A1c numbers

Discussion in 'Medical Topics' started by Oh No, Mar 8, 2019.

  1. Oh No

    Oh No Guest

    87 year old man 6 foot 175 pounds has A1C number 6.5. has been that number for 3 years on metformin. (Asper my AME)
    My new Dr (not a AME) say my A!C is great for my age, and I no longer need metformin.

    My beliefs the reason my A1C is at 6.5 is because of the Metformin.

    Should I stop taking it?
     
  2. rk911

    rk911 Line Up and Wait PoA Supporter

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    second opinion time.
     
  3. WannFly

    WannFly En-Route

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    As far as I know (not a dr) once you are on metrormin it’s on for life. Check with another dr before you stop
     
  4. bbchien

    bbchien Touchdown! Greaser!

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    Well look at your family longevity. How many more years do you expect to run the vehicle? (I’m not trying to be smart).....

    Back in the day my dad would ponder if the car would last as long as an expensive set of radial tires....

    Same goes for hypertension control.....
     
  5. weilke

    weilke Touchdown! Greaser! PoA Supporter

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    The 'correct' a1c level is a question that borders issues of religion and politics.

    In recent years, a level of 6.5 to 7.0 was the typical recommended target for type II diabetics. About a year ago, the american college of physicians (professional organization of primary care physicians) issued their recommendation for a less agressive target range of 7.0 to 8.0. 'And that your honor is when the fight started.....'
     
  6. bbchien

    bbchien Touchdown! Greaser!

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    And neither is based on much. The morbidity “long term” begins at about 8 IIRC....
     
  7. Tom-D

    Tom-D Taxi to Parking PoA Supporter

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    Well I'm not 87, or the guy who is. I'm 78
    But I am in about the same situation.
    and I hope to run this old body as far as I can.
    my urologist says my Diabetes is not being controlled as it should be, even though I am on Metformin. And like the guy, my general practitioner says I can quit The metformin.
    The Dilemma is who to believe.
    I am Type II diabetic
     
  8. bbchien

    bbchien Touchdown! Greaser!

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    I'd keep taking it if your decision is "BUT I AM NOT DONE YET" (loosely adapted frm monty Python, in which the statement was something about the liver)
     
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  9. Tom-D

    Tom-D Taxi to Parking PoA Supporter

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    Thanks Bruce,, for reenforcing what I was thinking.
    Now that I'm no longer worried about the 3rd class, is there a better medication?
     
  10. benyflyguy

    benyflyguy Pattern Altitude

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    Goal used to be 7 across the board. Then was less then 6.5 which makes a lot of sense long term. The funny thing is long term risk changes depending on how far you are down the road.
    Metformin is a great drug as first line in dm2. But as one ages it becomes less of a great drug due to some side effect issues. A lot of ppl “outgrow” this med due to side effect and interaction issues that the med can present on the “older body”.
    For the elderly (75+) category there are current recommendations that loosen the a1c goal to 7.5 or less. Main reason for loosening goal can again be found in the numbers. All cause morbidity and mortaility actually goes up as you medically drive the a1c lower in older individuals due to the risks associated with hypoglycemia (fall risk to name one). Same reasoning exists for medically driving bp to lower then 120/80 which is goal for younger individuals.
    In the end, as our patients get older we need to be reminded to treat the patient not just the numbers!!
     
  11. bbchien

    bbchien Touchdown! Greaser!

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    Tom-D it depends on whether you’re insulin resistant peripherally or centrally (liver). Prob. needs an endocrine to figure that one out....
     
  12. Tom-D

    Tom-D Taxi to Parking PoA Supporter

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    I'll have to figure that out.