My doctor said that I am borderline diabetic. He prescribed 500 mg of metformin, three times per day. My fasting serum glucose was 108 mg/dl [6.0 mmol/L] and my A1c was 6.1, without medications. I weigh 230 pounds and am 5 feet, 2 inches tall. I take water aerobics eight hours per week. This all came about because I have a difficult time losing weight! I also have high cholesterol, total 209, LDL 127, HDL 56, triglycerides 131, while taking Vytorin 10/20. Several folks have told me that this sounds normal to them and I’m concerned that I may not need the metformin.

Based on your fasting glucose and your A1c, I cannot tell that you really have type 2 diabetes for sure. The diagnostic criteria of the American Diabetes Association states that two blood sugars performed on a formal laboratory test need to be 126 mg/dl [7.0 mmol/L] or greater on separate occasions. Values of 100 to 125 mg/dl [5.6 to 6.9 mmol/L] fasting are consistent with impaired fasting glucose or pre-diabetes. Metformin has been formally tested in this setting of pre-diabetes. It was somewhat effective in preventing or delaying the onset of type 2 diabetes. However, intensive lifestyle was even more potent in doing this. One of the benefits of metformin is that it alleviates the insulin resistance and does not cause you to gain weight like other diabetes medicines can.

In the big picture, it sounds like you need to keep working on the weight loss by diet and exercise, as prescribed by your physician. Finally, there is no such term as borderline diabetic. Either you have diabetes or you don’t. Try to avoid thinking about diabetes in this way. Even if you have impaired fasting glucose, it does not mean you will not have diabetes. In fact, there is a high risk of developing diabetes in the future. In addition, people with pre-diabetes are already at increased risk for developing heart disease. Therefore, the medication your doctor has prescribed is helpful in decreasing your chances of developing heart disease.

JTL