My past three A1Cs have been over 7, my one that came back today was 7.8! I already eat a low carb diet and try so hard. I'm at a loss and so frustrated and literally just want to cry! HELP!! How can I lower my A1C?! Before last year I never had an A1C over 6.2 and since then its been a rollercoaster that I can't get off of! Any tips would be greatly appreciated as I am just so discouraged! Thanks in advance for the advice I can only get from my fellow diabetics who understand.
jen, how much basal are you using...have you upped your basal? i think many of us mentioned, if you low carb like you're doing, you have to also bolus for protein so it makes no difference and analog insulins work best with CARBS....can you provide us some of your numbers, wake up, ppl's, bedtime, etc...what are your I:CR? also, are you working with an endo, cde? do you have a CGM, can it provide any info, like spikes, highs in middle of the night, etc... It also could be you're taking too much basal. Also, have you done any basal testing?
I've found it practical to aim for lower targets. If I go 3 days and am running up, I'll think closely "did I count the carbs correctly" and that stuff, maybe try a couple more days of more focused carb counts and, if the numbers are still off, I nudge up the bolus for post meal highs and basal for fasting. Maybe it sounds easier than it is but I've had good results with this. It may also be useful to get set up to aim at a lower target? If your doc programs your pump to aim at 100, maybe 90 can nudge your numbers down?
I'm going to suggest something counter-intuitive - start over and begin eating (and dosing for more carbs). Have you basal tested since your pump start? If you haven't, you should do a fresh round or at least make sure that your overnight basal is correct and that if you aren't high going to bed, you're waking up with a good number.
There isn't a direct correlation between low carb and good results. Some of us actually do better when we eat a regular moderate carb diet and allow our insulin to work. I know my blood sugars are more stable when I eat between 40-70 carbs per meal than when I eat either fewer or more. You may find a higher carb diet works or you may not but your very low carb diet leading to a roller coaster and average blood sugars above 170 is burning you out. Trying something new will at least give you a psychic break.
I agree with this, trying to do this myself, too. It's not the carbs pushing your numbers up, as you're not eating 'ANY' and you're also working out tons, too. as you read on here most type 1's eat a balance diet or can eat carbs. It's your insulin doses, they're not correct, obviously. I would say start with basal, it's the foundation and if it's not right, no matter now much you bolus or correct, your numbers will continue to push back up and your liver and all kinds of other things (that I don't even really understand yet, my endo tried to explain) get involved and start messin' stuff up. REALLY really low carbing might be great for overweight people, type 2's but 30 grams of carbs a day for someone who is young, thin, etc..who doesn't need to be low carbing...I don't know. Please rethink and try to do what is suggested, try a new approach and post numbers, if inclined? you'll get there! :)
If you try so hard then you should never feel you have failed. Sometimes, life is just hard. And the character of the person should never be judged by the obstacles they must surmount, rather by the heart and effort they put into it. So I hope you will take a deep breath and work with us on this. You can improve things, maybe not overnight, but over time.
If you can describe some of the difficulties that you are having, perhaps we can help. Have your readings drifted higher? Have you had more unpredictable swings? What have you observed about what has happened?
Your profile is private so I have no idea if you use a pump or not. Besides all the very constructive comments you have gotten already. The one sure way to lower your A1C fast, is donate blood a week or two before your next A1C.
This basically gets rid of a pint of blood cells that have become "glycosylated" and forces your body to make new ones that are not yet glycosylated.
If you're otherwise healthy there's no reason you can't and who knows you could even save a life.
I am in the same boat. I just posted a blog about it a few minutes ago. I saw my A1c of 7.7 today and literally felt like crying. I don't know what else I can do that I'm not already doing.
I honestly wonder some days how Type 1s can possibly get an A1c below 6.0. I have never come close in over 20 years. I struggle just to stay below 7.5 most of the time.
So I don't have any advice for you, but can definitely sympathize with the frustration of putting in 100% and still seeing high results. What I try to do is be frustrated today, and forget about it tomorrow and just continue to try my best.
