Question: Dr. Hibberd, I think your advice is great and I'm wondering if you can help me. I'm taking a prescription heartburn medicine and I'm wondering if it can cause elevated blood sugar, as I am a borderline diabetic.
Dr. Hibberd's answer:
Your heartburn medicine is not likely causing your borderline diabetes. Be sure the cause of your heartburn has been identified and that it is not a heart disease problem.
Now might also be a good time to optimize your diet and exercise program. You must manage any weight excess that may be contributing to the onset of your glucose intolerance, and deal with your "borderline" condition. In my experience, most borderline cases are actually not as borderline as patients wish to believe and usually will benefit from early intervention. Borderline or not, you should follow these 10 steps:
1) Stop smoking, if you use tobacco.
2) Ask your doctor about taking a baby aspirin (81 mg) daily as a preventive supplement.
3) Request referral to a diabetic nurse educator or clinician for an explanation of your condition and review of management strategies recommended for now and later. All diabetic patients should be educated with insulin use early, so that if control becomes problematic you can easily transition to more aggressive management early and prevent the expense of hospital management
4) Consult a dietician for help with dietary education and selection.
5) Know your correctable risk factors for stroke, heart disease, and renal failure (hypertension, smoking, elevated cholesterol and triglycerides) and manage them aggressively now.
6) See an ophthalmologist annually to screen and treat you for reversible and preventable vision loss.
7) Know your HBA1C level used as an indicator of diabetes and get into the habit of self monitoring your glucose values to further fine tune your management.
8) Know your cholesterol levels an aim to get your LDL to 80 or less to minimize vascular disease progression. Understand these targets are difficult if not impossible to achieve without prescription lipid medication (most commonly a statin drug).
9) Ask your doctor to check your urine for micro-albumin, and consider the daily use of an ace inhibitor as a preventive medication to minimize damage to your kidneys.
10) Be sure you have been evaluated for co-existing conditions such as hypothyroidism that may be contributing to glucose intolerance.
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