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When is Metformin or Invokana prescribed?

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Posted on Sat, 30 May 2015
Question: On 5/28/15 I had blood work done and my12 hr fasting blood sugar was 106. 6 months ago my FBS was 97 and 6 months prior to that my FBS was 96. Today, my FBS was 96. My Doctor wants to put me on Metformin or Invokana. I am against taking any medication since my FBS have been within the normal range. (Lab's glucose range is74-109). I would like to know if I should take one of these medications. Presently I am on synthroid 50 mcg daily and Pravastatin 20mg daily. I am otherwise healthy. However, I suffered a knee injury in January 2015 and have not been given the okay to exercise. Yhank you fore your response to my question.
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Answered by Dr. Klarida Papaqako (1 hour later)
Brief Answer:
If all labs are within normal limits- no need for medications

Detailed Answer:
Hello,
Thank you for using HCM,

I read carefully your description and I fully understand your concern.

From what I am understanding every time you have measured your FBS it was within normal limits.
The criterias of diagnosing diabetes and deciding to start on medication are, any of the:
--fasting blood sugar ≥ 126 mg/dL (7 mmol/L), on at least 8 hours fasting.
-- symptoms of hyperglycemia such as frequent urination, drinking lots of water, blurred vision or hyperglycemic crisis with random plasma glucose ≥ 200 mg/dL (11.1 mmol/L)
-- 2-hour plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during 75 g oral glucose tolerance test
-- HbA1c ≥ 6.5%

So, if you have done any of those, and because of their results your doctor suggests to start on those medictions, then I would agree with him/her.
Otherwise, if only what you are telling me, makes the doctor advise to start with Metformin, then I would not agree, because its not needed.

Keep eating a healthy diet, drink plenty of fluids, check your blood sugar from time to time fasting and 2 hours after eating, and if it is within normal limits in general, then you you doing fine.

Hope this is helpful. Let me know if you need any further clarification. I would be happy to answer.

Take care.
Dr. Papaqako
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Klarida Papaqako

General & Family Physician

Practicing since :2010

Answered : 1783 Questions

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When is Metformin or Invokana prescribed?

Brief Answer: If all labs are within normal limits- no need for medications Detailed Answer: Hello, Thank you for using HCM, I read carefully your description and I fully understand your concern. From what I am understanding every time you have measured your FBS it was within normal limits. The criterias of diagnosing diabetes and deciding to start on medication are, any of the: --fasting blood sugar ≥ 126 mg/dL (7 mmol/L), on at least 8 hours fasting. -- symptoms of hyperglycemia such as frequent urination, drinking lots of water, blurred vision or hyperglycemic crisis with random plasma glucose ≥ 200 mg/dL (11.1 mmol/L) -- 2-hour plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during 75 g oral glucose tolerance test -- HbA1c ≥ 6.5% So, if you have done any of those, and because of their results your doctor suggests to start on those medictions, then I would agree with him/her. Otherwise, if only what you are telling me, makes the doctor advise to start with Metformin, then I would not agree, because its not needed. Keep eating a healthy diet, drink plenty of fluids, check your blood sugar from time to time fasting and 2 hours after eating, and if it is within normal limits in general, then you you doing fine. Hope this is helpful. Let me know if you need any further clarification. I would be happy to answer. Take care. Dr. Papaqako