I would like to know how you are getting such a spike on real food. Yet you do not show this spike on pure glucose in the contrived lab test which would be very quick with glucose.

Food stays in the stomach for at least an hour, to 4 hours in most people. You do not eat pure glucose but have to digest any complex carbs. This is not an instantaneous process. Any fructose would not show on your meter at all for a long time as it has to go thru the liver and be converted to glucose. This evens out any spike so that the sugars show more moderately. (this is why diabetics use fructose supplements in cooking instead of table sugar sucrose. )

I would expect the fast spike on the GTT test. The GTT test is not "real" and cannot really be compared to regular eating. It is used as a statistical test with the results determined based on many years of comparing diabetics to non-diabetics.

I think if you jump on medication at this point, with a normal A1C and no long term elevations showing, you might end up overmedicated and experience low sugar spells. Low sugars are dangerous to the brain and some studies show even one serious low sugar event can lead to dementia.

I urge caution, whenever starting drugs. ALL the diabetes oral drugs carry a pancreatitis warning and potential. I think you should really NEED the drug, to decide to use it. While you are stressing your body with those drugs for your lung condition, adding another would be problematic IMO.