Q: I am a 50 years old male who has been suffering from high blood sugar levels for the last one year. My fasting sugar level is 115-140 mg/dl and PP is 140-165 mg/dl. HbA1c ranges 6.5 to 7.1. I do exercises like walking and yoga for an hour regularly. I have not yet started taking any medicine. No sugar was reported in my urine. My blood pressure remains in the range of 85 -90 / 120-130 mm Hg with Olmetor (20mg) once every morning. Lipid profile is also in the normal range. What precautions do I need to follow in order to maintain my blood sugar levels?

A:For Diabetes Along with life style changes Metformin has been found to very safe drug 1.It prevent progression of Diabetes 2.If its used early its more effective in delaying progression of Diabetes 3.It helps to bring weight down 4.Very safe long term and medium tern,It can abdminal discoforte ,Nausea and Diarrhea but usually transient 5.Most patinet we reccomend sytarting with 500mg and increasing to 500mg three times day before along or after meals. 6.Its unsafe only if Creatinine is above 1.5 7.Yopu target hbA1c should be less than 6.5 8.If not on target with Max dose of Metform in sustain release form 2gm in divided dosages or Metformin plane 850 mg three times day,you may need another class of Medicatio Your Blood pressure is high as target BP should be 120 /80 rather appraoching 85 or even 135. You can increase youir Olmesartan to 40mg after discussing with yuour doctor. You should get annual check of Microalbumin urine retinal check ECG,TSH and Lipuds besides 3 montly Hba1C and 6 montly KFT and LFT .