should someone who has a 'diabetic marker' be put on medication for diabetes?

[eldercare]

I am concerned for my daughter in law.  She has not been diagnosed with diabetes (adult) but the doctor says she is borderline and has a "marker".  The doctor put her on diabetic medication anyway.  

I feel this is wrong and her body will become dependent on the medication so she will need it.  I think she is at a point where it can be controlled by healthier options.  

I have mentioned this to her, she is watching her diet now and not eating a lot of sugar, but it really doesn't mean anything coming from me.  I think she is being "set up" to be dependent on medication.  

Please give me your thoughts so I can pass them on to her.  

Also, is a "marker" nothing more than " other family members have had it?

Thanks you for your insight.

Karen

[JDRF Team SGG]

What I have read from other type 2 diabetics and from many articles about both types of diabetes, many type 2 diabetics can go off their medications eventually if they change their diets, lose weight and exercise. If this is true, then dependency is not an issue or these other type 2 diabetics would never be able to go off their oral medications after making these changes in their lifestyles. You said that her doctor says her glucose levels are borderline. That would seem to imply to me that they must be elevated, and he is putting her on medication to lower them. Borderline usually refers to elevated glucose levels that aren't frighteningly high yet. So it sounds as if her doctor is acting to protect her from the damages that high glucose can cause. This is smart, for those of us who volunteer for the Juvenile Diabetes Research Foundation often hear of people who develop complications even though they have not been diagnosed with diabetes for very long -- damages can happen quickly in some people if glucose levels are allowed to remain high. So taking medications to lower those sugar levels sounds like a smart plan.

If your daughter-in-law changes her lifestyle and loses weight, she might start getting hypoglycemic. She will know if her sugar levels are dropping too low, for she will have symptoms of fatigue, irritability, and other symptoms that you can do a Google search on to find out about. If this happens, or if she checks her glucose levels and they are below the normal range of 70-126, she can talk with her doctor and lower her medication. WIth some work and a little time, maybe she can go off the meds entirely since she is being helped before developing out-of-control full diabetes.

By the way, I have read articles about studies that seem to indicate that starting medications or even starting to take insulin BEFORE full diabetes is diagnosed, in other words, while the pancreas is still functioning even if poorly and before it gives up the ghost, seems to be suggested in order to prevent or delay the onset of full diabetes. I personally believe that her doctor is doing the right thing to protect her health.

[sandyhandz]

Hello -

I'm a nurse who also has diabetes, but I am in no way any kind of expert on the subject.  

Does your daughter-in-law have polycystic ovaries also?  Because Metformin (typically a diabetic medication) is used for women with PCOS and doesn't really affect their blood sugars.  If she is trying to become pregnant, the Metformin helps overcome the PCOS problems.  

If her doctor started her on medication for her "borderline diabetes", her blood sugars must have been of concern.  If someone's blood sugars are under good control, even if they're at risk, I've never heard of dr's starting them on medication.  

I'd suggest she really make a lot of changes on her diet and exercise regimen to help reduce the chances of needing the medication.  

I sure wish my mother-in-law were as concerned about me as you are about your d.i.l.!

[JDRF Volunteer CDB]

Even though this is a type-1 forum, and I'm here because of my type-1 daughter, my husband and his family are almost all type-2 diabetics, so I have some familiarity with it. From what I know (and I am not a doctor), the kind of medication they take does not encourage any kind of dependency. All it does is help the pancreas become more efficient and do a better job of producing insulin. Diet and exercise can also help achieve the same thing. Often if the type-2 diabetic becomes more active and loses 10 to 20 pounds, their need for medication diminshes or even goes away.

She is absolutely right to stay focused on the diet and exercise, but in the meantime the medication may be essential to keeping her blood sugar stable. She may well be able to give up the medication later if she is successful with diet and exericse.

Good luck!

[eldercare]

Thank you so much for an immediate response and I will do as you suggested.  God Bless.

[JDRF-Team-JW]

Hi Karen,

I am a Type I Diabetic and not a health professional. It seems that your daughter has been diagnosed with Type II diabetes. Without knowing more about her situation: her blood glucose numbers and other factors, it would be hard to determine whether or not the doctor made the best choice by putting her on medication. Type II diabetes can be treated with diet and excercise but that's not always the case. It may be that your daughter-in-law's physician put her on medication (pills, I assume) to help her bring down her sugar at these early stages. She might be able to control her diabetes with diet and excercise later on.

I'm not sure whether or not she can become dependent on the medication. What medication does in Type II diabetics is aid the person's pancreas in producing insulin. In Type I patients the pancreas produces no insulin at all. Is she feeling better since taking the medication? I hope she is seeing an endocrinologist who can guide her through this process and help her manage her diabetes. Not eating a lot of sugar is not the only factor in controlling diabetes. One has to watch all carbohydrate intake and know how their body reacts to certain foods in order to be able to control their blood sugar.

You seem like a caring, concerned mother-in-law. I encorage you to speak to your daughter-in-law and ask if she'd mind telling you more about what she knows regarding her condition and what was said by the doctor. I would also suggest you support her in her endeavor do deal with this, often times, frustrating condition. Perhaps both of you could do some research together (posting a question on this forum was a good start)and learn as much as possible about Type II diabetes. Encourage her to speak with an endocrinologist and ask as many questions as she can. That way it'll be easier to determine whether her treatment is right for her.

Good luck to both of you and feel free to post on this forum should you have any more questions.