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javagate

Courious... At what point do you think people should go on meds for T2

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javagate

Based on A1C, random numbers, fasting ? And at what actual number? I think some of the answers should be based on age , weight and amount of activity. Thanks for your thoughts

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apollo322

Good question, since I may be answering this question real soon:) For me it's always been if I couldn't keep my fasting numbers in the 90's-low 100's , if I saw spikes after eating even low carb over 140 more than once and if my A1c was 6.2 or higher.Truth is there is no logical hard and fast answer for any of it, and to be honest if taking something makes your numbers consistently better AND has no or limited side effects then why not do it now? My only answer is I'm a stubborn mule who used the med free thing as motivation to do what we all must do to get healthier. But now? Those things are ( thank god!) habits now....

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control
Based on A1C, random numbers, fasting ? And at what actual number? I think some of the answers should be based on age , weight and amount of activity. Thanks for your thoughts

No, the number should be based on one's ability to keep as close to normal blood sugars as possible without meds. If the person cannot do it by diet and exercise alone, it doesn't matter how old, how skinny or how active he or she is. Those are irrelevant criteria.

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javagate
Good question, since I may be answering this question real soon:) For me it's always been if I couldn't keep my fasting numbers in the 90's-low 100's , if I saw spikes after eating even low carb over 140 more than once and if my A1c was 6.2 or higher.Truth is there is no logical hard and fast answer for any of it, and to be honest if taking something makes your numbers consistently better AND has no or limited side effects then why not do it now? My only answer is I'm a stubborn mule who used the med free thing as motivation to do what we all must do to get healthier. But now? Those things are ( thank god!) habits now....

 

I wouldn't think getting to 140 after food alone would require meds.

 

At 200+ yes.

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apollo322
I wouldn't think getting to 140 after food alone would require meds.

 

At 200+ yes.

 

You are absolutely right, it doesn't require meds. It's more of a personal line of demarcation since that's where damage could begin to occur. You could wait until over 7 and 200 post prandial numbers if you like and the medical community would be fine with that.

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javagate
You are absolutely right, it doesn't require meds. It's more of a personal line of demarcation since that's where damage could begin to occur. You could wait until over 7 and 200 post prandial numbers if you like and the medical community would be fine with that.

 

I don't like getting to 140 either. Even 130 scares me

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jwags

When I was first dx'd my fasting was 242 and I was not put on meds. Since I was thin and fit my doctor thought I could manage it with diet. But after 3 months I couldn't get fasting below 160 so I asked for meds. The metformin has really helped my liver not dump glucose.

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Aggie

I'm curious about this too. So far on low carb my fasting is 98-105, and after meals I've never seen it hit 140 1 hour PP, though it hit 138 just once (uh, slight problem involving refried beans and a corn tortilla at a Mexican restaurant) it's more typically well under 120 at all times. I don't know what would happen if I wasn't low carb, but I think it wouldn't be good. And since so far my A1c is in the 5.6 range, I think I'll just wait and keep doing what I'm doing. I'd consider meds if my A1C goes over 6.0 and/or I see a trend upward in the blood sugar numbers.

 

I'm pretty leery of metformin because it's an appetite suppressant and really, I don't need that. Trying very hard to keep weight on, so far it's working. So it's good incentive to remain low carb.

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samuraiguy

My line in the sand to explore medication possibilities is when I have higher than "normal" A1C's (for me over 5.6) and/or cautionary FBG (95 plus) for more than two weeks. If my 1 and 2 hour PP don't stay under 140 without exercise eating my regular lower (not low) carb diet--I exercise after I eat and rarely go over even 120, usually stay under 110--then I will look at perhaps adding 500 mg Met back. I'm not so concerned however with an occasional spike over 130, even 140 as I check family and friends at carby food gatherings and many of them test briefly above those numbers even though they are definitely non-D or pre-D.

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Seagal

I agree with Control (post #3), but there are different ideas about it. If you were to follow Dr. Richard K. Bernstein's protocol, if you couldn't keep your numbers in the 83-85 (with diet & exercise)range throughout the day, he would have you on oral meds and if that didn't do it, insulin. He believes that all diabetics deserve non-diabetic numbers. So, if your numbers were 90-100 fasting and over 100 PP, you would be on meds/insulin. My dr. won't prescribe meds until I reach an a1c of 6.5.

