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I'm 27, no high BP, cholesterol levels are good, and had a physical 3 months ago with a fasting blood sugar level of 95. I recently got my insurance back and visited a doctor to treat my hypothyroid and sleep apnea. They did an A1C that came back as 6.0, and said not only am I prediabetic, that my hypothyroid is masking that I'm probably already a diabetic. He recommended metformin and trulicity for weight loss and sent me on my way. I feel like something isn't quite right here-can hypothyroidism mask diabetes? Is it possible the low thyroid is increasing my a1c? Would you typically recommend starting on metformin right away or giving the synthroid time to kick in first? I'm just feeling like this is not the right way to go about this situation, and I'm just looking for extra opinions.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 23 Doctors Online

Thank you for your query at
I understand your concern.
Firstly FBS 95 is normal. HBA1c 6.0 is definitely prediabetic state, a caution to the patient, to get on with the lifestyle modification. I disagree with the doctor's theory of hypothyroidism masking diabetes state. There is no relationship between thyroid and sugar levels.
I will ask you to avoid metformin, wait for 3 months, focus on diet and exercise and repeat your FBS, PPBS, HBA1c, and thyroid profile. Then we can base the treatment accordingly.
Hope this was helpful,
Dr. J

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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