### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I was diagnosed with diabetes after one A1C of 6.6 and put on low dose metformin, then half of lowest dose and now no meds. The A1C went to 5.8 and has stayed there. My egfr ranges from 47-49. I never see a phosphorous result on my labs, but everything else falls in range except low hematocrit and rbc and high mch. Do I need to modify my diet and what does this mean for my prognosis.

### output:

Hello, you haven't mentioned you hematocrit or the rest of the complete blood count results. It's hard to give specific advice without knowing the facts. Also, please note that the A1c result is credible only when the hematocrit is within normal range. Your EFR corresponds to stage 3 chronic kidney disease. At this stage, it's likely that no symptom is evident. 5% of stage 3 patients do have anemia, although it's far more common in stages 4 or 5. Your MCH is not helping either, without the rest of the results. If you do have a high MCH then a microcytic anemia is possible. Since you were using metformin, you should probably check your vitamin B12, which is a common cause of anemia in patients with diabetes. I could be more accurate if I had the results. If you're on a healthy diet then you don't need to do anything about it. If not, then the following general advice would be appropriate. Red meat: once in 7-10 days. Poultry: 3 times/week. Vegetables, salads: every day. Fish: at least 2/week. Don't forget legumes. Avoid sweats and fatty food. If you Chat Doctor. 