A1C rising

I was diagnosed T2 9 years ago at age 48. With improved diet, exercise & Metformin, I lowered my A1C to the 6 range. After a few years my A1C began to creep up, I started on insulin which seemed effective. Last year I was at 7.2 & now I’m 7.8. Feeling concerned. :worried:
I will test BGL more regularly & tweak my lifestyle in response. I was pleased to find this podcast today: “Type2andYou with Meg”–sensible reminders.
Have you been down this path? What did you do to take control?

Have you ever been tested for being a type 1?

When things don’t make sense, you could be a type 1/LADA instead. Too often we are wrongly diagnosed, I was for 9 years. One of the signs they say is having to use insulin to control your blood sugars within 3 years of a type 2 diagnosis. LADA is very slow progressing, 8 years plus in some cases. I just ran across someone that it was over 12 years.

I personally caught my very first BG fluctuation, but it was about 5 years before I was put on long acting insulin and then another 2 years before fast acting was added. But insulin add ons were because my blood sugars started to climb. I swam 75 laps in a gym pool 5 days a week, was a vegan since the 80’s, so there wasn’t a good reason for my sugars to go up. I had even asked if I could be a type 1 because I had had an uncle die from being a type 1. I was told no by my GP and endo without them ever testing me. It wasn’t until I switched doctors and was sent to a new endo I was tested and diagnosed right.

I always like to tell people to keep an eye out as the latest stats say 30% of type 1’s are still misdiagnosed.

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This is a great idea. Have you been testing bg after meals? If not, this may be something to do, to see if you need some/more mealtime insulin or consider reducing carbs. If your fasting bgs are ok, then higher A1C is likely due to higher after meal bgs.

Which insulin and when do you take it?

Welcome! What type of insulin are you using? Checking carbs at meals? Exercise? Just something to think about. Nancy50

I take Levemir once a day. I exercise most days of the week. My daytime meals include small amounts of complex carbs (ie beans). In terms of lifestyle, my persistent challenge is that I snack before bed. That is the one thing I would most like to change.
Confession: I realize I have been indulging too much in the “occasional” treat this summer (ie ice cream, fruit cobbler). Not once a week, more like 5x a week. With attention to that I hope to improve my numbers.

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Never tested for T1. Strong family history of T2.

You need to test at lest 3 times a day.

They took me of levimer and put me on tresiba. My CDE told me she found it works better. I agree. I drink hot chocolate at night, summer might do a sugar free fudgicle or pudding. Or diet soda and nuts. I try to do 6200 steps a day, plus water aerobics 3 x a week. Good luck!

Nancy Matulis

The dreaded “werewolf “ syndrome! Many of us have this problem. The sun sets and the snacking started up! It is the cause of most of my overnight blood sugar issues. A couple suggestions on this one. I do find if I don’t buy the stuff, I don’t eat the stuff. My go to late night snack now is popcorn. I know how much and what pre-bolus I need. I love peanut butter but just find the love of is not worth the delayed higher blood sugar. I think you just need to find the right snack that is not going to rise the blood sugar. That way you can snack but still have some control.
Another idea that did help me. I would sit in front of the tv and mindless eat. Suggestion was to call a family member when I was heading in that direction. But everyone was in different time zones, so I took to email. I would email friends and family so would always start it off with this was a mindless email to stop my bad habit and didn’t require a response if they didn’t want to. But it kept my hands busy. And I also work on a hooked rug. Again, keeping my hands busy!
Any little change will help. It’s not an all or nothing. Just one little thing could help. And yes testing a few hours after meals might help with where those highs are happening! Good luck and keep it up!



No, I was never tested for T1.

Thanks, Nancy. I’ll look into Tresiba.

Given all my successful dietary changes, I should be able to devise a fix. Thanks for ideas & encouragement.

Hi Deborah, I was also diagnosed around 10 years ago at the age of 48. I can tell you a few things that I have done and how I think about certain aspects of diabetes. Hopefully it will give you another way to deal with it. As soon as I was diagnosed, I knew that things were going to have to change in my life. I thought then it would be no more sugar, exercise and medication and then everything would be ok. The amount that I’ve learnt over the past ten years not just about the diabetes but about myself could fill a library. Anyway, I told myself that I could not take anything too seriously - no matter how bad it sounds. That the major part of dealing with diabetes would have to be handled by me. Which would mean that I’d have to educate myself and that would take time - and it has and will do into the future. So in the beginning I began recording blood sugar, blood pressure, pulse, weight and how much exercise I do every single morning. Some people write down what they eat and weigh their food. I don’t want (how I think) to be extreme in these cases. It’s a lifetime disease - and I don’t want to burn out. I’ve changed doctors once because I didn’t believe I was being treated well. I take a lot of medicine and try to understand what it all does. One of the most difficult things to do is what I call the balancing trick between food intake, exercise and medication. Once you have balanced this triangle then you’re well on your way to a satisfying life. By balancing the triangle, I mean getting good sugar and other medical results which are within the tolerances. Also feeling good. I hope that this has helped out a bit.


Hi Deborah: You may want to seriously consider a CGM. You know that you have food-related issues but, especially during the night, you don’t know how much of an impact the food you are eating in the evening has on your BG. A CGM would record your BG every 5 minutes 24/7 and then you could easily tweak your insulin type, dose and food to meet your lifestyle. High A1C is 95% or so due to nutrition in Type 2 and 5% to exercise. You can fix your A1C strictly with nutrition armed with a CGM and then work your exercise back in.

You could easily get your A1C back down 1- 1 1/2% just by having the intelligence you would gain from CGM. If you are on Medicare, depending on your plan CGM would be covered 80%-100%. If not on Medicare you may have another insurance plan cover some or all of the cost. Sorry, just noticed you are not quite old enough for Medicare yet.

Don’t worry about qualifications because you can always adjust your regimen to meet qualifications.


Neither my PCP nor endo has ever mentioned the possibility of a CGM. After my next A1C (if not improved), I’ll discus this.

I was hyper-focused on diabetes in my first couple years: testing, logging, learning. And I seemed to have balanced “the triangle” well. My doctors considered me a poster child of compliance.
Life changes (menopause eg) seem to have disrupted the balance I attained. Right now, I want to focus again & see if I can gain better control.

Think of yourself driving your body without a speedometer and without a gas gauge. You can always put a stick in your gas tank from time to time to see how much gas you have left (Finger Stick), but it is certainly not the best way to drive with peace of mind. With a CGM, you will rapidly learn how all foods you consume affect your BG and you will be able to eat a greater variety of foods and have an A1C you will be happy with. Most likely, the question is not if you will get a CGM but when you will get one as you still have several decades of life to enjoy ahead of you so you may want to at least start doing research before you go to your next visit.

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@Deborah3 – I strongly agree with @CJ114 about CGM use. One of the best benefits of using a CGM is that it can teach you in a customized way how your glucose metabolism works. The knowledge that it can bring is a potent tool that can not only lower your A1c but also reduce glucose variability and most importantly, increase your quality of life. Flying blind is no way to live with this disease.

If you can afford and gain access to a CGM, it will likely help you in many more ways than you can imagine. Doctors don’t often appreciate the full range of benefits that a CGM can bestow.


I would say take it easy but it seems that you’ve got it all under control. You been given heaps of advice here. Just take it all with a grain of salt or 2. And remember any improvement however small is good - No need to wish you good luck - you’ve got everything under control.