Reducing A1c

[Cellro]

Following some routine blood tests at the end of June I found out that my A1c was very high at 89. This was a surprise as I had no real symptoms other than losing a bit of weight which I’d put down to stress. I immediately started to follow the Michael Mosley plan and was re-tested two weeks later at 83. I was then sent for an abdominal ultrasound - all clear - and have continued with low carb ever since and lost a couple of stone and many inches.
Throughout this I’ve just been left to get on with it and GP has shown no interest - and it’s impossible to get an appointment. Yesterday I had a follow-up 3 month blood test and I’m down to 68. Is this good progress in three months? It’s obviously still higher than I’d like but as I’ve had no opportunity to talk to a doctor I have no sense of whether I’m doing well or am likely to now be given medication. I still have no symptoms and feel better than I have in ages, but I’m very careful with my diet.

 

[filly]

You are doing well. Carry on with what you are doing and the Hba1c will keep coming down. I haven't seen a doctor or nurse and just do what I am doing.
I am not able to exercise so makes it a little bit more difficult for me.
Best Of Luck.

 

[Guilty]

Hi @Cellro those numbers are high and in the 'diabetic range'.

You've done fantastic with your diet and losing so much weight! And that will have so many other benefits for you on top of the A1c so keep it up

No-one on this forum can diagnose you. But just to be clear 68 is still a high reading. And you'll want to discuss with your doctor.

But it sounds like you are doing very well diet wise. I don't know what your current activity levels are - but if you can do a short walk after a meal that helps as well.

And it may sound soft, but regularly getting a good night's sleep makes a difference.

Good luck!

 

[CatsFive]

That's fine, just keep on as you are. You should get a blood test every 3 months. If you don't receive an appointment, ring the surgery.

 

[Cellro]

Thanks everyone. Had a text from GP this morning saying results were ‘much better’ and have an appointment in a week. I’ve also just joined a gym so hoping these numbers will continue to drop!

 

[Outlier]

Well done! And do stay with us to find out more info from real people who have had real life experience of this illness in all its varieties. Don't hesitate to ask anything you'd like to know more about. I still learn something new most days from this very supportive group.

 

[ElenaP]

I immediately started to follow the Michael Mosley plan ......continued with low carb ever since ....... feel better than I have in ages, but I’m very careful with my diet.

Well done! I love to hear people taking control of their eating and exercise.

 

[KennyA]

Following some routine blood tests at the end of June I found out that my A1c was very high at 89. This was a surprise as I had no real symptoms other than losing a bit of weight which I’d put down to stress. I immediately started to follow the Michael Mosley plan and was re-tested two weeks later at 83. I was then sent for an abdominal ultrasound - all clear - and have continued with low carb ever since and lost a couple of stone and many inches.
Throughout this I’ve just been left to get on with it and GP has shown no interest - and it’s impossible to get an appointment. Yesterday I had a follow-up 3 month blood test and I’m down to 68. Is this good progress in three months? It’s obviously still higher than I’d like but as I’ve had no opportunity to talk to a doctor I have no sense of whether I’m doing well or am likely to now be given medication. I still have no symptoms and feel better than I have in ages, but I’m very careful with my diet.

Good progress!

That's about a 20% A1c reduction in three months. Clearly what you're doing is working for you, so crack on with it. Don't forget that as well as what you eat, things like illness and stress also tend to raise your BG. And your liver will have got used to running at higher levels of blood glucose so will continually be adding glucose to your blood. Livers are slow learners.

Are you checking your BG levels before and after food with a glucometer and/or a Constant Glucose Monitor? I found that really helped me eliminate food causing glucose rises. The NHS will usually say that as a T2 (which I'm assuming you are) you don't need to test - this means they don't have to fund the meter and strips - but I guess most people on this forum test.

My experience was that weight loss wasn't a smooth decline - I lost a bit, then hit a plateau, then lost a bit more. Down a series of steps, really.

 

[Outlier]

My experience was that weight loss wasn't a smooth decline - I lost a bit, then hit a plateau, then lost a bit more. Down a series of steps, really.

Me too.

 

[Cellro]

Good progress!

That's about a 20% A1c reduction in three months. Clearly what you're doing is working for you, so crack on with it. Don't forget that as well as what you eat, things like illness and stress also tend to raise your BG. And your liver will have got used to running at higher levels of blood glucose so will continually be adding glucose to your blood. Livers are slow learners.

Are you checking your BG levels before and after food with a glucometer and/or a Constant Glucose Monitor? I found that really helped me eliminate food causing glucose rises. The NHS will usually say that as a T2 (which I'm assuming you are) you don't need to test - this means they don't have to fund the meter and strips - but I guess most people on this forum test.

My experience was that weight loss wasn't a smooth decline - I lost a bit, then hit a plateau, then lost a bit more. Down a series of steps, really.

