Hi friends! I need some advice on lowering my A1C quickly. I am a 33 year old type 1, diagnosed at 18 months old almost 32 years ago. I have had a high A1C (between 9.0 and 11.5) for the last few years with no complications. My husband and I are wanting to go thru the in vitro process to have another baby (tubes tied after my only daughter 10 years ago). The in vitro doctor won't progress with the procedure until my A1C is 7.0-7.5 (I'm currently at 9.0). I seen my endo who adjusted my pump basal rates but I'm really needing my A1C to lower fast so we can get this show on the road! Any suggestions? Advice?? Thanks a bunch!
Read Dr. Bernstein's Diabetes Solution and Read Jenny Ruhl Blood Sugar 101. You must lower your carbs. I am a type 1 and I learned a lot about carbs by reading the Atkins diet. Get as much information as you can and then make changes that you can handle. It won't happen all at once. I'm sure there are other members here who can help you.
Yeah I figured I would have to really lower the carbs. My endo suggested SouthBeach so I guess I can start there. Thanks for the reading suggestions, I'll be going to the book store and will do some research! Thanks so much.
Try low carbon diet and test frequently
I have heard that a sudden drop in a1c can precipitate onset of eye problems. Do research that. I know Many members on this site could help with that info.. There is also a group ("oh baby" I think it is called) for pregnant or want to be pregnant diabetics . I would do low carb, read the books Think like a pancreas and Pumping Insulin.. You can learn how to adjust your pump settings yourself, which is what you will need to do if you are considering a getting healthy for a pregnancy. The process is slow, learning curve is long, but You are motivated. Learn all you can and try a little bit of change each day.
God bless,
Brunetta
I just put this in another thread but it looks like you have a Medtronic Pump so I'll recycle it here as it might help:
I'd say look at the pump data to see where anomalies or perhaps "opportunities" are. My pump data is a good opportunity to see "woah, every day after lunch I'm low [or high, or whatever...]" and fix it. We would need more data to fix it but I think most diabetes problems can be fixed. Unfortunately, it takes work to fix it. And, if you screw up and run low, you can pound your head on concrete floors, roll around naked in puddles of cranberry juice or see orange people with plaid hair, all things I've done. Not for a while though.
By "pump data", I mean the pie charts in whichever Carelink reports have pie charts in them. I use those to look for concentrations of "off" numbers. It doesn't have to be way off but if I see an area where there's lots of lows, it's not unusual to have the next area turn out to have lots of highs. The pie charts kind of get the "trees" of individual readings out of the way and replace them with a "forest" of results that are more macro than micro. If you can find some areas with numbers that are off, look at pump settings there. If the fasting is off, I will tweak the basal, just a little bit, and if it's post-postprandial, I'll tweak the bolus ratio.
For this "theory", it doesn't matter if it's up or down, the point is to see what you can do and what happens when you make a change. If you try something that works, you have kicked diabetes' ■■■ and just need to keep doing it. It can be a good feeling. If you want, it is probably recommended to check with your doctor or CDE, because insulin is wicked and all that but, if you propose changes in a careful manner like that, I would be very surprised were a doctor not to go along with the suggestion.
I have found it can be useful to eat less carbs however I think that it's possible to eat more carbs if you are *very* certain that your bolus ratio and basal rates are nailed down tightly. If either is off, even a little bit, I have found that it's much harder to get tight results. Dr. Bernstein is very clever and I like that about him however his "Solution" is very strict carb control and, while I tried it out once, for about a week, I've been able to get good results while eating a bit more liberally. Good luck with this!
If your A1c is 11.5, that is an average blood sugar of 280 mg/dl. You have some work to do. It isn't going to be easy, but you can do this. First, there are technical things about accomplishing this. You have already gotten suggestions to look at a low carb diet. And it will be important to really get on top of using your pump. You need to be in the driver seat figuring out all your settings and how to use it properly. Get the book that Brunetta suggests "Pumping Insulin" by Walsh. Become an expert carb counter, take an education course on carb counting, get some books like Scheiner's "Ultimate Guide to Accurate Carb Counting." Do your own basal testing to determine basal rates and then using your new skills properly adjust your ratios. Many people find that their basal needs vary during the day and that they are more insulin resistant at certain times (like morning).
