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A1c

A DiabetesTeam Member asked a question 💭
Illinois City, IL

My A1c 6.0 and I have lost like over 50 pounds what can I do to get it lower,my doctor have not put me up in the medication and I am worried is that it might just go back up. It was 6.5 when i was told i was pre. I try to eat right under 800 cal a day and i walk at least 5 miles a day. Breakfast green tea with ginger two pieces it wheat toast
Lunch is a smootie with fruit and som vegs
Dinner is normally protien, vegs, green tea
Snach is peanuts, wheat crackers …
Sometime ill have coffee with… read more

December 26, 2022
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A DiabetesTeam Member

Hi again @A DiabetesTeam Member,
Good morning from South Jersey. I personally do 15-20 carbs per day, 5-8 carbs per meal, when I am maximizing my carb loading while eating to my meter. 5-8 carbs per day is what I did for the 1st 3.5 months after diagnosis.

If you want to read some useful information from the right perspective and guidelines, go to the Diabetes UK site. Their information is pretty good and tells you what you need to do to take control of your diabetes journey.

If you read the articles here on this site, they can help you understand more about your diabetes journey.

Another good site for your education is Diabetes from WebMD.

All that being said. Welcome aboard and into our family. Love you. Praying for you. Want only the best for you. That's what family does. How can we help and support you. I wish for you more good days than bad and have many exceptional days too.

Take it slow. Baby steps. Start with one and keep doing it daily. When you are ready do another and keep doing it every day. Soon you are on your way.

Cut out all added sugars in food and drink.

Cut back carbs, especially cut white carbs.
White flour products.
White potatoes.
White rice.
White pasta.

Cut all carbs to a serving per meal. Did you know that a serving of carbs, is 15 carbs. 15 net carbs is:
I slice bread.
1/3 cup potatoes.
1/3 cup pasta.
1/3 cup rice.
1/2 cup beans.

A serving of broccoli is 3 net carbs.
A serving of cabbage, brussel sprouts, cauliflower, bok choi, Chinese cabbage and other cruciferous vegetables is in the 2-3 net carb range per serving.
A serving of greens is 1 net carb.
2 eggs is 1 net carb.
Half an avocado is 1 net carb.
7-10 almonds or the equivalent in other nuts is 1-2 net carbs.
6 blueberries, or 4 raspberries, or 2 blackberries is in the 1-2 net carb range.

Does this primer help you.

Most type 2 diabetics can handle 100-130 net carbs spread equitable throughout 3-5 meals and 1-2 snacks daily.
Some can only tolerate 80 daily.
Some only 50 daily.
Some only 30 daily.
And then there is me at 15-20 daily. 5-8 net carbs per meal.

I eat to my meter, my blood glucose numbers spreadsheet, and my food journal. They tell me what foods I can eat somewhat freely, what foods I must limit, and what foods I must almost totally avoid.

A good morning fasting blood glucose number is below 7.0(126).
A good 2 hour number is below 7 8(139). This will prevent further vascular damage and progression of diabetic complications and comorbidities.

Another number to note is the hypo range, approaching or below 3.9(70). A severe hypo can cause disorientation, coma,and death. I avoid hypos at all costs.

Good luck. Baby steps.
Never give up, never surrender, never ever.
You got this.
Have a wonderful day.

This is a 5 carb breakfast.

December 27, 2022
A DiabetesTeam Member

Hi @A DiabetesTeam Member,
You are headed in the right direction, have made positive changes. It sounds like your doctor is pleased with your progress.

1st, I would like to say congratulations, your hard work is paying off. We celebrate with you for breaking that less than 200 pounds goal. I personally started out at 240 pounds and a BMI of 34.4. I gave myself many intermediate weight loss goals.

I am doing this without medications for now, my choice. I celebrated with several hours of extended self care, also took my Bride out to dinner.

20 pounds to 220, I celebrated.
20 pounds to 200, I celebrated.
12 pounds to 188, top of the 183-188 range, I felt physically good, I celebrated.
5 pounds to 183, I celebrated.
3 pounds to 180, a milestone goal for me, I gave myself a break. I was content.

