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What dictates the magnitude of your A1c?

Discussion in 'Type 2 Diabetes' started by Glyko, Sep 4, 2021.

  1. Glyko

    Glyko · Active Member

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    Is it the number of carbs alone or also the number of times you eat that can affect your a1c negatively?

    I think going omad is a bit extreme for me in the long run, but two (or three) meals would be ok. However, I need to get my a1c down a bit and willing to reduce my intake frequency if it lowers my sugar.

    Can you help me with my question? Thanks in advance
     
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  2. Antje77

    Antje77 LADA · Moderator
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    The hba1c depends on your blood glucose throughout the whole day, over 8 to 12 weeks.
    So every time your blood sugar is higher, it will make the hba1c go up.
    What about using a glucose meter to see when you're going high?
    Reducing those highs will reduce your hba1c.

    I can eat very low carb meals without my blood glucose going up, so this won't affect my hba1c, even if I ate 6 of those meals a day.
    But eating a very high carb meal can make my BG stay high for hours, which does affect hba1c if it's a regular occurence.
     
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  3. Glyko

    Glyko · Active Member

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    Thanks!
     
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  4. KennyA

    KennyA Type 2 (in remission!) · Well-Known Member

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    When you do a finger prick test, that gives you a direct snapshot of where your blood sugars are now. Might be on the way up, the way down, or stable. The A1c test is different, and gives a picture of what your BG has been like for the past three months. it does this by using "the major glycated component of haemoglobin" attached to your red blood cells. That correlates pretty well with your average blood glucose over the past three months - because 90-120 days is about how long a red blood cell lives. About 50% of the A1c value comes from the last 30 days before A1c testing and only 10% from the first thirty days, so it's weighted towards more recent BG levels. It's not a perfect relationship - my finger prick testing averaged would predict an A1c of about 32, but my A1c is 36-38. Close enough for most purposes.

    The driver for lowering blood glucose (for me anyway) was lowering carbs. As long as I don't eat a lot of carbs (for me a lot is more than about 20-25g a day), the number of times I eat doesn't matter. I don't usually want to eat several meals, because what I am eating (meat, dairy etc) means that I'm never really hungry. Twelve hours between eating is normal and 18 isn't unusual for me. Not an effort, if you're not hungry.
     
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  5. TriciaWs

    TriciaWs Type 2 (in remission!) · Well-Known Member

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    I found I was better off eating 2 meals plus one or two snacks a day, because testing showed I could have at least 85g of carbs (later 100+g) a day as longer as I never had more than 30g in a single meal.
    The only way you will know how this works for you is to get a meter and test, before and then 2hrs after every meal.

    GPs prefer the HbA1c rather than a single snapshot as you could just eaten an unusually high carb meal or be stressed or getting sick. But because the HbA1c test is an average over several weeks it can mask highs that still do damage even if the average number looks good so I preferred to do regular testing at home and use the 3mnth/6mnth test by my GP to check my meter was ok.
     
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  6. bulkbiker

    bulkbiker Type 2 · Oracle

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    It's both.
    If you wish to reduce your average blood sugar levels then

    a. stop putting sugar into your body.. go as low carb as you can.
    b. stop creating blood sugar spikes by eating too often

    A bit of intermittent fasting combined with ultra low carb worked wonders for me and many others here.
     
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  7. Antje77

    Antje77 LADA · Moderator
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    This suggests eating always creates a blood sugar spike.
    For many, it doesn't, provided they ate very little carbs.
     
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  8. bulkbiker

    bulkbiker Type 2 · Oracle

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    In the early stages of T2 I think you'll find that eating will usually cause a blood glucose movement of some kind.. it will rarely be a downward move.

    However perhaps I was a little unclear I agree.
     
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  9. jape

    jape Type 2 · Well-Known Member

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    My doctors (family doctor/endocrinologist/nephrologist/hematologist) every time ask for both a snapshot, as well as an a1c reading when I do bloodwork before an appointment. I am not sure why they ask for the snapshot, because I can easily manipulate it such as giving me an insulin shot, and voila I am in the hypo range! I can only influence the a1c reading if I have consistently been either a good or bad boy for the entire 3 months!
     
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  10. carty

    carty Type 2 · Well-Known Member

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    I agree with this I am a skinny type 2 and if I only had 2 or even 3 meals a day I would not even maintain my (under) weight but I am keeping my BG level stable
    Carol
     
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  11. Glyko

    Glyko · Active Member

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    Thanks everyone! I think I"ll try eating twice and lowering my carbs. Want to get my a1c to below 41.
     
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  12. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    Also it depends how you define "spike". Non diabetics must have a rise in blood glucose in order to trigger insulin to control it.
     
  13. Antje77

    Antje77 LADA · Moderator
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    When eating carbs, yes. I don't need to inject insulin for no carb food, so I expect I didn't trigger an insulin response to no carb food before I got diabetes.
     
  14. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    Agree. I think all else being equal, independent of the type of food, regular snacking will always be worse for your metabolic performance. When I was still daily testing, my fasting glucose was always appreciably lower with zero snacking. Even with the same caloric/macro intake, one meal a day always yielded lower blood glucose at any given time of day.
     
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  15. SuNuman

    SuNuman Type 2 · Well-Known Member

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    Hi. Having an a1c of 36 what levels do you see on your meter 2 hrs after or fasting? X
     
  16. jonathan183

    jonathan183 Type 1 · Well-Known Member

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    Protein can still requires insulin - but this is delayed and lower requirement than for carbs.
     
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  17. KennyA

    KennyA Type 2 (in remission!) · Well-Known Member

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    That figure depends on what I've eaten, when I ate it, the outside temperature (raises my BG), what physical work I've done (BG up and down, erratic), whether I'm ill or not (BG up), whether I've had any alcohol (BG drops like a stone) ....there are more. I eat around 20g carbs/day - some days much less. I'm normally in ketosis, running on ketones due to low intake of carbs. I estimate today (so far) about 5g carbs, yesterday about the same. Didn't eat at all until 7pm, just coffee until then, had done a bit of clearance work in the garden, and I did happen to test tonight - I don't usually these days unless I'm eating something new. Tonight was because I had only one strip left in the pot and it needed using.

    That's the context for the reading I had of 5.0, which was unsurprising, and might have been anything from 4.3 to 5.3 on another day. I don't usually see a big rise in BG after eating, maybe 0.5 generally (from veg) or as much as 1.0 if I've had (eg) chickpeas in a curry. I don't want high levels - it's been a long time since I had a result above 6.0 - but I also don't want spikes.

    Just as my reading depends on a huge number of factors, it will have no relation to yours, even if you did exactly the same things. You have to learn how your own system responds. I record my readings and keep notes of what I've eaten and any other relevant factors. It's really helpful.
     
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  18. SuNuman

    SuNuman Type 2 · Well-Known Member

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    So essentially an a1c as good as yours - we don’t want to see anything over 6. Thanks. X
     
  19. KennyA

    KennyA Type 2 (in remission!) · Well-Known Member

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    No, I don't think you can assume that. You have to work out what your own BG responses to food, exercise, illness etc. are. My responses are little or no use to you. You're setting yourself a target and if that's what you want to do it needs to be based on how you respond, not how I respond.
     
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