Is HbA1c 6.2 % a diabetes concern?
Patient's Query
Hello doctor,
My wife's fasting glucose is 131 mg/dL. Her post lunch glucose level is 121 mg/dL and urine does not contain sugar. Her HbA1c (glycated hemoglobin) is 6.2 %. Her height is 5 feet and 4 inches and weight is 149 pounds. What to do now?
Hello,
Welcome to icliniq.com.
By these laboratory readings she has prediabetes (blood sugar levels are higher than normal but high to consider it as diabetes). This should be treated. What to do will depend on a lot of factors. You have not provided any other medical history, family history, other medicines, lifestyle, etc.
Patient's Query
Hello doctor,
She had gestational diabetes 13 months back and that got reduced immediately after delivery. Seven months back she got it checked as completely normal. Her father had diabetes. Due to baby care, she is having irregular sleep pattern. She cannot control hunger and does not drink water much. She drinks only 51 ounces a day. Please guide us.
Hi,
Welcome back to icliniq.com.
Both gestational diabetes and family history are strong reasons to treat prediabetes. There is a possibility for natural progression to develop diabetes in next couple of years unless patient lose at least 5 to 10 % of body weight and maintain it. Is the patient breastfeeding right now?
Patient's Query
Hello doctor,
No, she is not breastfeeding right now. Also, she had GDM in 8th month only. Will she need any medications for life-long to treat prediabetes? Will diet control and weight reduction help her situation? Please guide.
Hi,
Welcome back to icliniq.com.
The prediabetes range is HbA1c (glycated hemoglobin) 5.7 % to 6.2 %. Diabetes is 6.5 and more. She is closer to diabetes range and having a history of gestational diabetes mellitus (GDM). Her father with diabetes puts her even at higher risk of progressing to diabetes. I would recommend low dose tablet Metformin which will keep her in the prediabetes range for a long time. Weight loss is always helpful, but I recommend doing treatment and weight loss both, not either or. The recommended dose of tablet Metformin for now would be 500 mg with dinner. She should have follow up HbA1c (glycated hemoglobin), creatinine and GFR (glomerular filtration rate) in four months to evaluate its effect. If she is not breastfeeding, then she can start the treatment.
Patient's Query
Hello doctor,
Is it necessary to take the medicine lifelong or only for four months?
Hello,
Welcome back to icliniq.com.
If she achieves significant weight loss of at least 5 to 10% of current bodyweight and the HbA1c (glycated hemoglobin) drops below 5.7 %, then she can come off tablet Metformin. She will require follow up to make sure it is not going up again, which is what happens with natural progression. Treating prediabetes is still much better than treating diabetes at which point complications can set in.
Same symptoms don't mean you have the same problem. Consult a doctor now!
Endocrinology
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