Don't rush to meds for diabetes treatment

Q: My recent nonfasting glucose was 102, and my A1C was 6.21. My physician wants to repeat the A1C in three months, and, if it is still elevated, he will recommend oral diabetic medication. What is your opinion? I am 82.

A: Your blood tests do not unequivocally indicate diabetes. Even if these numbers were based on a fasting glucose and A1C, I would not recommend medication.

Nonfasting blood tests for diabetes, cholesterol and other disorders are not reliable enough to form the basis for a diagnosis. The tests measure not only what your body is making and storing, but also whatever fats, sugar, etc., were in the food you ate in last six to 12 hours. This is why most physicians order blood work when a person has not eaten anything since dinner the night before the testing.

I urge you to request a retest after fasting. This will provide a more accurate result. If your numbers are similar, you do not need medication. I believe that your numbers, however, will be even lower in the normal range.

If your numbers are abnormal, don't take any medication before trying nonmedical treatments, such as getting more exercise, losing weight if you are stout and cutting back on sugar and sweets.

Given your age and the normal blood-test results, I'd simply follow up with blood-sugar testing once or twice a year.