I figure if my BG is high, take more insulin. If it's high for a while, I'll adjust the insulin. I keep adjusting it until it's where I want it, and then go a bit more, get a flurry of lows and turn it back a notch. I've seen your other blogs Jen and I can see you're making progress. It's really important to not give up too. Your best seems to be getting better and, if you keep at it, continued success is inevitable.
Does your A1C match your meter readings? Your meter readings should have gone up along with your A1c's...are you increasing your insulin to account for this?
I know there are several people on here(myself included) who keep very tight control and get consistently higher A1c's than their meters suggest. In my case its only about 0.5-0.7% higher, not 2%, but a 5.6(114 avg) vs 83 avg that my meter shows is a big difference, especially when you put all that effort in to maintain near-perfect numbers.
Ultimately, A1c is just a lab test and is prone to inaccuracies. Ive read that biological factors play a part also, so this test may just not be as accurate for some people as others. As long as you are testing often and are sure you are not missing any highs, Ive learned to trust my meter and not worry too much about my A1c.
My biggest obstacle is random unexplainable spikes in my blood sugar. For instance, this morning my fasting blood sugar was 115 and was stable around 120 for a few hours then without food my CGM began to spike. My blood sugar went from 120-245 in one hour with no food!? But with the same basal rate two days before my sugar plummeted with no food within the hour, its SO frustrating! My doctor has basically shrugged his shoulders and said "I'm an odd case".I also have a huge fear of lows and try to keep my blood sugar over 100, anyone else deal with this?
I may try eating more carbs and bolusing more. I've been on insulin for 2 years and the most I've ever taken for a meal is 1.5 units because I am so afraid of hypos.
Could it be late spikes from protein/fat? What'd you have for breakfast? Maybe the longer you low carb the more your body is converting protein into carbs?
I don't weigh enough to give blood and am also IGA deficient :( very very interesting though....
Sorry, my suggestion will probably not work quickly. But it does work.
One thing that has always worked for me but it requires some dedication.
Write stuff down!
I like to use Excel but whatever works for you, even hand-drawn, is the right method.
Charting allows you to not only look at the immediate moment but also allows some analysis, looking back, that can form the basis for a good decision going forward. Do strategic BG testing- mealtime, 2 & 4 hour post-meal, waking and retiring.
Do basal testing if needed. You need to chart that.
This is all hard work - no way around it. Other short term tactics may work faster but charting is one of those fundamental tweaks, more powerful than it seems.
I don't do this all the time, not even close. I do chart when things seem "out of control."
I also upload weekly my CGM, pump, and meter to a web-charting software called Diasend.
Do you often spike around that time of day or was it a one off? I've had that sort of spike happen on occasion when there were air bubbles in my tubing and when I had a leaky reservoir.
I agree with Terry write everything down until you figure it out.
"the most I've ever taken for a meal is 1.5 units because I am so afraid of hypos."
Do your carb counts for meals (including 50% of the protein) ever exceed 1.5 units? If they do, try taking the exact dose indicated by your IC ratio even if it exceeds 1.5 units. If you are scared of lows, try testing every 30 minutes until you gain confidence. Your CGM should make it easier.
Maybe going very low carb isn't working for your body, or you aren't getting enough calories overall. Are you taking any medications aside from insulin? If you can find a good CDE, they might be able to help as well.
wow! you are iga deficient too? I just went to try to give blood and join the international bone marrow bank. they wouldn't take my blood cuz im a diabetic (I live in spain, think it might be different in the states) and didn't want my marrow because of the iga deficiency...
I don't think donating blood to get a lower a1c would be very beneficial, haven't those overly glycated cells been doing their damage for however long they been swimming around in the circulatory system? I don't know, am asking.
Exercise helps and low carb does not mean the foods you choose to eat aren't turning to sugar. Fatty foods spike blood sugar. Other medical issues, stress, age all play factors. Have you had your thyroid checked lately. A slightly low level can cause hikes in BGs along w/ weight gain.
If you bolus rate isn't covering your meals you set yourself up for high spikes and after treating hypos. Are you seeing an Endo?