<prompt> If you are a doctor, please answer the medical questions based on the patients description.I am 52 years female and for last 4 years I was diagnosed as a pre diabetic .My status almost always stays as Fasting sugar between 120 to 140 and Postprandial always normal My Hbac1 remains below 6.5Should I start Metfield or still manage with lifestyle changes  <response>: Hello, Treatment with metformin is not absolutely necessary at this time. Glucose control requires a combination of lifestyle changes which include increased physical activity, body weight control and a proper diet. Regarding physical activity, 30 minutes of fast walking every day is effective and sufficient. If youre doing more than that already then you should keep on doing it. I cant give you a specific diet plan, butte main idea is to avoid food with high calories fat and eat a lot of fiber. Your diet should make you lose weight if youre overweight or obese. If the aforementioned measures are not sufficient to control the blood sugar and keep it less than 120-130 in the morning fasting and less than 140-160 a couple of hours after meals then Chat Doctor. You can contact me again if youd like any clarifications. Kind regards! 