Thank you. Yes, I’ve been using a monitor to check and I have noticed that it’s slowly coming down over time. I’ve been avoiding bread, pasta, rice etc but if / when I reintroduce them I’ll check before and after I eat. Weight loss has plateaued a little but I’m less worried about that, I’d just like to get my numbers down and I’ve heard so many stories about people going into remission in 2-3 months that I feel a bit disappointed.

 

[ianf0ster]

Thank you. Yes, I’ve been using a monitor to check and I have noticed that it’s slowly coming down over time. I’ve been avoiding bread, pasta, rice etc but if / when I reintroduce them I’ll check before and after I eat. Weight loss has plateaued a little but I’m less worried about that, I’d just like to get my numbers down and I’ve heard so many stories about people going into remission in 2-3 months that I feel a bit disappointed.

Congrats on bringing your BG readings down. You don't say which Michael Mosely plan you are using, whether it's the earlier ultra-low calorie approach, or the more recent variant which focusses more on keeping the carbohydrates down.

You are right to prioritise getting the blood glucose and HbA1C numbers down. For overweight Type 2 diabetics, it's usually the Diabetes that causes most of the weight gain and so getting back to 'normal' Blood Glucose levels means having less insulin sloshing around which makes weight control/loss much easier (insulin is a fat storage hormone).

Nobody really gets into remission within 2-3 months. Those that say they did are bending the definition of remission - which include maintaining non-diabetic HbA1C numbers. It took me around 4 months before I had a 'pre-diabetic; HbA1C (that just so happened to be the time before my next HbA1C after diagnosis), but my finger-prick BG readings 2hrs after first bite of each meal were at 'normal' levels (on a Low Carb way of eating) in just a few weeks.

However upon my 'pre-diabetic' HbA1C my GP scheduled my next HBA1C test for another 6 months. Thus it was impossible for me to be in remission until at least 10 months after initial diagnosis! Not that there was any accepted definition of remission back then in 2019/20.

 

[Cellro]

Congrats on bringing your BG readings down. You don't say which Michael Mosely plan you are using, whether it's the earlier ultra-low calorie approach, or the more recent variant which focusses more on keeping the carbohydrates down.

You are right to prioritise getting the blood glucose and HbA1C numbers down. For overweight Type 2 diabetics, it's usually the Diabetes that causes most of the weight gain and so getting back to 'normal' Blood Glucose levels means having less insulin sloshing around which makes weight control/loss much easier (insulin is a fat storage hormone).

Nobody really gets into remission within 2-3 months. Those that say they did are bending the definition of remission - which include maintaining non-diabetic HbA1C numbers. It took me around 4 months before I had a 'pre-diabetic; HbA1C (that just so happened to be the time before my next HbA1C after diagnosis), but my finger-prick BG readings 2hrs after first bite of each meal were at 'normal' levels (on a Low Carb way of eating) in just a few weeks.

However upon my 'pre-diabetic' HbA1C my GP scheduled my next HBA1C test for another 6 months. Thus it was impossible for me to be in remission until at least 10 months after initial diagnosis! Not that there was any accepted definition of remission back then in 2019/20.

I did the Michael Mosley low blood sugar diet (800 cals) for two months and now I’m still following main principles but not counting calories so strictly. Also using recipes from Fast 800 keto and some Glucose Goddess recipes. Still avoiding carbs and sticking to protein, healthy fat and veg with some beans, legumes etc.

When I test my levels are better than they were at the start but still average around 9 after meals, even when eating low carb.

I’m down to a BMI of about 28 and would like to lose about another 7lbs to get back to the weight I was in my 20s. I think I’ll do better if I find an approach on can live with longterm as I know if I’m too strict it’ll become harder to maintain.

I suspect GP will want to start me on metformin which I have mixed feelings about, but maybe that’s what’s needed to help me get back into normal range.

 

[MrsA2]

@Cellro
It seems you are assuming it's T2, but just be aware that weight loss as a symptom is often a red flag for T1, which sometimes starts slowly and the 2 can be difficult to separate. As are the other more rare types of diabetes.
When you have your appointment you might want to stress that your numbers are still routinely high and ask for the T1 tests to rule that out.

 

[Cellro]

@Cellro
It seems you are assuming it's T2, but just be aware that weight loss as a symptom is often a red flag for T1, which sometimes starts slowly and the 2 can be difficult to separate. As are the other more rare types of diabetes.
When you have your appointment you might want to stress that your numbers are still routinely high and ask for the T1 tests to rule that out.

Thank you. Yes, I will.

 

[ianf0ster]

I'm not a fan of Glucose Goddess (my neighbour's son bought him a book by her), I have my own personal diabetes expert which specialises on my diabetes in my body. - It is my BG meter!

