My A1C is Up

In My Humble Opinion
1

From 7.9 to 8.3. And AFAIK I am doing everything right.

I cut all sugary pop from my diet. I eat sweets only sparingly.

What am I doing wrong?

BTW, a little more background. My doctor recently put me on Januvia. And he doubled my Metformin, ironically to get my A1C down. Also this is only a couple of weeks since the last time I had my A1C tested (I had a different doctor do it). Now I did read A1C changes slowly over time. Could it be my beneficial lifestyle changes haven’t become apparent yet?

Any advice would be helpful. I am at my wit’s end and very concerned now.

:slight_smile:

2

Start boning up on keto eating, get the carbs out of your diet and exercise more and your A1C will follow. And remember, carbs aren’t just sweets–bread, corn, potatoes, most grains, all are high in carbs and best avoided if you want to get your blood sugar under control. Add in a half hour per day of exercise and you’ll have this under control before you know it.

3

All of that :arrow_up:, and test your fasting and postprandial glucose to see if you can identify problematic factors. For example, I ate two pieces of bread yesterday (I normally eat only one), and one was at dinner (I normally don’t eat bread after lunch). My fasting glucose this morning was 30 points higher, even though I put in several kilometers of treadmill walking after dinner. The solution for me is to adhere to my normal bread-eating standards.

4

Count carbs. Not sugar.
Carbohydrates turn into sugar after you eat them. . A slice of bread is the same as a small piece of chocolate. But carbs are hard to avoid.I can skip the chocolate dessert, but dammit, I want a good sandwich.And pizza, and spaghetti, and.lasagna and potatoes, and… ::frowning: …

Also, A1c measures sugar which sticks to a certain kind of blood cell–cells that live for 3 months. So it measures what you were eating 3 months ago, and you won’t see changes immediately.

5

A1C is a 90-day measurement. Don’t sweat it if the needle isn’t moving yet.

6

My (probably imperfect) understanding is that A1C is a measure of blood sugar readings over the past 3 months, not just from a point in time three months prior to the blood draw. So, it measures what you were eating 3 months ago, yes, but it also measures everything else in the meantime. As I understand it, it’s the preferred reading for your doctor to understand how your blood sugar is behaving, because it’s not just a point in time (like the readings you’d get from a typical glucometer).

And, to just reinforce what has already been shared here: you can cut out the sugary sodas and still be intaking a lot of carbs if you’re still eating a lot of starches: white bread, rice, most pastas, potatoes, etc. While it’s an imperfect rule of thumb, essentially, any “white carb” is more likely to quickly spike your blood sugar. After I was diagnosed with diabetes, I found that white rice, in particular, was the kiss of death for my blood sugar, so I don’t even touch it anymore. Potatoes, OTOH, in moderation, don’t have the same kind of effect on me.

7

Carbs are the key.

8

Diabetes is a disease that naturally will progress over time. To combat that, actions like more exercise, fewer carbs, and medication changes are needed.

However, know that rising from 7.9 to 8.3 is pretty much a statistically meaningless change. You’ve essentially gone from ‘fair control’ to, well, more ‘fair control’. I’ve had patients whose A1C was checked twice, in less than a week (due to lab/ordering error) and I’ve seen that much variation and more happen in that brief time, which tells me the test is not all that precise. A1Cs should not really be checked more often than every 3 months.

9

I dropped my A1C from 10+ to 5.0 over six months. On just 500mg/day of Metformin. By doing what I explained in the last thread you posted but apparently never returned to.

Eat zero simple carbs. Not “sweets sparingly”. ZERO every day. No sugar, no sugar substitutes, no bread of any kind no matter what it’s made of. No rice. No potatoes. No pasta. No grain. Period. Zero is an easy number to remember and an easy number to comply with.

Don’t eat packaged food if you can identify anything on the ingredient list as a sugar or an -ose or a starch.

Instead eat all you want of green, red, etc., colored veggies, meat, fish, dairy, nuts, & oils. Plus maybe a couple bites at most of not-very-sweet fruit per meal. Go light on beans of any sort; a few bites max. Do NOT stint the veggies; this is not supposed to be the all-bacon diet. That’ll kill you just as dead, albeit via another route.

Eat less total volume than you’re used to and exercise at least a little every day and move the weight off your body.

The mental model I use (not even remotely scientifically accurate, but it works for me) is that my body is allergic to the diet I had been feeding it. Keep eating that crap and your eyes will quit and your feet will fall off. Eat real food with no simple carbs in it and you’ll thrive. It’s a wrenching habit change but I felt 20 years younger when I was through the transition. A decade later it’s still working perfectly.

You can do it. But big results demand big changes. A few pills and a little less dessert can’t offset you feeding your body what it’s deathly “allergic” to.

And what it’s “allergic” to is simple carbs. Of which sugar isn’t even the worst. But sugar is the main additive to damn near everything in a can or package from salad dressing to soup to hot sauce.

I don’t mean to sound hostile. I mean to sound emphatic. This works a champ. I hope you can adopt it and watch the changes happen before your eyes. Fixing the A1C and losing the weight was truly a Fountain of Youth for me. People would pay millions for this in pill form. And you can do it for free! All ya gotta do is master your own spoon.

Nowadays (again a decade later) I don’t exercise much bbesides walking and I eat a few bites of simple carbs at most meals. But still zero sugar. And I have to take my post-meal BG readings at 90 minutes instead of the usually recommended 2 hours. Why? Because my BG is back down to my fasting level of about 100 if I wait 2 hours. The only way to know whether a meal was too carby is to test sooner than normal.

