A1c of 11, what to do?

Hi every one … i m swiff suffering from type 1 since teens i was dignosed in 7th class but i always take this as my positive point coz it really doesn’t bother me only thing change is i have to take insulin 2 time a day… in start i was on low crab but evenly i ate what ever i want but with little bit restriction in amount … the flow of life going on… now i m in undergraduate life ( dentist to be) which was upto an end… when i was in teen i don’t aware much of hba1c n its control bit due to doctor profession i come to know about that… but when i last checked my hba1c it was 11 i was shocked as it wass very high likee… in my undergraduate life i saw pt in that hba1c on bed having some serious issue but i don’t have any… but the i ho through family physician explain all that … he ask me to start low crab with full diet… i start following all that the after 3 4 month i gone through another test n have 9 hba1c i was like thats god it was coming to normal i continue me y diet but not as properly as i was doing in that time. N i also take care of my insulin timing … but recently when i gone through test it was again 11… now i m confused what should i have to do…

Hi Swiff, I have moved your post to a topic in the main forum so it will be seen by a larger audience.

Are you still only taking insulin 2x/day? If you are, this is the first part of your problem. You should be taking a long-acting insulin such as Levemir, Lantus or Tresiba to handle your basal insulin needs and injecting a rapid-acting insulin such as Humalog, NovoRapid/Novolog, Fiasp or Apidra when you eat (or using a pump). Are you on a modern insulin regimen? Also, are you testing enough or at all? The A1C shouldn’t be too big of a mystery if you are testing. Carb restriction is a valuable tool for improving control but you still need to be meeting your basal and bolus insulin needs with the right insulin regimen or it won’t matter what your diet is.


I agree with @Scott_Eric. I recommend that you search online about a basal/bolus insulin regimen. In order to dose insulin well, you need to know what your current blood glucose is and how to correct it if trending in an unfavorable direction. You’ll also need to understand how to calculate an insulin dose for the meals you eat. Carb counting is a necessary skill to do this.

Do you have the resources needed to get a continuous glucose monitor (CGM)? They are expensive and most of us need some help from a government social program or private insurance. If you can’t get a CGM, I would make every effort to secure a glucose meter and a sufficient supply of test strips. More data is better.

Most importantly, try to increase your diabetes knowledge as much as life allows. A good place to start is reading the book, Think Like a Pancreas by Scheiner. Good luck with all your efforts. Participate here and you will find another valuable resource to help you achieve your health goals.


My advice is simple…test more often, four to eight times a day if you can and make corrections as needed. Watch your carbs an limit processed foods. Eat healthy, be kind to yourself.

You are going to feel so much better once you get that a1c down around 6.


Hello I would definitely change your doctor, I would find a endocrinologist that specializes in diabetes and also get on a insulin pump this will make a big difference in your a1c’s
Also I got diabetes type 1 when I was 16 and just because you don’t have something now doesn’t mean you won’t get something then you have no chose your stuck . In have tryed to take care of my diabetes the best I could and it definitely should be your number one priority. Please take care of your diabetes it’s so easy to just try to be normal but that will only down the road put your health in jeopardy, and then your don’t have a choice

Thanks stemwinder_Gray i really need a good advice n counseling to control my diabetes

Yah i went through diabetologist… he too recommend the same… lantus along with rapid acting n i have started that… i have checked my sugar level since start of this it was going above 300 afterevery meal… now i m confuse what should i do… i think both insulin takes atleast 3 4 days to work properly but could it b dangerous if my sugar level remain higher for longer period

I have glucosemeter n i checked offenly thanks for suggestion i surely read this book
I want to ask do any one plz properly explain carb counting

Do you want to know why to carb count or how to carb count? Or maybe both.

That’s great to hear. It really boggles the mind that your doctor wasn’t putting you on the standard treatment for almost the last 20 years, but you’re on the right track now! Now you need to determine your Lantus dose and your carb ratios. Read Think Like a Pancreas which @Terry4 suggested for an overview.

Yah exactly i want to know

i Google that book but couldn’t found any pdf do any one have link?

I use the app MyFitnessPal to count all my foods (for years before diagnosis, actually). It makes everything much easier. But it is a bit of a trained skill to know how much food weighs or its size/volume. I got a measuring cup and food scale to train myself for a while.

You’ll eventually need to know your Insulin Sensitivity Factor and Insulin-to-Carb ratio. But some can keep it easy for a while with something like 3-5U fast-acting insulin before a big meal, and not worry too.much about counting.

You can find much of what is in Think Like A Pancreas at this website.

The author has been a guest speaker here, and has Type 1 diabetes. I have learned a lot from his books and website.

On the website, you can find info on consulting services they offer for a fee. I have not used them, but some have posted here that they did.

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I transitioned to basal + meal bolus insulin after 20 years on R/N, which I think is what you’re looking at here. The basic idea is that the basal insulin should keep you at an even blood glucose level when you’re not eating anything, and then you inject the amount of fast-acting insulin you need to cover however many carbs you’re eating at mealtime. But there’s a lot of testing and calculation involved before you can do it that precisely. You have to determine what your insulin-carb ratio is (how many units cover how many grams of carb), what your fasting basal requirement is, and what your correction ratio is (how much your BG decreases for a single unit of insulin).

You’ll need to do some fasting tests and carb tests to get the numbers dialed in. I know in my case it took a couple of weeks to get that all figured out, so I started with my endocrinologist making some educated guesses on basal dose and a sliding-scale for mealtime boluses. Not sure at this distance of time what that was based on, but presumably a matter of looking at my total daily dose on R/N and conservatively matching that. Usual standard is that TDD should be split 50/50 between basal and bolus, though on a low carb diet that’s not how it works. But it’s a good starting place for a standard diet.

There’s a learning curve but for me it was life-transforming. After 20 years I felt for the first time like I was controlling my medication to fit my needs rather than struggling to arrange my life to fit my medication. I think you’ll find you have a much better quality of life–not just better numbers–when you make the switch.


I’m with the others. You need a more diabetes competent doctor. I also found that some doctors are so dogmatic about carbohydrates that they overlook the calorie factor. Eat moderately, exercise daily, test often. I just helped another person who was concerned about the cost of test strips. U found that the cheapest meter that Walmart had is as accurate as my more expensive model, and the strips are much cheaper too.