbing forums too. Try to reduce carb intake and eat "good" carbs as this will help with blood sugar control.

And well done on the exercise regime too - again that will help you.

Take control and don't let it control you. There is plenty of advice and info on here so ask away as there are many that are more knowledgeable than me!

Good Luck. x

If you are adjusting your diet accordingly you may never progress to diabetes. Its a bit like putting the cart before the horse. I can understand that you dont.want complications to arise but pre-empting it with medication is most probably not the best way to go about it. Your eye problems could be from something totally unrelated to diabetes. I have quite high pressures in my eyes at times and it can affect your vision.

Abri said:

I am pre-diabetic but my doctor says he cannot put me on medication yet as my sugar levels are not high to warrant medication. Was taking medication not going to help me delay the onset of diabetes? I bought myself a meter to monitor my levels and they are relatively normal ( around 4.5 before meal and around 8 2hrs after meal) but i recently noticed that my vision seem to deteriorate sometimes. Is this not a sign that i should take medication to prevent diabetic complications? Why does it seem as taking diabetes medication is not generally supported by doctors?

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Personally? I would take what you describe, in toto, to drive me to modify my diet, as required. If what you have done isn't reducing your post meal numbers enough for you (you don't say how long after eating the 8 was recorded), then you need to consider trimming back a bit more.

If you carry any spare poundage, dropping some of it would be useful, if you can.

My diagnostic, and subsequent stats are in my signature. I don't, nor have I ever taken diabetes medication, preferring to encourage my body to do what it can. If, at some stage, my body is unable to keep my condition in check, I would have to consider medication, but I'd very much prefer not to.

In my view, pre-diabetes should be treated as a wake up call to make any relevant lifestyle changes, rather than a trigger for pharmaceutical support.

Good luck with it all.

My understanding of T2D is that it stems from an original high-carbohydrate intolerance, which leads to high levels of insulin (made by your pancreas) to deal with the high levels of blood glucose (caused by lots of carbs and sugars, which your body just cannot handle), which in turn causes your body to turn off to the signals to tidy away the glucose and get your level at the desired one - that 'turned off signal' is called insulin resistance. You have early signs of insulin resistance. Taking medication will not help your body regain insulin sensitivity, is my understanding. You need to help your body deal with the insulin resistance. Your doctor is actually doing you a big favour by telling you to deal with that, although it is a shame he or she did not spell it out to you. This is where lowering the amount of carbs you eat comes in, and absolutely lowering the amount of added sugars, and processed (ie factory made) food. Trans fats and sugars are the enemy of your health.

Yes, increasing activity levels will help your body deal with the glucose in your blood, and any stored fat you have, to get your blood sugars to a normal level (your goal I take it). Your liver is not at the moment badly affected - this I can see by your Fasting Blood Glucose level - which I would kill my first born to get again! (Not really! But you see what I mean.) What you have is a high post-meal blood glucose level - and this does indeed tell you your body is beginning to have a hard time with the high levels of carbs and sugar it is having to deal with. You can see, then, why diabetics and pre-diabetics tell you at absolute bottom line level - lower the amount of carbs/sugars your body has to deal with. (This is the 'diet' component.) And yeah - more activity will get those excess post meal sugar levels you have now into your cells which is where it should be, as long as the cells aren't overloaded. What you absolutely don't want is for the excess sugars from too many dietary carbs and sugars to end up stored around your liver and pancreas - because then you will join folk here in the T2D forum.

Please, anyone, if I am wrong in what I am saying - do tell me! (And Abri), but metformin will aid you if your liver finally gives up the ghost and switches off the signals due to being overloaded. (I am hoping that liver health can be regained, but this is something I still have yet to see.) Metformin will then attend to one of the switches, and help the liver not excrete blood glucose into your system due to hormone messages, when you already have plenty of glucose floating around in there. (I, like many diabetics, have this issues, which is called 'the dawn phenomenon' or 'liver dumps', and is reflected in that morning fasting blood glucose you mentioned, and yours is normal. This is what is meant by 'wrong signaling'.)

This is why your doctor wants you to lower the amount of blood sugar you have in the first place, and not go on medication.

By the way, I am sorry that you have discovered that you cannot consume large amounts of carbohydrates and sugars without the organs of your body crying out in anguish! (That's my dramatic way of describing it.) You have my sympathy, absolutely. But all the prediabetics and T2 diabetics in here have the same issue. You can still have a great life and fun with food with lowered carbohydrates, I promise. But you won't be like your family and friends who didn't and don't become pre-diabetic in the first place.

By 'high post-meal' of 8.0 I should say 'slightly elevated'. 7.8 is the magic level signifying health for a post-meal reading, which I operate from (according to various health commentator's, and Jenny Ruhl's rules.)

