need help bringing down A1C

[RichM]

ok, my doc is really pissing me off. "Oh you are doing fine." no im not when my A1C has gone up every visit. from 5.9, to 6.5 currently. he hasnt given me any advice. so i turn to you people. what are some tips to help lower my A1C, besides of course, control your BGLs. what types of foods and stuff?

[Siren]

ok, my doc is really pissing me off. "Oh you are doing fine." no im not when my A1C has gone up every visit. from 5.9, to 6.5 currently. he hasnt given me any advice. so i turn to you people. what are some tips to help lower my A1C, besides of course, control your BGLs. what types of foods and stuff?

First, what type of diet are you on? I personally don't eat any unnatural complex carbs, and it's worked well for me. I do, however, still use low carbohydrate milk in my tea. I don't eat pastas, rice, sugar, or drink juice, but I load up on vegetables. To raise my hypos, I use low carbohydrate ice cream.

I'm on lantus, but I use Regular with it, which has worked better for me than the very fast insulin.

Hope that helps,
Melissa

[Cyborg]

Exercising, counting carbs, taking the proper amount of insulin and eating low carb all help bring the a1c down. BTW, a 6.5 is very good...

[princesslinda]

I'm T2, so I don't have a lot of advice as for how you can lower your blood sugar levels.

I'm wondering if it isn't time that you saw an endocrinologist...or at very least another doctor who might be more aggressive in helping you keep your levels more consistent (I'm assuming that their inconsistencies are causing the A1C to vary). I think some docs just feel that if we fall within their "normal" levels, all is well. Like you, I would be concerned if my levels kept rising, even if they were within "normal" levels.

[cheryl]

well i got mine down from a 8.9 to a 6.6 all bymyself I notice if I stay away from partially hydrogentaed oils in foods and they are in loads and eat lite wheat bread there is nature own whole wheat that is 10carbs a slice which is good, I do great with my bgs I can even indulge on things that people would not do because if I eat any kind of junk food it has to say not have those oils, also no msg.......it helps keep me more level i got to say......

Cheryl

[RichM]

my diet is ok at the moment. i occasionally eat pasta (maybe once a week). i have been eating higher carbs lately though. I also noticed that my cholesterol is at 153. my mom says thats kinda high for a 19 yr old. i know for awile i was eating sandwhiches and stuff at my work. come to find out, my favorite one had 993 calories and 60 grams of FAT!!! i was like omg. so i cut those out and really dont eat a lot of fat now. I eat white bread more than i should, but i do like the honey wheat bread. 40 carbs for a turkey sandwhich. i tend to find myself sneaking a few bites of ice cream or jello,(something sweet) a lot though. i keep telling myself, oh this isnt going to do anything. even though you guys say 6.5 is good, im not happy with it. i want my 5.9 back lol.

[RichM]

First, what type of diet are you on? I personally don't eat any unnatural complex carbs, and it's worked well for me. I do, however, still use low carbohydrate milk in my tea. I don't eat pastas, rice, sugar, or drink juice, but I load up on vegetables. To raise my hypos, I use low carbohydrate ice cream.

I'm on lantus, but I use Regular with it, which has worked better for me than the very fast insulin.

Hope that helps,
Melissa

ah, i forgot about that. i LOVE SUSHI! i dont tend to eat a lot because of the rice. if you can, refresh my mind when you say complex carbs. you mean like carbs in rice, white bread, etc..?

[Siren]

ah, i forgot about that. i LOVE SUSHI! i dont tend to eat a lot because of the rice. if you can, refresh my mind when you say complex carbs. you mean like carbs in rice, white bread, etc..?

I eat 40-75 grams of carbohydrate a day, just to give you a baseline of where I'm coming from.

Complex carbs generally come from two sources: the carbohydrate found in refined starches (flour and rice) and vegetables. I avoid the processed foods (the flour and rice) but load up on the vegetables. This is where 90% of my carbohydrates in a day come from.

I've never had sushi. It always kind of scares me because the rice in the seaweed wrapper always looks like it has eyes! The closest I get is wild range salmon, which I eat regularly and enjoy.

Simple carbs are what we think of commonly as sugar: fruit, fruit juice, sugary treats, and milk products. I avoid these entirely, with the exception of my tea and correction for my hypos. They make me more nervous than sushi!

