Changes in diet - no significant change in A1C

I had an appointment with the endocrinologist today, and my A1C is down to 5.3 (it was 5.4 in late November - 8.6 last May!).

I was really curious about how my A1C would change. Because of my pregnancy, I made some very significant changes - including starting humalog at mealtimes and humulin at night. Pre-pregnancy, I was able to bring my A1C down significantly through (what I would consider restrictive) low carb high fat diet and exercise. Now, I eat a moderate amount of carbs, about 120 per day or so.

I would have sworn that my A1C was going to go through the roof!

So, here’s my question - maybe it’s more philosophical. When making decisions on diet, did you find a cut and dry, black and white answer? That very clearly option 1 works for you and option 2 does not? While I still focus on eating healthy foods, previously I wasn’t eating any grains or refined carbs. And yesterday I had ice cream!

Maybe it’s about weighing the costs - in this case, the use of insulin gives me the freedom of a wider menu, while previously my goal was to avoid insulin at all costs.

I’m sure you didn’t mean “humulin,” a Regular short acting insulin. Perhaps you’re taking Humulin N, which many are familiar with as NPH.

Count yourself lucky that your metabolism allows moderate, what I would consider generous, amounts of carbohydrate. Carbohydrate consumption and how our metabolisms respond to different levels of carbs exist along a spectrum. When you reach your personal threshold of “too many carbs,” your body and meter will tell you.

At a low 5% A1c, you are doing a great job! I hope you have a healthy baby. I agree with you, insulin is a potent treatment that allow people like us to live a more normal life. Good for you and your doctor for not extending your avoidance of insulin. It’s not poison; it is a natural hormone and a highly effective tool in the right hands.


Certainly adding insulin to the treatment plan will enable you to consume more carbs while maintaining good numbers and a good A1c. The downside of that, at least in my experience, is that it becomes much more difficult to manage weight , which depending on your individual case, may increase the need for insulin. It does not mean that your experience will be different and, with pregnancy, the requirements are likely quite different. I do believe that careful management can achieve the right balance between good diabetes management and a comfortable, yet healthy diet overall.

Everyone is different, and as such, we each have to find out what works out best for us.

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@Terry4 yes, my mistake. It is NPH at night! Sorry for the confusion! Yes - I think insulin was the key here!

@Thas perhaps. I haven’t gained any weight at all. My endo seems to think that postpartum my needs will return to pre-pregnancy levels, and that there are other things I can try (that she considered more “weight friendly.”). So far, though, so good.

Yes - I guess that’s the crux of it, really. That every body is different. I was just so surprised that such a major change in diet could still work. I know that many PWD (T2s) in this forum require insulin and still eat very low carb, so I was surprised.

being pregnant with diabetes is never easy and just do the best you can. , I wouldn’t go under 80-100g, there isn’t enough known about keto pregnancy, though it’s been part of our evolution. try and keep the insulin/carbs down as much as you can, you want to keep bubs weight down and normal. as much as possible

As much as I’ve learned online and from discussing these issues with other people struggling with diabetes— when it comes to pregnancy-- I would highly recommend only taking nutritional and medical advice from medical professionals-- even if for just these 40 weeks…

There’s just too much at stake to be taking medical advice from weirdos like me on the intetnet when it it comes to pregnancy.

I wasn’t really asking for advice - I feel like I figured out something that is working for me. I was more wondering about other people’s experiences with selecting dietary guidelines that work for them. I was surprised that I could so drastically change my diet and still make it work!

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Being insulin dependant, I’m able to maintain my a1c within a pretty tight range with a variety of different diets, but have to vary my insulin usage accordingly of course— I would say that for me the different types of diets change the level of work that goes into maintaining a good a1c more than they change my ability to do it. Certainly when I eat lower carb I experience less variability and am overall less concerned about what my bg is doing…

I was following a much more carb restricted diet in order to maintain tight control while using novolog only to cover meals. Using afrezza has allowed me to include quite a bit more carbohydrates into my diet and still have tight control.

Nothing in diabetes is ever “black and white”. (Well, except for the fact that it can kill you if you ignore it entirely.)

There is just too much individual variation. As experiences teaches and the previous posts illustrate beautifully, every physiology responds differently to inputs. What works brilliantly for me might work only so-so for the next person and not at all for someone else. And vice versa.

