When Your A1C Isn’t Doing What You Want

A1C lab test tube dreamstime_s_97774299

Do you dread getting your A1C done?

It’s like getting a report card every few months, only you’re not sure what kind of “grade” you will get on your A1C (the 3-month blood glucose average).

I know so many people who avoid having their A1C done because of the anticipatory shame and blame associated with it. And the judgement! Often people judge themselves or feel judged by others. That feeling of disappointment can come at you from several angles.

You might also be the type of person who gets your A1C done like clockwork but still find yourself dreading the outcome. Or you try like heck to get it lower and nothing seems to work.

In either case, having your A1C checked often leads to internal dialogue:

  • Will it be “bad”?
  • Is it going to be worse than last time?
  • Am I going to have complications?
  • Does this mean I will need to start medication or insulin?

These are normal questions.

Diabetes is all about the numbers because they help us understand our state of health or our level of risk. But this can backfire when we focus solely on the numbers because they don’t tell the full story.

In this post, there are 2 parts. I hope to give a perspective on the A1C number and then leave you with some tips to consider.

Let’s Start with Part 1: a Perspective on the A1C Number.

In the diabetes professional world, we get loads of research and data from many sources. I recently stumbled across this poem I wrote while sitting in a days-long conference where I got tired (and a bit miffed) of listening to all the focus on numbers.

We need not lose sight of the fact that each individual is unique, way more complex than our A1C or whatever other number is being measured. Perhaps I should have taken a break and cut class as the science can get to be too much! But I also hear from so many of you who feel like you’re treated like a number. Who hasn’t felt that way?! So we adapt and in order to speak the lingo, many of us use negative self-talk when getting our results.

Don't Judge Me - a poem by Theresa GarneroAKA “The A1C Poem”.

Well, now that we got the rant out of the way about not using a number to define us, here’s a positive sign: the American Diabetes Association just updated its Standards of Care to focus on time in rangeThis is HUGE! You can have an ideal A1C but meanwhile, experience lots of highs and lows. Soon we will all be talking about time in range instead of just the almighty A1CFor those checking your blood sugar, it’s helpful to get this perspective.

What exactly are the recommendations? Scroll on down to read more.

Time in Range from Diatribe

Let’s Finish with Part 2: Eleven Proven Tips to Lower Your A1C

Check out these 11 tips to lower your A1C (7 of which came from this article which gets into more detail for numbers 1-7).

  1. Follow a carb-balanced eating pattern (uh, our diet)
  2. Get intentional physical activity (as in, exercise regularly in a dedicated way)
  3. Lose weight if you need (yeah, most of us desire to shed some pounds)
  4. Take medications, if needed, and do so consistently
  5. Follow up with your healthcare provider (did you know that attending a year-long diabetes education program can lower your A1C by up to 2%?!)
  6. Manage stress and mental health (stress raises blood sugar!)
  7. Find a community for diabetes self-management (that’s where Sweet People Club comes in!)
  8. Get enough sleep as lack of it will definitely impact blood sugar and weight.
  9. Manage pain (another form of stress!)
  10. Address any infections or dental issues (they’re known to raise blood sugar)
  11. Talk with your healthcare provider about supplements that may help. For example, Pendulum Therapeutics just released a supplement to help your microbiome that lowers A1C by 0.6% (and that was on top of taking medicine because it helps to flatten out after meal blood sugar spikes). There’s no “magic bullet” here but rather ways to help your healthy eating and active lifestyle efforts.

Lastly, an important note. If your A1C is continuing to climb despite being on multiple medications, ask your provider if you should be worried about Latent Autoimmune Diabetes in Adults (LADA). Typically, we’d see A1Cs not responding to diabetes pills if that were the case.

May this spark an idea of something else to try.

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