Q: I am a 55 years old male who underwent HbA1c test recently. My glucose fasting is 105 mg/dl, cholesterol is 218 mg/dl, LDL cholesterol - 139 mg/dl and HbA1c is 6.40%. My urine test showed 75 -120 WBC/HPF (much reduced compared to last year). Does this require any medication?

A:Your labs suggest evidence of borderline diabetes (prediabetes). Normal fasting blood sugar is <100. I would suggest you getting a 2 hr 75gm oral glucose tolerance test done and if it is >200 it is suggestive of diabetes, if 140-199 it is suggestive of prediabetes (impaired glucose tolerance).

The first step in management would be watching your diet specially the calories, fat and carbohydrates and increasing the activity. This will help lower your cholesterol as well. Monitor blood sugar at home before meals and two hours after meals randomly. If BG still high after diet and exercise, see your doctor to initiate medical treatment The urine result that you have reported as increased WBC cannot be interpreted without looking at the whole urine analysis result. Usually urine WBC is looked at for determining evidence of urinary tract infection and comparing it with previous year's result does not carry any significance.