I have been recently diagnosed with type 2 diabetes and my doctor wants to start me on combination drug. (I forget the name 2/500 once a day) My A1c was 7.8 and I had a fasting blood sugar of 161 mg/dl [8.9 mmol/L]. I am 5 feet, 8 inches, 260 pounds. I have been researching information that suggests diet and weight loss before taking pills. My doctor did not even write me a prescription for a glucometer. He just told me to come back in six weeks for another A1c test. Is this too high of a blood sugar to try diet and exercise? My blood pressure was high, 145/90, so he also started me on Zestoric.

Your A1c of 7.8% indicates that your average blood sugar is around 200 mg/dl [11.1 mmol/L], which is almost twice normal. If you came to see me, I would probably start you on carbohydrate counting so that you can learn to limit your portion sizes of carbohydrate each meal, some kind of regular physical activity which you can both enjoy and work into your busy schedule and blood sugar checks with a blood sugar meter before and two hours after one or two meals a day to get an idea about how your blood sugar is before and after you eat. This information would then help me to determine whether or not you need medicine and which medicine(s) would be best for you. I would probably start you on one insulin sensitizer, you were started on a combination (Avandamet is Avandia AND metformin together in one pill). I suggest you consider seeing a diabetes specialist for a consultant with a referral for nutritional counseling by a certified diabetes educator.

JS