You can do this. The benefits are totally massively worth it. Your spoon is a rattlesnake that will kill your eyes and your feet and your kidneys. Just get a good grip on it and make it your ally, not your enemy.

10

Oh lawdy yes, it is a real bear to avoid carbs. Basically, it turns the supermarket from a maze of aisles into a NASCAR circuit–produce, meat, dairy, paper products, done. All that shit in the middle? You can’t really eat any of it aside from a duck down the nut aisle. Sucks but that’s the American diet laid out right in front of you. Looking at the vast sugary wasteland in the middle of EVERY grocery store is an education in why we’re all fat and sick.

11

Berberine

This is a plant derivative from goldenseal. Don’t take my word for it. Go to the link and read the reviews. I take three a day, one when I get up, one at lunch, one at dinner (I don’t eat breakfast).

My blood sugar came down IMMEDIATELY. For years before lunch it would be 140-ish and after a meal often over 200. Now before lunch it will often be 80-sh and 2 hours PP it might be 140. I haven’t come near 200 in many months at any time. My a1c has been as high as 8 and at my last check a couple of months ago, it was 6.2.

I told my doctor that I was taking berberine at my last “wellness” zoom visit and she said, “Oh yeah, some of my patients have told me they’re getting good results with it.” <headslap> Why isn’t she suggesting it? Who knows?

I also take Metformin and I watch my carbs (but not ALL that much).

Google it. Try it. Can’t hurt. Might help. I suggest the one I’ve linked to as it is ONLY berberine with nothing else added.

12

Yeah exercise. Especially if you can’t go totally low carb because it’s too hard. Find a good balance with how much exercise you can do and how many carbs you can forego. Gotta make it work for the rest of your life.

13

Full disclosure, I couldn’t do full keto with a gun to my head but I can certainly do very restricted carbs and exercise and that works for me just fine. I have to stay strictly away from sugar, though, that shit is suicide by the spoonful!

14

Even easy exercise. I really jumped on the DIET!! angle up above, but exercise matters lots too.

Now that I’ve been doing this for years I’ve noticed I can eat a modest helping of rice at dinner. And accept a BG spike of an extra 50 points. Or take a leisurely walk around my neighborhood for about a mile immediately after that dinner with the same rice and have zero spike or even a reading lower than my average.

I’ll trade a nice walk in a nice place for sitting on my butt and being 50 life-points closer to premature blindness any day.

Some simple carbs are necessary for long term health. But IMO a low A1C is more necessary sooner for that same long term health. So …

Go cold turkey and defeat the A1C. Then once it’s normal-ish you can add back measured amounts of simple carbs once you can withstand them. You’ll also find after a couple years that sweet stuff tastes lousy and bread or pasta is boring & filling & bloating; who wants that? Which makes doing without them a minor quirk, not a daily test of will power.

15

@LSLGuy, wow! Good work!

16

Good advice given above! I’ve done all that, and that is good. But probably the best thing for me was to get a continuous glucose monitor. I started with the Freestyle Libre, but now wear a Dexcom 6. I don’t need to prick my fingers 6 or 8 times a day (which eventually lead me to not testing because my fingers hurt too much). The Dexcom 6 alerts me to when my BG goes too high or more importantly, too low, and I can then do things to remediate that. The monitor stays on for 10 days, and I have a continuous record that is also sent to my endocrinologist. Knowledge is power. Good luck!

17

I lowered mine from 6.4 to 5.6 in about a year (and dropped about 50 pounds as well). I give credit to two things: one, Metformin; two, seriously cutting carbs (at first, all carbs; later, lowering net carbs). I call it the What’s That diet:
“Rice? Pasta? Beans? Bread? Pizza? Sugar? Most desserts? What’s That?”

18

I might as well fill you all in. I went to my GP last week. And he said that for the first time in a long time, my A1C is going down. I think he said 8.1 or something. But it was 9 something last time. But warned me, we want to get it in the 7 range.

Oh, and I should tell you. He said my Type 2 Diabetes is affecting my kidneys now. I asked him how much, percentagewise. He said just 2%. But we’ve got to watch it.

Yeah, I have been making gradual changes. And it is apparently working.

BTW, on the Kidney thing: would more water help? My urine color varies wildly throughout the day. From almost clear to dark yellow. It’s dark yellow when I wake up. Maybe I should drink more before I go to bed.

I’m probably calling the doctor’s office Monday. I certainly could bring these things over the phone. (Why do lawyers charge for phone calls and no one else? I digress.)

:slight_smile:

19

Drink lots of water throughout the day and minimize your use of salt. Test your blood pressure often. The bad thing about kidney damage is that it’s permanent. There’s no way to heal the damage.

20

OP should talk to his doc about how to deal with his diabetic nephropathy. Hopefully the OP is on an ACE or ARB, & has BOTH blood pressure AND blood sugars under better control. Sodium is less important, and pushing fluids doesn’t help beyond just making sure one is basically hydrated. Extra fluid is just extra filtering for the kidney to do.

A statin may also help reduce artery blockages, including renal arteries. Sglt2 inhibitors can help also, to slow progression (victoza, januvia, others)

I’ve seen kidney function improve when my patients with diabetic nephropathy are compliant with these steps. While dead nephrons don’t come back to life, dysfunctional ones can improve with changes in angiotensin levels and improved renal perfusion