I am a fan of Dr David Unwin (follow @LowcarbGP on Twitter) but I just learned to 'eat to my meter' and found enough low carb foods I like in order to make that sustainable. I only test occasionally now since I know what my reaction to my meals is (unless I'm ill, stressed, coming down with an infection etc.)

Some of us Type 2's react strongly to the carbohydrates in beans and legumes - have you tested this on yourself?
The only beans I eat are french beans i.e in the pod. The same with peas - only 'mange tout' because otherwise they raise my BG too much.

Since your BG numbers are still quite high, perhaps I should ask what a typical day's meals are like for you, together with BG levels before a meal and then 2hrs after first bite?

 

[Cellro]

I'm not a fan of Glucose Goddess (my neighbour's son bought him a book by her), I have my own personal diabetes expert which specialises on my diabetes in my body. - It is my BG meter!

I am a fan of Dr David Unwin (follow @LowcarbGP on Twitter) but I just learned to 'eat to my meter' and found enough low carb foods I like in order to make that sustainable. I only test occasionally now since I know what my reaction to my meals is (unless I'm ill, stressed, coming down with an infection etc.)

Some of us Type 2's react strongly to the carbohydrates in beans and legumes - have you tested this on yourself?
The only beans I eat are french beans i.e in the pod. The same with peas - only 'mange tout' because otherwise they raise my BG too much.

Since your BG numbers are still quite high, perhaps I should ask what a typical day's meals are like for you, together with BG levels before a meal and then 2hrs after first bite?

I don’t test every day but I’m usually about 6ish before a meal and 9-10 2 hours after. Breakfast is Greek yogurt with berries, nuts and a little nut butter.
Lunch is usually an omelette or chicken salad or cauliflower rice salad with some kind of protein.
Dinner is usually chicken or fish or a sometimes a steak with salad, roasted cauliflower / squash or lentils or beans or chickpeas.

 

[ianf0ster]

Those numbers, especially that big a rise for breakfast and lunch doesn't seem right for an ordinary Type 2 based upon what you say you are eating, unless you are eating a huge amount of it.
Though I can understand it more with dinner - because of the legumes. Do you like any low carb veg such as courgette, aubergine, leek, cabbage, sprouts, broccoli?

What's in your salad? Does it have potato, carrot, some other higher carb veg, salad cream, mayo, thousand island or some other high carb dressing?

 

[Cellro]

Those numbers, especially that big a rise for breakfast and lunch doesn't seem right for an ordinary Type 2 based upon what you say you are eating, unless you are eating a huge amount of it.
Though I can understand it more with dinner - because of the legumes. Do you like any low carb veg such as courgette, aubergine, leek, cabbage, sprouts, broccoli?

What's in your salad? Does it have potato, carrot, some other higher carb veg, salad cream, mayo, thousand island or some other high carb dressing?

I eat low carb veg. No root veg and haven’t had a potato for months. Salads are lettuce, avocado, tomato, cucumber, radish. Bit of oil and vinegar. No mayo or salad cream. I’m a health journalist so pretty up to speed on nutrition. I only tend to test after dinner and sometimes first thing. I wouldn’t say I’m having particularly large portions either. There is a family history of type 2 though and my mum also struggles to keep her numbers down.

 

[CatsFive]

Thank you. Yes, I’ve been using a monitor to check and I have noticed that it’s slowly coming down over time. I’ve been avoiding bread, pasta, rice etc but if / when I reintroduce them I’ll check before and after I eat. Weight loss has plateaued a little but I’m less worried about that, I’d just like to get my numbers down and I’ve heard so many stories about people going into remission in 2-3 months that I feel a bit disappointed.

Unfortunately, IMHO there is quite a bit of machismo here about getting the numbers down. What I think matters is you make changes you can sustain in the long term - decades not months - that bring them down. You are getting there, and the advice to test before & 2 hours after a meal is good.

 

[Paul_]

Keep up the good work, @Cellro!

I was diagnosed in July with an hba1c of 83 and have my next blood tests next week. The advice you've received on this thread is sound, based on my experience. It got my fingerprick blood glucose readings down relatively quickly and monitoring before then after meals has been a very useful tool for diet changes. As @CatsFive says though, a successful but sustainable approach to lowering blood glucose is the most important thing - as for what's sustainable for you, only you can answer that. We all have different levels of insulin resistance, so what works for one of us, might not for another.

I love chickpeas and beans too. Based on my experience, I'd just recommend watching the serving sizes of these with meals. I might love them, but my blood glucose doesn't, so definitely worth weighing them out and reviewing meter readings before/after meals containing them. Once you've made a start as you have, it's often a series of small changes to meals that get big results overall, so tweaking portion sizes of "offending" meal items can work wonders.