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Oral glucose tolerance test (OGT)

Question
My son, 35 years old, has a pathological oral glucose tolerance test (OGT) - performed at the general practitioner- CF center did not regard the test to be necessary - Hb A1c 5.4.
The blood sugar values after 60 min: 278 and after 90 min: 243.
Should one begin with little dosages of insulin or which approach can you recommend?
Many thanks and best regards,
B.S.
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12.06.2013