Question: I was diagnosed with type 2 diabetes about two years ago and am not taking medication for it. My last A1c (done at the Diabetes Expo in Boston) was 6.8%. My concern is that fasting numbers— which used to be 120 to 140— are now around 150 to 160. Should I be concerned?
Answer: Yes, your fasting numbers are a concern. Upon diagnosis, it is estimated that at least half of the insulin-producing beta cells are destroyed. That leaves about half of them to carry the torch of producing insulin so they need protection from further destruction by preventing an environment of hyperglycemia. If you are 160 before breakfast, how high is your glucose two hours after? The probability of a rising A1c is high. The question that merits investigation — has something changed in your life that explains the rise and can be addressed (like pain or sleep disturbances in the night) or does your pancreas just need a little medicinal help to keep the trend from continuing? This needs in-person evaluation by a diabetes savvy professional. Some may say not to worry about a 6.8%. Others may take a preventative approach and recommend a typical front line drug (like metformin).
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