Q I am 45 years old. I just had my annual check-up and was found to have a high body mass index (BMI) and high fasting glucose of 126mg/dl (normal range is 56-120mg/dl).

My doctor told me that it is mild diabetes, and advised me to do more exercise and control my diet, and prescribed metformin 850mg.

I have been experiencing some abdominal discomfort ever since and do not seem to be enjoying my favourite food as I did in the past. Can I stop taking the medication once my diabetes gets better?

A You are likely to have Type 2 diabetes, which means your body is still producing insulin (a chemical messenger which helps the body use glucose from food), but in insufficient amounts or it is less sensitive to it, causing the blood sugar level to be high.

The body produces more insulin to try to overcome this apparent lack. This excessive amount of insulin is associated with greater obesity and in turn, makes the body even less sensitive to insulin, setting up a vicious circle of further deterioration of diabetes.

Excess insulin is associated with increased blood pressure and cholesterol. Insensitivity to insulin also causes your body to become less able to absorb sugar to maintain and repair itself. Furthermore, the high blood sugar level itself is harmful.

When these problems are combined, they can lead to a wide range of complications such as heart disease, stroke, kidney failure, blindness and foot amputation.

Anti-diabetic medications such as metformin do not cure diabetes. But they help to achieve blood sugar control and slow down disease progression. Metformin, in particular, increases your body's sensitivity to insulin and may potentially stabilise or decrease body weight.

Since clinical studies have shown its benefit, and diabetes is a long-term condition, it would be best for you to continue with metformin. If you stop metformin, your blood sugar level will probably be high again.

Taste disturbance and abdominal discomfort are some expected side-effects. While they are rather disturbing, they may lessen with time. You may want to discuss with your doctor the possibility of reducing your dosage of metformin if you are unable to tolerate the side effects.

Managing diabetes well begins with a good partnership with your health professionals. Together with that, if you eat right, exercise regularly, take your medication, and are conscientious about the necessary health checks, you can expect many healthy and meaningful years ahead.

IVAN CHEW, PHARMACIST, PHARMACEUTICAL SOCIETY OF SINGAPORE

More information and advice can be obtained from your pharmacist. Send your questions to sthealth@sph.com.sg