My own experience echoes that of Thas and Sam. Insulin lets me eat pretty much whatever I want, but at a price: more difficulty with weight, and greater variability in BG. As is always the case, you have to do what works for you, without reference to how it works for some other person, notional or otherwise. What works, works. What doesn’t, doesn’t.

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While I often hear that “all bodies are different,” I find that medical advice isn’t usually tailored that way. And online, it seems like folks take certain stances very strongly, without allowing for variety. All the books and blogs I’ve read say something like, “follow these exact steps and you will be ok.” Diabetes advice seems to be black and white.

Through experimentation I found two solutions that seem to work for me. It’s almost like - the fear associated with a diabetes dx pushed me to make extreme changes (and maybe that’s what I needed), but a more moderate approach seems to be more comfortable for me.

Agree. The advice is. But the disease isn’t, and that’s where the big disconnect lies. One size doesn’t fit all.

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No matter how many examples I come across, it always seems to take me by surprise! I wish the medical establishment was better at understanding this inherent diversity.

always take medical advice, forums are just for reading and getting good and bad info. you may find something worthwhile talking to your DR about.

my opinion, good or bad?
what is always constant is that all carbs, some fats and body metabolism needs insulin, insulin pushes carbs to fat. it is a fat storing hormone.

If one is T2 insulin resistant, you are probably overweight and already have excess insulin, eating high carb and taking more insulin to cover it, because you have to get the glucose out of the blood…it can be compounding the problem

this is only 8 minutes and may explain my view.

@jack16 - no thanks, buddy. The whole point of this thread was that different things work for different people. I really resent your answer. You’ve assumed all sorts of things about me, and honestly it’s pretty patronizing. So, yep, I’m all set and was not asking for your body judgment. I’d say with my current A1C I’m doing just fine.


I’m sorry you feel I was judging your body, that wasn’t the intent. I was speaking in general. your intake of 120g of carb I think would be seen by most as low carb. When pregnant is one of the times the body becomes more insulin resistant to put on weight.
It’s chemical as the link said, there is no criticism.

I have varied my diet minimally over the past five years being T1D. I’ve had moderate weight gains and weight loss episodes while eating the same exact foods for months at a time. My A1C has been around the 6.0 range, so while there is room for improvement (being on MDI without a CGM mind you), I feel like I’m in good shape.

In regards to your philosophical question… I’m not sure if you’re talking about diets affecting weight or diets affecting A1C (or both), but if I had to choose which one was more important to me, I’d certainly choose a decision that affects my A1C!

So, I’d probably say while your title says “Changes in diet - no significant change in A1C (Bravo!)”, my story would probably be
(1) "No changes in diet or A1C, weight fluctuating by +/- 20 pounds.
(2) "No changes in diet or A1C, insulin resistance fluctuating between 41ui/day (current) to 57ui/day (last Spring)
…note that those two went hand in hand. When I was taking more insulin, my weight was on the rise. My diet now is almost entirely the same, minus cheese, nuts and hummus and a bunch of other low carb options…

So on making decisions on diet, my cut and dry answer for the most part is “Can I afford it”.

The only thing I understand completely about my betes and food is that carbs make my digits go up and eating as low carb as I can do keeps me the flattest…!! When I feel like the battling the graph… I’ll throw caution to the pizza!!! But most days, for me and mental sanity, it’s just easiest to eat what I know won’t surprise me… Which means I sip on air.

When I overeat protein I gain weight quickly. And face down in some left over steak, grilled chicken or a block of cheese is just so tempting!!:stuck_out_tongue_winking_eye: But… I experimented and found that sigh, yes… Cutting way back on nuts, cheese and meat helped me maintain my weight much easier.

Of food. Why do I love you so!:heart:️

This, like most things D, is so individual that the exceptions (almost) outnumber the rules. I can eat protein (and, pretty much, fat) to my heart’s content without a weight issue. But walking through the room where there is an exposed glass of fruit juice adds 1 pound for each 5 minutes I spend there. Or so it seems, anyway.


@jack16: being T2 insulin resistant doesn’t necessarily mean that the person is overweight. Skinny and athletic people get T2 as well. Billie Jean King is a good example


I think we can all agree on this quote. Where it gets complicated, for me, is to determine at which point depriving my body of one of the only three macronutrient groups reaches a nice equilibrium in exchange for perfectly stable blood sugars… That’s where the room for debate really is I think-- and a fascinating debate with many tentacles it truly is.