Oral diabetic medication

Hi there thanks for your generosity with this forum.  I have a question for you,  I was not diagnosed with diabetes, (my hemaglobin A1C was okay) but was on the high end of normal.  I know my blood sugars were running high for a while.  I have recently lost 25 pounds with diet and exercise and my sugars are pretty darn good, but I have been diagnosed with a "fatty liver" via CT and ultrasound.  It was found when my doctor checked the sugar, and drew a bunch of labs, I had elevated LFT's.  I don't drink at all ever, and never have, so they have determined I have NAFLD.  From the research I have done, this all could be related to insulin intolerance.  My doctor agreed and has suggested to put me on an oral diabetes medicine which I guess is the standard to treat it now a days.  My doctor is a family practice doctor and not an endocrine and I guess I will be followed by my FP for this. All of this is okay, but I do have a question for you.
Okay, finally, heres the question!  Once i am put on an oral diabetic medicine, does my pancreas get damaged in anyway and becomes more reliant on the pill?  Will it cause me any harm and possibly make me more prone to diabetes in the future?   Thanks so much!  Shannon

[Anita Ramsetty, MD]

Hi,
In general, diabetes pills do not "harm" the pancreas. Many do stimulate the pancreas to work harder to produce insulin, but others work in very different ways. My guess is that your doctor wants to place you on an insulin sensitizer like Rosiglitazone or Pioglitazone which are often used to treat NAFLD. As far as I know from the data, the use of these do not make you more prone to diabetes in the future(infact, a study in pregnant women with abnormal blood sugars showed that a trial with a related medication--Troglitazone-- decreased their progression to diabetes in future.)
Hope this helps,
take care.