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Tested for Diabetes, with blood sugar level 165. Should I start diabetes medicine?

this is the first time my randam blood sugar is 165 (HbA1C is 7.4) am i diabetic... do i have to start diabetic medicines now only? or if I do diet and exercise and reach back to normal blood sugar level? if yes what all the diet and exercise i have to do. now iam doing gym regularly. my e mail address is YYYY@YYYY
Asked On : Tue, 26 Mar 2013
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Internal Medicine Specialist 's  Response
Welcome to HCM,
Your Random blood sugar is 165 mg/dl but your HbA1c level is 7.4 % which is high so what you need to do is to check your Fasting blood sugar level and Postprandial blood sugar level as FBS .125 and PPBS > 200 mg is criteria for diagnosing diabetes and if tests are abnormal then decide about treatment.
You can take diabetic diet with 25 K cal/kg body weight and avoid refined sugar take good balanced diet of proteins,complex carbohydrates and fats,please continue exercise and if you are overweight try to reduce to near ideal weight.
In such cases we also like to check Lipid profile so as to advise regarding control of lipids.
Even if your blood sugar is controlled then monitor with FBS and PPBS every month and HbA1c every 3 months.
iF reports are abnormal then visit a Physician or Endocrinologist to get prescription of appropriate treatment.
Good Luck.
Answered: Tue, 26 Mar 2013
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Internal Medicine Specialist Dr. Mayank Bhargava's  Response
Jan 2013
Thanks for posting your query.
Diabetes is a multi organ disease with involvement of almost all organs of body due to its complications.
Blood sugar both fasting and postprandial must be in controlled range.
Diabetes is due to progressive loss or destruction of beta cells in endocrinal part of pancreas.
When diabetes has been diagnosed, less than 20% beta cells remains in pancreas and progressive destruction of beta cells is still continuing.
If we look at your random blood sugar, then there appears to be no need of any treatment while at the same time HbA1c is on higher side.
You should consult with internal medicine specialist/ endocrinologist and should go for thorough check up.
You should also go for complete blood count, blood sugar both fasting and postprandial, serum C peptide level, renal function test, lipid profile.
Diabetes can be controlled either by use of oral tablets or by use of insulin.
If diabetes has been diagnosed in your case then diet restriction and exercise may be helpful for control of sugar but not sufficient for control.
Take care,
Dr. Mayank Bhargava
Answered: Tue, 26 Mar 2013
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General & Family Physician Dr. Jay Patel's  Response

The answer to your question is "YES" you will need to take medication along with exercise well as healthy diet.

Normally for the BORDER LINE DIABETIC- ( HbA1C-7.0-7.1) or 120-130 mg/dl, exercise and the diet modification will be a great help and may no need any kind of medicine,

But in your case your have HbA1C -7.4 OR 165 mg/dl , is to much to to taken care by exercise / diet control alone, as far as exercise and diet control alone is concerned it will help to work of difference of 10-15 mg/dl. so to cover another 40 mg/dl in your case help of medication is needed.

More over the diet and exercise are variable factor , as some day your eat alot of sugar but to a birthday celebration, other day due to climate problems may not be able to reach the GYM , and the long term commitment for the hardcore exercise and diet is very rare to see according to long term research, more over extreme exercise will give greater toll on the bodies joints as well, leading to joint problems in future.

So best treatment is combination of all 1) exercise, 2) diet control 3) medication. This regimen will take you to long way.

1) Fiber-rich foods- Fiber can decrease the risk of heart disease and help control blood sugar levels. (such as vegetables, whole grains, legumes (beans, peas and lentils) and low-fat dairy products.
2) Good' fats - such as avocados, almonds, pecans, walnuts, olives, and canola, olive and peanut oils.

3) Foods to avoid - Deep fried , high oil, high cholesterol and high complex carbohydrate diet.

Best way is to monitor daily intake of food and calorie , recommend calorie is about 2000 kilo calorie, so needs to check how much you eat rather the what to eat.

Answered: Tue, 26 Mar 2013
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