When the American Diabetic Association recognized a
possible increased risk of diabetes in 1997 via blood sugar levels, they called
it impaired glucose tolerance. It is
diagnosed when a fasting blood sugar is between 100-125. Recently the Hemoglobin A1c was officially
added as one of the screening tools for diabetes. But that doesn’t translate into being a
screening tool for Prediabetes.
Prediabetes is not a disease per se, rather it means that
the risk of diabetes is there. Primary
care aggressively treats Prediabetes nowadays.
I will prescribe a medication commonly given in diabetes called
Metformin, especially if the patient is overweight. Metformin is the best medication by pill form
that reduces the Hemoglobin A1c.
Prediabetes, like Prehypertension denotes necessary
lifestyle changes. If lifestyle
modifications are not followed, the end result is the official diagnosis of
diabetes.
Eating a healthy diet, exercising regularly, and living an
active lifestyle all improve your chances of “curing” yourself of Prediabetes.
Update
on Rhinosinusitis
Recently the Infectious Disease Society of America released
first guidelines for treatment of Rhinosinusitis. These guidelines help PCPs in treatment of
upper respiratory symptoms.
Symptoms include high fever, facial pain, purulent nasal
drainage, and/or headache.
Be sure to call your doctor if you exhibit severe sinus
symptoms for more than 3-4 days, or a “double sickening or worsening” for 3-4
days or for unrelenting moderate symptoms for over 10 days.
These 3 examples all qualify for antibiotics. If improvement is exhibited after 3-5 days,
complete 7 day course of antibiotics. If
no improvement, then a CT or MRI is indicated.
I hope all you stay well during the upcoming rainy
season. The allergies will soon be upon
us. To partially quote Star Wars, “may
good health be with you.”