Abri said:

I am trying to control my levels through diet and exercise (jogging for 5km four days a week). I thought medication would assist to keep my levels within the normal range. Thanks very much for sharing your opinion. I read somewhere that even the levels around 8 may cause one to suffer from vision loss, this made me to get worried.

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I'm not suggesting that a reading of 8 is what I'd consider to be "good" but there are too many factors to consider for that number to mean anything.

At Thanksgiving (I'm in the USA) dinner last week, my family all tested their blood sugar levels just to see what it said. Some of the readings were as high as 220(about 12 mmol/l) two hours after eating.

However, that was largely attributed to the large quantities of food(carbs) some of us ate, the varying GI ratings of each food, and the high levels of dietary fat which also slow down the carb absorption rate. Everyone (but me) was back under 5.4 within 4 hrs. None of my family members have been diagnosed with diabetes and I come from a family of athletes who are, for the most part quite sensitive to insulin.

Side note: I'm a type one and ate around 400g of carbs for dinner (not a typo). My glucose level 2 hrs after eating was 5.8. However, I had to "fight" rising blood sugars for close to 6 hrs as a result of how much food I ate. I mention that only to say that the "2hr rule" doesn't always apply.

(Obviously, I get the most out of my "cheat meals")

TorqPenderloin said:

I'm not suggesting that a reading of 8 is what I'd consider to be "good" but there are too many factors to consider for that number to mean anything.

At Thanksgiving (I'm in the USA) dinner last week, my family all tested their blood sugar levels just to see what it said. Some of the readings were as high as 220(about 12 mmol/l) two hours after eating.

However, that was largely attributed to the large quantities of food(carbs) some of us ate, the varying GI ratings of each food, and the high levels of dietary fat which also slow down the carb absorption rate. Everyone (but me) was back under 5.4 within 4 hrs. None of my family members have been diagnosed with diabetes and I come from a family of athletes who are, for the most part quite sensitive to insulin.

Side note: I'm a type one and ate around 400g of carbs for dinner (not a typo). My glucose level 2 hrs after eating was 5.8. However, I had to "fight" rising blood sugars for close to 6 hrs as a result of how much food I ate. I mention that only to say that the "2hr rule" doesn't always apply.

(Obviously, I get the most out of my "cheat meals")

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OK. Understood.

Re your family's BG levels after a carb-rich Thanksgiving dinner - very interesting.

AloeSvea said:

OK. Understood.

Re your family's BG levels after a carb-rich Thanksgiving dinner - very interesting.

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To confirm, I'm not suggesting you shouldn't be concerned, but based on what you shared with us, I don't see anything that suggests your doctor should have prescribed you medication.

I'd just keep an eye on things, and make sure the situation isn't progressing.

Abri said:

I am trying to control my levels through diet and exercise (jogging for 5km four days a week). I thought medication would assist to keep my levels within the normal range. Thanks very much for sharing your opinion. I read somewhere that even the levels around 8 may cause one to suffer from vision loss, this made me to get worried.

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Can I ask what sort of diet you currently have and what your BMI is?

Abri said:

I do not have a specific diet but i try to avoid carbohydrates.

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I use brown rice and low GI bread.

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Hi Abri. I'm not trying to pick on you or anything, but those two statements are kind of contradictory. I totally understand what you're saying however, because I thought the same way when I was first diagnosed.

The main thing to know is that "low GI" and "low carb" are two different things. Low GI means that the carbs in the food are released relatively slowly (compared to sugar), and that's a good thing even for a non diabetic. Unfortunately however, for many diabetics low GI is still not enough, and we may need to also restrict the amount of carbs quite drastically. So sadly, even things like brown rice and low GI bread can be bad for us.

It would be helpful, and we could offer much more detailed advice, if you posted up a full break down of a typical day's meals and snacks. Then we could really look at what type of things you could reduce and what foods you could replace those with, in order to get better dietary control of your pre-diabetes.

Your diet seems ok for a non diabetic Abri, it's actually very similar to how I was eating before I got diabetes.

I notice that, as is usual for most people, pretty much every meal is based around a starchy carb (bread, rice, cereal etc). This is the area where you can really improve things if you want to wind back your pre-diabetes and stop it progressing. It is however also the area where people often find it difficult to get their head around making any changes. After all, those starchy carbs are our low cost and convenient staples - and we're always told that they're an important part of a healthy diet.

What many of us find is that if we replace those starchy carbs with more veg (low carb) and some protein and especially fats to replace their calories that our blood glucose levels are greatly improved. I know it might seem difficult or unappetizing, but if you look over in the low carb diet forums (http://www.diabetes.co.uk/forum/category/low-carb-diet-forum.18/) you'll get lots of info and recipe ideas.

I'd recommend trying a low carb high fat diet for several weeks (it may take a few weeks for your body to really get adapted to using fats as you primary energy source instead of carbs) and see what type of improvement you get in your post meal BGLs.