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As a doctor, during the diagnosis and treatment of diabetes, I often encounter patients asking: “How high does my blood sugar need to be before I need to take antidiabetic medications?” There is no unified answer to this question because each person’s situation is different. However, based on clinical experience and guidelines, I can share some knowledge about blood sugar control and the experience of improving blood sugar levels without medication in certain situations.
First, we need to clarify what the goal of blood sugar control is. For most diabetic patients, the goals of blood sugar control are:
Fasting blood sugar: 4.4-7.0 millimoles per liter
Postprandial (after meal) 2-hour blood sugar: not exceeding 10.0 millimoles per liter
Glycated hemoglobin (HbA1c): not exceeding 7.0%
When blood sugar levels exceed the above targets, doctors may consider starting medication. However, there are three situations in which patients may not need to take antidiabetic medications immediately:
Newly diagnosed diabetes patients with mildly elevated blood sugar
For newly diagnosed type 2 diabetes patients, if the blood sugar level is only mildly elevated, doctors may first recommend lifestyle changes, including dietary adjustments and increased physical activity. If patients can achieve target blood sugar levels through lifestyle changes within 3-6 months, medication may not be necessary immediately.
Gestational diabetes patients
Gestational diabetes patients often effectively control blood sugar during pregnancy through strict dietary control and appropriate exercise. Most gestational diabetes patients do not need to take antidiabetic medications because medications may affect the fetus.
3. Certain specific types of diabetes patients
For example, some patients with elevated blood sugar due to surgery, trauma, or other reversible reasons may have blood sugar levels return to normal on their own after removing the cause, without the need for long-term antidiabetic medications.
So, how high should blood sugar be before needing to take antidiabetic medications? Here are some reference indicators:
Fasting blood sugar persistently above 7.0 millimoles per liter
Random blood sugar (not considering last meal time) exceeding 11.1 millimoles per liter
Glycated hemoglobin (HbA1c) exceeding 7.0%
When blood sugar levels reach the above indicators, doctors may consider starting medication based on the patient’s specific condition.
Here are some experiences to improve blood sugar without medication:
Diet control: Balanced diet, reducing sugar and carbohydrate intake, increasing dietary fiber to help lower blood sugar.
Increased exercise: Regular aerobic exercises such as brisk walking, swimming, cycling, can enhance insulin sensitivity and lower blood sugar levels.
Blood sugar monitoring: Regularly monitor blood sugar to understand fluctuations and help adjust diet and exercise plans.
However, it is important to note that even without medication, patients must closely monitor blood sugar levels and maintain communication with their doctors. If lifestyle changes are not effective in controlling blood sugar, timely initiation of medication treatment is essential.
In conclusion, the treatment of diabetes is individualized, and the need for antidiabetic medications depends on various factors such as the patient’s blood sugar level, overall health status, and risk of complications. As a doctor, I recommend that diabetic patients follow the following principles: first, try to control blood sugar through lifestyle changes; second, monitor blood sugar closely and communicate with the doctor promptly; finally, if needed, do not be afraid of medication treatment, as rational medication use is an essential part of diabetes management. With a scientific approach and a positive attitude, diabetic patients can lead a high-quality life.
