Greetings, Dr. Roach I am a 63-year-old woman in good health. In addition to strength training at the gym three times a week, I walk or use the elliptical four to five times a week for thirty to forty minutes. I consume a lot of healthy foods at home, such as salads, fruits, fish, and poultry every day. Even though I like to nibble and occasionally eat out on the weekends, I have lost thirty pounds since 2018 and now weigh 149 pounds at 5′ 7″.
Despite not fasting for those tests, my A1C was 5.7% and my glucose level was 124 mg/dL in November 2022. Prediabetes was a major issue for my endocrinologist. I followed a very strict diet for the next six months, and as a result, my A1C has recently ranged from 5.3% to 5.8%. I still eat generally healthily, but I really can’t stick to the strict diet that brought my A1C down to 5.3%.
Based on our prior discussions, I am confident that my endocrinologist will recommend medication when I see him next week. I want to know if I should start taking medicine to reduce my A1C. Is my body suffering because of a little higher A1C? What level of A1C would I need to start taking medicine at if I waited and kept an eye on it? My cholesterol is good, and all of my other blood results are normal. — D.P.
ANSWER: Even though your diet and exercise routine seem to be perfect, you are still in the prediabetes area because prediabetes is most often characterized as an A1C between 5.7% and 6.4%. I tell my patients that they shouldn’t feel bad about not being able to achieve the ideal blood sugar level since some people simply can’t.
The aim of your endocrinologist will be to keep you from developing diabetes, which is typically identified by two A1C readings of 6.5% or above. A balanced diet and consistent exercise were found to be more effective than medication, even if the latter is occasionally employed to aid achieve this. Naturally, regular exercise and a cautious diet that you can stick to would work better together than either one alone.
It is up to you whether or not to take medication. If your A1C of 5.8% causes any harm, it will probably be minor. You are much below the most common A1C target of 7.0% for a healthy 63-year-old with diabetes.
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Greetings, Dr. Roach My mother-in-law wants to kiss my baby despite having a herpes simplex virus (HSV) infection. According to her, cold sores are no longer communicable when they have crusted over. At what point does an HSV infection cease to be contagious? — D.G.
ANSWER: Herpes simplex virus 1 is the most common cause of cold sores. While cold sores can be an annoyance for adults, an HSV-1 infection in a newborn can have disastrous consequences, including skin, eye, and mouth disease. Meningeal (meningitis) and brain (encephalitis) infections are particularly dreaded. The spread of the virus, known as disseminated illness, is extremely deadly.
Every baby is susceptible to contracting HSV. A newborn born to a mother who has never had HSV is completely unprotected. It is crucial to keep family members who exhibit signs of an HSV infection at a distance.
The period of time when the wounds are crusted over is insufficient. The grandmother of the kid should hold off until there are no more lesions or symptoms, which normally takes two weeks.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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