It's easy to get answers about health and nutrition! Just send your question by email to email@example.com and Dr. Harlan will respond to selected questions of general interest. Answers will be posted in the Ask Dr. Gourmet newsletter (sign up now!) and archived in the Ask Dr. Gourmet section of the website.
I have heard from doctors or nurses that if you are prediabetic you are really a diabetic. Or if you are taking Metformin that you are diabetic. Is that true?
In the last few years the criteria for diagnosing diabetes has become much more stringent. This is because we know now that even modest elevations in blood sugars can have a devastating effect in the long term. Presently, the diagnosis is made when the morning fasting blood sugar is greater than 126 mg/dL.
We are, however, concerned when fasting blood sugars are consistently greater than 100 mg/dL. Likewise, those with fasting blood sugars that are higher than 110 mg/dL are considered by some to be "prediabetic." (Note that there are groups that believe that a fasting blood sugar > 100 mg/dL should be considered prediabetic.)
Another test that your physician might do is the Hemoglobin A1c (Hgb A1c). This test gives us a longer term, three month look at average blood sugars.
Less than 5.7% is considered normal.
5.7% to 6.4% is considered prediabetic.
Greater than 6.5% is considered diabetic.
Metformin is a drug that has been shown in some research studies to help those with prediabetes prevent worsening of the condition. For many, this is an excellent choice.
There is certainly another choice. It is clear from excellent research that diet and exercise can have a profound effect on Type 2 diabetes. You can find out more about the best research on diabetes and diet here:
And there are excellent resource for exercises here:
It is clear that while using medications such as metformin can make a big difference, treating prediabetes with lifestyle change is clearly the best choice. Making that choice can clearly prevent diabetes and its associated conditions, such as high blood pressure, heart disease and stroke.
Thanks for writing,
Timothy S. Harlan, MD, FACP