provlima

Pre t2 for 15 years with A1C of 6 .....should I be on metformin?

9 posts in this topic

I have been diagnosed a pre diabetic for 15 years with my A1C hovering around 6 all those years.

 

My doctor doesn’t seemed concerned about it, and I’ve followed his advice to lay off the carbs. He has never suggested any drug therapy.

 

Last May I started daily BG testing and "eating to the meter",  but there has been no significant change in my A1C,  despite my strict low carb diet .

 

I am wondering if my  long term condition might be causing damage resulting in possible future health problems. I am thinking  if taking a drug like metformin might affect my A1C in a positive way.

 

Is there a downside to this drug?

 

I realize that the 6 reading is relatively good compared to those on this board who have higher readings, but still want to bring that reading lower and if its possible to do it why not try.

 

Would appreciate any comments from those who have been dealing with pre diabetes.

kooka likes this

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My situation is similar to yours, however, my A1c was in pre diabetic territory for around four years when I requested to be on Metformin.  I'm a thin exerciser, but T2 is in my family so I guess I'm genetically predisposed to it.  When my A1c hit the high 5's I also bought a meter and drastically cut my carbs.  Initially, my A1c dropped to 5.5, but then it crept back up again despite hardly eating any carbs for the next 4ish years. When it hit 6 I asked for Metformin, which I've been on for around three years.  On Metformin, my A1c bounces back and forth between 5.6 to 5.9, with my last two staying at 5.7.  As far as a downside to Metformin, I've been lucky in that I haven't experienced any of the digestive issues and diarrhea that a lot of people do taking this drug.  It hasn't lowered my A1c as much as I had hoped.  I think that may be because I'm not classically insulin resistant, meaning my fasting insulin has always been low before Metformin and continues to be the same on Metformin.  Also, my fasting glucose has always been normal, in the high 80's to low 90's.  My husband, on the other hand, is overweight and has high fasting insulin and slightly elevated fasting glucose.  When he takes Metformin, his fasting insulin and glucose goes down in addition to his A1c, and he loses a little weight.  Unfortunately, he does experience the digestive side effects so he's not as diligent in taking it as he should be.  You can always give Metformin a try to see if it does anything.  I'm on the ER form, which I've read is easier on the stomach (two 500 mg per day).  I'd also like to add that I've read that non-diabetic women going through menopause often experience a rise in their A1c, as well as older men, and it is theorized that this rise may not be glycemic based.  Have you had your fasting insulin tested? That would tell you more regarding insulin resistance.  Also, if you have weight to lose, you may want to start there before the Metformin.  The strange thing with me is that that when I added carbs back to my diet in the form of bread, my A1c actually went down from 5.9 to 5.7 and stayed there for my last two tests.  So, I'm eating bread in moderation and as long as my A1c does not go back up to 6 I will continue.  Good luck to you!

kooka and TX_Clint like this

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My doctor accepts 6.0 as good for older people. I doubt if it would lead to complications. The ADA now says 7.0 for elderly people but I disagree. Some doctors want you in the mid 5's. It would be great if they would all agree on something but thats doubtful.

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I have been on the max of ,etformin for 10 years and my HBA1 c has never gone much below 5.9. In the past 5 years it has been between 6.4-6.8. So sometimes even with low carb diet, meds and exercise, your HbA1 c does not get better. My strategy is just not let it go higher.

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Some additional thoughts. Hba1c is an Average. BG can be high and equally low for similar lengths of time and still give nice numbers. Lower Hba1c are more work with smaller gains. Diminishing returns.

 

There may be more benefit by ensuring 1 hour after eating BGs are below 7.8 mmol or 140. This has been known as the threshold for neuropathy down the road.

Fraser likes this

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My goal after diagnosis was to delay going on meds for as long as possible.

That's still my goal.

That's a great goal if it works for you.  Cutting out carbs and being an avid exerciser with no room to lose any weight (barely weighed 105 lbs) did nothing to lower my A1c to normal.  I needed Metformin which only managed to lower it to 5.6 at best.

cbokay, ran23 and gabrielo like this

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My goal after diagnosis was to delay going on meds for as long as possible.

That's still my goal.

I so agree with you about the drugs.  And exercise and diet is everything.  I'm positive of that.  Now to exercise more so my fasting BGs will be under 99 mg/dl every day.

gabrielo likes this

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I have been diagnosed a pre diabetic for 15 years with my A1C hovering around 6 all those years.

Sounds like your body has it under control. If it were me, I'd get a more accurate test (not an a1c) before going on drugs.

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