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I’m taking 2,000mg of Metformin every day
You’ve maxed out metformin - if you’re taking it, you need to add something else. Technically, you should already be using insulin. If you’re not ready for that, ask you doctor about adding an additional pill or two from another class of diabetic medications. 
 

The longer your a1c remains elevated, the more your blood vessels are destroyed, increasing your risk of heart attack, stroke, kidney failure, blindness and limb amputation, among other problems.

 
The longer your a1c remains elevated, the more your blood vessels are destroyed, increasing your risk of heart attack, stroke, kidney failure, blindness and limb amputation, among other problems.
What about those of us that have a constantly (seemingly) elevated glucose but an a1c that never reaches the limit of diabetes?

Anything on that? I am going to see a doctor for an assessment in three days to be followed quickly by a physical, so it's not like I'm getting advice from just you, so feel free to give your take. 

 
What about those of us that have a constantly (seemingly) elevated glucose but an a1c that never reaches the limit of diabetes?

Anything on that? I am going to see a doctor for an assessment in three days to be followed quickly by a physical, so it's not like I'm getting advice from just you, so feel free to give your take. 
Weight loss and exercise, first and foremost. While there’s no great data on meds to prevent diabetes, it may be reasonable to take metformin if you only have prediabetes - A1c 5.7 - 6.4.

 
You’ve maxed out metformin - if you’re taking it, you need to add something else. Technically, you should already be using insulin. If you’re not ready for that, ask you doctor about adding an additional pill or two from another class of diabetic medications. 
 

The longer your a1c remains elevated, the more your blood vessels are destroyed, increasing your risk of heart attack, stroke, kidney failure, blindness and limb amputation, among other problems.
Thanks for the info, doc.  The 9.1% was taken while I was still on 1,000mg Metformin per day.  Last week, they increased the prescription to 2,000mg per day but I haven't had a blood draw since the prescription was changed.  

What about these meds I see on TV like Jardiance?   Any other meds I should perhaps be considering, short of switching to insulin?  '

TIA.  

 
johnnycakes said:
Thanks for the info, doc.  The 9.1% was taken while I was still on 1,000mg Metformin per day.  Last week, they increased the prescription to 2,000mg per day but I haven't had a blood draw since the prescription was changed.  

What about these meds I see on TV like Jardiance?   Any other meds I should perhaps be considering, short of switching to insulin?  '

TIA.  
There are tons of meds. Each have slightly different indications, many of which hinge on your other medical problems. Jardiance is especially good for diabetics with cardiovascular disease, in concert with lipid lowering therapy and blood pressure meds. Your doctor should know the stepwise progression from single drug (monotherapy) to multiple oral meds to injectables, including insulin. The ADA recommends dual therapy for anyone with an A1c > 9, including consideration of Insulin. A1c over 10 mandates insulin regardless.

 

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