Q: I am a 32-year-old male weighing 89 kg and my height is 5 feet 11 inches. My fasting sugar is always between 120-140, but my PP sugar is normal. Do I have some serious abnormality? Do I need to take any medicine? I am taking Lipril 5 twice daily for my BP. My BP is 130/90 after taking this medicine. Do I need to change my medicine? I also have fatty liver.What do I need to do bring my BP level to normal?

A:First, you should undergo an HbA1c test, which will determine whether or not you need any medication. HbA1c is a reflection of the overall sugar control, and most of the studies are based on this test rather than day-to-day basis sugar or random sugar. The HbA1c test measures a part of the red blood cells. Glucose in the blood attaches to the part of the red blood cells. This part can be measured, and gives a good indication of your average blood glucose level over the last 2-3 months. If it's higher than 6.5, then you need to discuss with your doctor and at least take Metformin 500 mg twice a day. Second, your BMI is 27.3, i.e., you are overweight (based on your height). You should reduce your weight to around 70-73 kg. Third, you have more fasting hyperglycaemia, which can happen in early diabetes. Lose weight and take fruits and vegetables regularly. Fourth, your blood pressure should be lower than 130/80. You should also get your urine microalbumin checked. If it is positive, then that would indicate early kidney damage and target of blood pressure becomes much lower.