Ok, that being said, you can do all this and still not be successful. Why? Because it is 90% mental. You can know everything to do, but not do it. So you need to really work on this. You need to become diligent. You need to not skip boluses. You need to test. A lot. Get a prescription for at least 10 times a day. And you need to correct. If you are 280 mg/dl 3-5 hours after a meal, you need to correct. And if you 300 mg/dl when sitting down for your meal, you need to get your head around the need to correct the high blood sugar before attempting to bolus and eat. And you need to make these things part of your routine, they aren't a bother, it is just part of life like brushing your teeth.
ps. And I agree with Brunetta, you should take this in steps bringing your blood sugar down over a period of weeks.
"Try low carbon diet and test frequently"
I thought this was a "Freudian Slip," until I looked it up. There actually is a "Low Carbon Diet." The subtitle of the book is "A 30 Day Program to Lose 5000 Pounds--Be Part of the Global Warming Solution!"
Thanks for the advice Brian and when it comes to my diabetes you are 100% on point when you say its mental. I've been doing this for 33 years, since before I could talk and it has been a roller coaster, not because I don't know what to do but because I just don't do it! My endo changed my basil rates and my insulin-to-carb ratio so now its all on me to do the rest..**sigh**
Thanks for the info...after reading all of these posts I realize that I already KNOW what to do, I just need motivation to actually do it. I have been doing this my entire life. When I was a child my mom took care of it, when I was a teenager I would get grounded if I didn't take care of it and now as a 34 year old wife and mother I am in charge of my family, my career, my household...I don't want to be in charge of my diabetes!! Can someone else do this please!!! So my plan is to test every 2-3 hours, lower my carbs as much as a I can (this is the hardest part for me) and keep my eye on the prize! Thanks again for replying!
Do not try to do it all at once, Kristy. do test the basal rates that the endo gave you to see if they are correct. But not all in one day or all in one week even. The book Pumping insulin has a lot of charts to show you how to do it. Then you can check the insulin to carb ratios and insulin sensitivity. Do not do it all at once. You may get overwhelmed. I pick one to three 1/2 days out of the week when I need a basal rate change, and that is just for a three - four our window, like from 8-12 a.m. I get that straight for one week then move to the next 4 hours for the next week. It can be done but it is slow. If you know that the basal rates and insulin-carb ratio are effective.. go with them and then move to the mental stuff of doing low carb and sticking with it.. But do not get overwhelmed. Slow and steady, from the tortoise and the hare fable, wins the race.
God bless,
Brunetta
"Can someone else do this please!!!"
I nominate this for best comment of the year, lol!
Thanks Brunette..I guess I am trying to rush because I want to have a baby and soon! But you are right, if I rush I will get overwhelmed! Lol, this morning was great I woke up with a 75, 2 hours later at 95..I checked at noon and was 155 without eating or drinking anything! How in the world did I go from 95 to 155 in 2 hours without eating or drinking??!! I have so much to learn :)
Probably dawn phenomenon. Have you considered a CGM (continuous glucose monitor)? Maybe use one until the baby is born.
I think simply cutting way back on sugars and starches can go a long way.
Another thing that will help is keeping track of things. I *loathe* logging but have developed my own "workaround" that mostly works pretty well with the Medtronic pump reports. If you look at things over time, as you make changes (I'd guess that the doc has adjusted your rates so that you're taking more insulin?), you should be able to see them and get out of a mode where results can be more random (this is sort of what I did from 1984-2008 so I'm not totally unfamiliar with the process...). Every time you see some kind of change in numbers, you can celebrate it. It sounds corny but, while diabetes can be a downer it also offers a chance to win a big victory every time you test. Even a number that's off can be good data that you can use to inform your overall plan of success. I agree with being very careful however I also am always suspicious of a doctor who markets it as "a" plan as, in most cases, there's a sort of constant stream of adjustment and tweaking. I think we have to really take charge of our own diabetes (diabeteses?) to succeed. Doctors can only do so much and, a lot of times in my experience, it seems like they are guessing.
Kristy,
Please, please carefully think about how quickly you want to bring down your A1C. Brunetta is right, it can cause problems with diabetic retinopathy. I was on insulin shots for 25 years before I went on the pump. After starting the pump, I wasn't particularly aggressive, but my A1C did come down at 2-3% fairly quickly. And I paid. I was soon diagnosed with proliferative retinopathy. I had several thousand laser shots into my eyes over several months. I had multiple bleeds into both eyes. The worst was in my left eye, and I was functionally blind in that eye for about four months. You can't lift anything moderately heavy or do anything with your head lowered.
I suggest you get a very comprehensive exam from an ophthamologist, and mention these concerns.
I had no problems or symptoms with my eyes before a routine checkup found all these problems. The timing may be a coincidence, but this is a known side effect of quickly lowering blood sugars.
Best of luck to you
Michelle