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Calgal98

I was 6.1A1c when first diagnosed. My reg doc put me on met. After much reading I decided to ask for an increase. I took a home A1C yesterday after a week in Hawaii and got a 5.2 That's just where I want to be. I also take glypizide, as I'm paranoid about those occasional slides into 140+. I test way too much, but like to have tight control (I'm ocd). I follow a low carb regimen, but will occasionally have something off program. My morning numbers are now usually under 100. That's the number that I keep an eye on. I'm on 2.5 mg of glyp, and 2000mg of Met xr.

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randian

I think the big question is what kind of control do you want? I want tight control so I take insulin. 2-3 units (rarely 4) for a meal, and not only are my peaks lower but my pre-meal and fasting numbers are much better too.

 

Most endos would probably be perfectly ok with my diet-only numbers. I wanted to do better than merely "acceptable".

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Caravaggio

For me it's keeping my blood glucose within a range that lowers the risk for complications while at the same time maintaining a quality of life acceptable to me.

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Maggiegong

I share the belief that the ideal is to have levels ALWAYS in the non diabetic range. Here is my conundrum however. When considering upping the Metformin from the current dosage of 500 mg per day (ER) to possibly 1000 which of the numbers is most important? Last two A1C readings have been 5.4. I very very rarely spike over 140 after a meal but I just can't stop my fasting readings from wavering between 100 and 110. I think this is too high but the other good measures mean the doctor is reluctant to up the meds. I don't get lows so the A1C isn't a false average. Walking huge distances everyday when I was travelling overseas helped the fasting levels but it's unsustainable unless I stop working to fit it in my day. The question is still WHICH numbers count most?

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samuraiguy
For me it's keeping my blood glucose within a range that lowers the risk for complications while at the same time maintaining a quality of life acceptable to me.

 

I agree, I believe there is a balance between surviving with diabetes and thriving with diabetes. I wouldn't want to live one more extra day eating a diet I had to "force" myself to enjoy, but am also cognizant I can modify my favorite food (and their portion size) to be less "spiky" and still remain under my goal blood glucose numbers. If there comes a day that meds have to help me do that, then I'll just work it into my already fairly tight management routine.

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apollo322
I share the belief that the ideal is to have levels ALWAYS in the non diabetic range. Here is my conundrum however. When considering upping the Metformin from the current dosage of 500 mg per day (ER) to possibly 1000 which of the numbers is most important? Last two A1C readings have been 5.4. I very very rarely spike over 140 after a meal but I just can't stop my fasting readings from wavering between 100 and 110. I think this is too high but the other good measures mean the doctor is reluctant to up the meds. I don't get lows so the A1C isn't a false average. Walking huge distances everyday when I was travelling overseas helped the fasting levels but it's unsustainable unless I stop working to fit it in my day. The question is still WHICH numbers count most?

 

I honestly think the a1c is the most important. While a lot of emphasis is placed on fasting its a pretty easy number to get "wrong" by testing too far after waking , or some other cause of a liver dump. If your all day average is relatively low- and to me 5.4 is fantastic- I wouldn't consider a med.

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javagate
I honestly think the a1c is the most important. While a lot of emphasis is placed on fasting its a pretty easy number to get "wrong" by testing too far after waking , or some other cause of a liver dump. If your all day average is relatively low- and to me 5.4 is fantastic- I wouldn't consider a med.

 

I like the 5.4. No meds needed I agree :) :) :)

 

Here's one thing to keep in mind :)

 

Using these figures (A1C, Fasting, etc) to: Identify and Diagnose PD and T*.

and

Using these figures to: Manage ourselves.

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Toolbox
I honestly think the a1c is the most important. While a lot of emphasis is placed on fasting its a pretty easy number to get "wrong" by testing too far after waking , or some other cause of a liver dump. If your all day average is relatively low- and to me 5.4 is fantastic- I wouldn't consider a med.

 

I've often wondered if I'm waiting too long to test in the mornings...after showering, shaving, getting dressed and then testing. Still in the 102-107 range by doing this, but would rather be in the 90's. And I'm really not sure what it means if I do test earlier and I'm in the 90's and then 30 minutes later I'm back in the 102-107 range before eating.

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