2 more pounds over the next 6 months to 178, BMI 24.8 (18.0-24.9 is in the healthy normal range).
That was my goal. I danced, jumped up in the air, shot my fists in the air and took my Bride out to dinner.

At each celebration, I took my Bride out to dinner at her favorite steak place, Texas Roadhouse.

Now I found out that as Japanese, I still need to drop my BMI below 23 for the best diabetic outcomes. It's not easy, but it is simple. I dreaded that weight loss hard work.

I have been in clinical remission, non diabetic A1C, since 3.5 months after diagnosis in February 2021. My undiagnosed diabetes journey for the previous 12 years led to a quite advanced diabetes journey. My initial A1C of 13.5, means my average blood glucose number was 340(18.9) with numbers exceeding 400(22.2) to 500(27.8) on occasion.

My doctor wanted me on metformin, long acting insulin, and quick acting insulin. I negotiated with her for a 3 month reprieve. She said I could only get another 3 months, if I got my A1C down to 6.1.

My guidance from my doctor was take your morning fasting blood glucose number 1 day, and your 2 hour number the next, because insurance would only pay for 1 test strip a day. I quickly decided I needed more data points to better understand what foods did to my blood glucose numbers. With insurance it cost $100.00 for the test kit meter, with 50 lancets, lancet pen, and 50 test strips. Additional test strips were over $1.00 each.

I went outside of insurance and after recommendations, hit Amazon for Auvon system. Walmart’s ReliOn brand was another lower cost test strips for their systems consideration. Metrix is another. I did 2500 tests, the first year.

I met her A1C goal and am still without diabetic medications for now. A1C 4.9 at 3.5 months, 5.3 at 9 months later, 5.1 was my last A1C. I am in clinical remission.

Baby steps.
Never give up, never surrender, never ever. You got this. Have a blessed day.

December 27, 2022
A DiabetesTeam Member

A1C is simply an representation of your average blood sugar.

Your A1C of 6.0 equates to an average blood sugar of 126 which is actually a super well controlled number.

No, it's not "normal - non-diabetic" but it is low enough that there is no recommendation/guidance for your Doctor to try and drop it any lower with medication.

You state the the Doc didn't "put up" your medication so are you saying that the Doc medicated you when your A1C was 6.5?

If that is the case they already went slightly against the guidelines that establish an A1C of 7.0 as the line where they start medication. Of course, the Doc is not bound to that if they believe there would be some benefit, but it would not be "typical".

The weight loss certainly had a positive effect on your Insulin Resistance so is at least partially responsible for your A1C improvement.

It is sometimes a number of complex reasons why our blood sugar is what it is. Some of it is in our control - our weight, what we eat, how much we exercise/how active we are, but other conditions, age, hormone levels/slight disfunction all play into our sugar levels.

Once you take your BMI down to below 25, eat as healthy as you can and medicate as necessary you still may never get down to a "normal non-diabetic" A1C. Sometimes the best you can accomplish is controlled or "well controlled" as is your case.

There may be little value, and some "danger" in trying to medicate your level lower. It's one thing if you can make lifestyle changes to get there, but to do it with drugs could lead to some periods of dangerously low blood sugar which can kill you in your sleep. So it's always about "balance".

But you really should discuss your "expectation" with your Doc and get their advice as to whether it would benefit you at all to try and take it lower "with meds". Otherwise, just keep doing what you are doing and if your BMI is still over 25, getting it under may shave a couple more tenths of a point off your 6.0

December 26, 2022
A DiabetesTeam Member

You're doing an awesome job! 😊
Stay motivated with what you're doing. I was prediabetic now normal and I was walking 10,000 steps 5 days a week, eat a light breakfast like peanut butter crackers with blueberries 🫐 and decaf tea with stevia, lunch was a baked meat, veggies, strawberries and drink water and dinner was same. I snack sometimes on unsalted nuts or a small green apple but nothing to eat after 8pm only water or unsweetened tea 🍵. I'm so proud of your progress Lizzie!!!
Hugs from Iola 🤗

December 27, 2022

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