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AskNadia: Am I a Type 2 Diabetic

My HbA1c was 6.8% last December, and as of April this year my HbA1c is 5.3%. Am I diabetic? I am taking 500 mg of metformin and 20 mg of teneligliptin 20 mg/dL.

Fasting blood glucose is 115 mg/dL, and after exercising/walking for 30 minutes, my blood glucose is 134 mg/dL. Does this put me at risk for being diagnosed with diabetes? Can you help me solve this issues?
Thanks
Gopi

Dear Gopi:

If your Physician has put you on metformin, it usually means they are trying to stabilize your blood sugars. An A1C of 6.8% means your average blood sugar reading for the last 60 to 90 days is 148 mg/dL. People without diabetes experience blood sugars between 70 and 140 mg/dL.

Metformin

Metformin was introduced to the U.S. market from France in 1995. It’s discovery dates back to 1922, and it is the least expensive medication both domestically and internationally. The World Health Organization considers it a necessary drug for therapy with an affordable price tag for most patients. Even in the U.S. metformin is the least expensive medication for people living with type 2 diabetes.

How it Works

Metformin is effective as the first line of therapy for insulin resistant type 2 diabetes patients because it stimulates the pancreas to produce more insulin. The oral medication has some side effects that can be intolerable; gas, abdominal pain, diarrhea, and nausea. Everybody responds to the medication differently. You may have been lucky and experienced none of these side effects.

It is important to mention, sometimes people are allergic to the medication and have to go to a compound pharmacist to make a custom metformin cream that is tolerable for the patient and helps maintain normal blood sugar levels.

Over time, metformin can become less efficient in preventing high blood sugars, even after you watch what you eat and exercise. Augmenting metformin with anther medication to achieve healthy blood sugar levels is the second line of therapy.

Teneligliptin

Teneligliptin is Dipeptidyl Peptidase-4 also known as a (DPP-4) inhibitor. It is prescribed when a patient living with diabetes is unable to maintain normal blood sugars with diet, exercise and an anti-diabetic medication like metformin.

The DPP-4 Inhibitor teneligliptin was approved in Japan in 2012. It is marketed in Korea, India, and Japan.

In the U.S. we do have other DPP-4 Inhibitors physicians prescribe; JANUVIA, Onglyza, Tradjenta, and Jentadueto X.

Teneligliptin Works Differently Then Metformin

Metformin stimulates your pancreas to make more insulin while the DDP-4 inhibitors work by increasing hormones that stimulate your pancreas to produce more insulin and stimulate the liver to produce less glucose.

Your Fasting Blood Sugars

Your blood glucose readings of 115mg/dL and 134 mg/dL are what you would expect from a person without diabetes as it falls within the 70 to 140 range. Where it can be confusing is when you consistently experience normal blood sugars . So, how can you have diabetes? The reality is that your blood sugars are not high because of the two prescriptions you are taking in addition to exercising.

Kudos for a job well done. You have found the perfect balance with exercise and the two medications in preventing high blood sugars. Your results are phenomenal. Keep doing what your physician recommends. You are a doctor’s dream, achieving blood sugar reading in the non-diabetic range, assuring you the risk for diabetes complications is less likely in the long run.

Source:

Diabetes Health Type 2 Medication Chart

Joslin

DPP-4 Inhibitors Teneligiptin

Disclaimer:

Nadia’s feedback on your question is in no way intended to initiate or replace your healthcare professional’s therapy or advice. Please check in with your medical team to discuss your diabetes management concerns.

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About Nadia:

Nadia was not only born into a family with diabetes but also married into one. She was propelled at a young age into “caretaker mode,” and with her knowledge of the scarcity of resources, support, and understanding for people with diabetes, co-founded Diabetes Interview, now Diabetes Health magazine.

Nadia’s Blog is named the “Best Diabetes Blog for 2017” by Healthline. She has also received 19 nominations for her work as a diabetes advocate.
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2 thoughts on “AskNadia: Am I a Type 2 Diabetic”

  1. Hi Nadia,

    I am type II diebetic and I take Metformin 250 mg Twice a day and Glemepiride 3mg in morning and 1 & 1/2 mg at night I also take 14 points of Insulin using Solostar lantus. My 30 days average reading is 139 mg/ dl. I exercise 2 hours six days a week. Can you advise diet for me??

  2. Recent diabetes conferences have called into question what an A1c does and doesn’t mean, but it is all we have, except for the finger stick reading of an instant in time. I have T1D for 57 years, but have studied pre-diabetes and type 2 as well. The looming epidemic of type 2 is scary for the country and the health system (it is estimated that there are 86 million people in the US with pre-diabetes, but 90% of them are undiagnosed). I congratulate Gopi on her exercise and compliance with her medications. At least her doctor has tested her and is paying attention.

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