Hemoglobin A1C

[Night Elf]

So I had my annual physical today. My A1C was 6.0 and Kaiser lists 6.4 as the upper normal range. Beyond that is considered diabetic. My doctor wants me on a low carb diet. DH looked up A1C numbers and he read that over 7.0 is considered diabetic. Any idea why Kaiser is considering 6.4 to be the upper normal number? She said I should avoid all sweets, potatoes, rice, and bread. That's a diabetic diet, isn't it? This would be a huge lifestyle change for me. I forgot to ask her, but did ask the nurse if I was supposed to stick to a certain number of carbs a day like my mom with diabetes does. I was just told to avoid the foods and that the numbers weren't important. Overall, they didn't seem that concerned because the doctor didn't spend a lot of time explaining to me what a low carb diet would look like, beyond telling me to avoid those foods. What do you think?

[*lifeoftheparty*]

I have had gestational diabetes twice. Been pre-diabetic for years, and have recently crossed over into diabetes.

 

As it had been explained to me. 5.8 to 6.4 is pre-diabetes territory. 6.5 and above is diabetes territory, however, you only need insulin when you are above 7.0.

 

Basically, anytime your blood sugar goes over 140, it is doing damage to your body (heart, arteries, kidneys, liver, eye sight, etc.) in some way or another. An a1c is basically blood sugar of 140. So you (we) may not need insulin at this point, but it is still damaging your (our) body and must be brought down.

 

Bread, sugar, rice and pasta will absolutely cause your blood sugar to sky rocket. I ban them 100%.

 

Potatoes are ok for me in 1/2 to 1 cup portions, as long as I stay under my carb limit for each meal. You'll have to see what they do to you.

 

I have an excellent doctor, and he prescribed Merformin for me, to help. And I will go back in. 3 months to see if it has helped.

 

He did not send me to a nutrition class, b/c he knows me, and knows that I already know the info. backwards and forwards. But you should have been sent to a nutritionist who could then explain everything and then maybe give you a meal plan to follow.

 

They would explain that you want to keep your blood usage stable.... No spikes, up or down. So you don't want to completely go without carbs or go too long without eating b/c that will cause your sugar to get too low. That is not good on it's own. It also means that any carb you eat will cause a spike- also not good. Like I said, you want a nice steady "line".

 

For me, I need about 30-40 carbs per meal and 10-15 per snack. I need to eat every 3 hours or so. Some people can have more, some people need less- depends on your level of activity and how resistant your cells are to insulin.

 

You should really try to get in to see a nutritionist, through Kaiser, or find a holistic one on your own. And ask about Metformin, it will help. Also ask if they will prescribe you a blood monitor. You an buy them on your own, but the strips are much cheaper with a scrip. I check mine a few times a day, few days a week, to see how I am doing, or to see how certain foods affect my levels.

 

You want under 140 one hour after a meal, or under 120 two hours after a meal. And under 100 in the mornings (fasting). At this stage, I highly suggest the monitor and checking your levels, fasting and after meals, so you get a good idea how you are doing...

 

For instance, your fasting numbers are not affected by diet. They are affected by your liver dumping glucose in to your system around 3 am- you can really only fix that number by weight loss and/or exercise/activity and going to sleep and waking up earlier. Mine was 128 this morning- which is bad- clearly, I need to get moving more.

[*lifeoftheparty*]

Also, they are considering 6.4 to be high normal b/c their info. is outdated and they aren't putting "preventive care" as a high priority.

 

Nowadays, pre-diabetes is from 5.8 to 6.4 because it means you will more than likely end up diabetic if you don't do things to prevent it- like a low carb diet, and/or going on Metformin.

[Mandylubug]

My dr didn't like my a1c at 5.7 and will be rechecking soon. I was instructed to continue to lose weight and watch what I eat. Looking for an a1c of 5.4 next time. I have a strong family history of diabetes. It isn't an if for me but a when will I require daily monitoring of levels. If I can keep my numbers low, the dr will be happy. I know an a1c of 6.0 would have me checking daily and really keeping a very strict diet. I was told with my a1c as low as it is, I can still be doing damage.

[SweetMissMagnolia]

my endo. wants mine to be below 6---I had it tested 2xs this past year so far and one was high 6something and the other was 7...I'm due to have a new test done but with hubby's new work schedule I don't seen how I can get it done.....UGH!

[Night Elf]

Okay, thanks for the information. What worries me the most is knowing how many carbs I should aim for and DH and I are surprised that they didn't give me that specific information. I think I might email the doctor and see if i can get it from her. For this labwork, my fasting glucose was 97. The highest it has ever been was 115 with testing at Kaiser, which I have done 2or 3 times a year. I've never checked after meals though. In the past, I've been on Metformin because of another drug i was taking. When they took me of that med, they took me off the Metformin.

 

Okay, a little more research is in order. Thank you for explaining the 5.8 to 6.4 for me. My mom and her sister are both diabetic and my mom said I will definitely be too unless I change my diet right now. Ugh.

[Lawana]

To get you started, read this. http://www.bloodsugar101.com/

Rather than aiming for a certain number of carbs, it makes more sense to find out how *your* body responds to various foods. The only way you can do it is by monitoring your blood sugar after you eat.

Good lick.