Dr. Paul Donohue Good Health



Dear Dr. Donohue: Three or four weeks ago I was diagnosed as having diabetes. I take one glyburide tablet a day. I check my blood sugar level, and it is always good. I am watching my diet and have taken off 12 pounds. I have read that this medicine can possibly cause cardiovascular disease. Is that so? -- P.D.

Dear P.D.: Glyburide (DiaBeta, among other brand names) is an oral diabetes medicine that stimulates the pancreas to release more insulin -- the hormone that regulates blood sugar.

In 1970, a study threw everyone into a tizzy because it purported to show that a diabetes drug of the same family as glyburide caused users to have more heart attacks than did diabetics who controlled their blood sugar by strictly adhering to a diet or by taking insulin.

From the time of the publication of that article until a short time ago, proponents of the study fought with others who felt that the study was erroneously conducted.

In 1998, the debate ended. A new study showed no link between oral diabetes medicine and heart attacks.

You can use this medicine without worry.

Dear Dr. Donohue: I am 67 years old, 6 feet tall and weigh 160 pounds. My blood sugar after fasting overnight is 104 mg/dL (5.7 mmol/L) and my Hb A-1c, 6.5 percent. Do I have diabetes? Do I have prediabetes? -- J.S.

Dear J.S.: Doctors make a diagnosis of diabetes when the fasting blood sugar is 110 (6.1) or higher. You are as close to perfection as any human ever comes.

Fasting blood sugar levels of 110 (6.1) but less than 126 (7.0) fall into a zone called impaired glucose tolerance. A substantial number of people with such readings will go on to have overt diabetes unless they make drastic changes in their lives. They must lose weight, exercise more and eat a diet in which vegetables, fruits and grains are the main constituents.

The Hb A-1c blood test gives doctors a good idea of what a patient's blood sugar averaged in the past two months. A value less than 7 percent tells the doctor that the patient has been in good control for the past two months.

You do not have diabetes. You do not have prediabetes. You do not have impaired glucose tolerance.


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