On protein: I live on eggs, chicken, salmon, and the occasionally bit of pork. I liken beef to the protein equivilent of sugar and feel it's horrid. I won't touch it.

Does that help any?

**** If you decide to cut your carbohydrates and processed foods, be very aware of your sugars. I tested ten times a day until I established my levels. Such a diet will cause hypos if you don't adjust to it. ****

[karen]

Your A1C is still very very good, but if you want tighter control here is a very good article.

Diabetes Self Management (http://www.diabetesselfmanagement.com/article.cfm?sid=11&aid=2102)

[RichM]

thank you siren for your help. It will take some getting used to lower my carbs. but that shouldnt be a problem. Also Karen, great article. thank you. AND THANK YOU EVERYONE!

[xMenace]

What is your insulin regimine? Start by profiling your basals. Many MDIers have gaps that can be addressed.

[David_S]

my diet is ok at the moment. i occasionally eat pasta (maybe once a week). i have been eating higher carbs lately though. I also noticed that my cholesterol is at 153. my mom says thats kinda high for a 19 yr old. i know for awile i was eating sandwhiches and stuff at my work. come to find out, my favorite one had 993 calories and 60 grams of FAT!!! i was like omg. so i cut those out and really dont eat a lot of fat now. I eat white bread more than i should, but i do like the honey wheat bread. 40 carbs for a turkey sandwhich. i tend to find myself sneaking a few bites of ice cream or jello,(something sweet) a lot though. i keep telling myself, oh this isnt going to do anything. even though you guys say 6.5 is good, im not happy with it. i want my 5.9 back lol.
If you don't have a carb book.. get one. Like the calorieking.com one.. I have that .. free from endo.. and I have one from Borders.. I check all fast foods.. restaurants before ordering.. I eat only light wheat bread.. your sneaking little bites is probably the culprit.. and maybe the portion size of your pasta meals.. I had a big mac.. I took off the bread and put it on my light wheat bread.. took it from 47 carbs to 17. It makes a difference..

[BlueSky]

.... my A1C has gone up every visit. from 5.9, to 6.5 currently. ....
As it is over a year since you were diagnosed T1, your honeymoon is probably coming to an end. And you can expect to to find it more difficult to mantain good control as the amount of insulin your beta cells produces declines. You may need to increase the amount of insulin you are injecting, and you will have to make sure that basal aand bolus amounts are kept in balance. You will also have to be more careful with matching the carbs/protein you eat with the action of injected insulin.

Having said that, an HBA1c of 6.5% is not that bad. I have difficulty getting my HBA1c below that, and I have been working on it for 30 years! You are at the beginning of a long learning curve, and you may be able to improve your control. But it will take a lot of testing-and-measuring. Don't get stressed about this. It really isn't worth it. Keep up the good work!

[Cyborg]

ah, i forgot about that. i LOVE SUSHI! i dont tend to eat a lot because of the rice. if you can, refresh my mind when you say complex carbs. you mean like carbs in rice, white bread, etc..?

I love sushi too. I've switched to sashimi (raw fish w/o the rice) and a small roll. I do bolus for the protein in the fish using an extended bolus with my pump, and a regular bolus for the roll.

[marked]

I would say take a long look at what you are eating vs what you are dosing.If eating high carbs it means dosing large amounts of insulin, if you are trying to keep the bs's normal for good a1c. The big equalizer in dosing high doses of insulin is the potential for a lot of lows. You can certainly achieve a 5.9 with yoyoing but it really sucks.
Mark

[Siren]

The big equalizer in dosing high doses of insulin is the potential for a lot of lows. You can certainly achieve a 5.9 with yoyoing but it really sucks.
Mark

This is sooo true. Back when I was on NPH/R, (yes, I'm showing my prehistoric age), I had the best A1-Cs of my life. They were on par with a non diabetics! My doctor was psyched! Of course, he wasn't the one unconscious in the emergency room 3 times a week with blood sugars in the 12 range. I've heard of studies from canada claiming that NPH actually causes this reaction because of zinc, but I'm not sure how founded they are.

This, however, is one of the reasons I advocate cutting carbs before upping medication and why I try to take as little insulin as I can get away with. I'm incredibly paranoid of going hypo. With hyper, you at least get time to deal with it. My hypos were always so sudden and "helpless feeling". I'm just much happier removing the stimulus that ups my base insulin consumption.