Three months ago my A1C was 7.0. I was really happy and my doctor and I discussed getting it down to 6 by this summer or soon after so my husband and I could start trying. HOWEVER, there has been a lot of stress in my life recently and my last A1C from a week ago went up to 7.4. I know it is not horrible…but my husband and I really want to start trying soon and I am just at a loss. I feel so guilty that it is my fault that we have to wait so long to be parents. Even though I know my husband does not see it that way, I do. I have fallen off the “writing my blood sugars down” bandwagon recently, and I know that helps a lot. Does anyone else have any advice for getting my A1C down further and perhaps for getting rid of some of my guilt??
Andrea, I’ve been there. I felt like my quest to bring my A1c under 7 was never going to end.
My best advice is all from friends here on TuDiabetes:
-
The highest number in your day is 1 hour after a meal. That number alone, when it is out of range, can spike your average. So controlling your post-meal one-hour spike should be a specific goal for you. Aim to not go over 140 (for me, 160 was more realistic, but still…). To do this, you need to (1) delay eating until the blood sugar is in a decent pre-meal range, (2) take your insulin far enough ahead of the meal that its peak matches the food’s peak - which loosely translates to 10-30 minutes before your first bite of food, (3) test frequently at 1 hour and at 2 hours after a meal to see if you are achieving the results you want, and (4) control your carbs at meals to be a reasonable amount your body can handle (for me, that was no more than 45g at a big meal).
-
Start setting a lower threshold for when you treat a low. For instance, instead of treating a low below 70, try treating only below 60. Of course, do this as cautiously as you can so that you do not put yourself in danger, but most OBs and endos will warn you that you will ride low for much of your pregnancy and need to adjust your body’s sensation of low. Do the same for highs - treat a 140 or above as a high and monitor it closely to bring it down. During pregnancy, highs have to be attacked aggressively and quickly.
I feel like the medical community offers us little help in explaining HOW to reduce an A1c. I was told my whole life to “bring it down” - whether it was 15 (yes, it was once) or 8. From childhood on, I would just walk out of the office wondering how exactly I was supposed to do it. Exercise helped “a little.” Eating better helped “a little.” Not overtreating helped a lot. (Let glucose tabs be your friend.) But understanding when to test, how to target and attack the worst numbers, and how to time my insulin made all the real difference for me.
Best of luck. Hope some of this advice is applicable for you.
I can only add that I have been there and I still am.
I went from having my A1c around 6.5 for a while to a 7.9, then back to a 6.8 and now I think I’m back up higher. Now we are waiting for better blood sugars, but I feel like I can only do that if I have no other stress in my life, which hasn’t happened yet.
For me, writing down blood sugars and forcing myself to stick to a routine “as much as possible” helps.
Just letting you know that you are not alone!
Hi Andrea, I’m Patrice 28 and type 1 and me and my hubby are hoping to start soon too!! just waiting on my blood sugar to get better!!! My last A1C was 7.1 which isnt bad, I’ve had a bad few month’s my Dad passed away very suddenly on the 2nd of Jan this year, I do feel like i’m holden everything up as me and hubby has to wait for my D to be very good!!
i’m taking 5 mg folic acid since feb, and the pass 2 weeks i have been checking my blood sugar 15 times a day and once or twice a night and I have found that this really has helped me control my BS!!! alot better, I had blood taken today and will find out what my new A1C is next week i’m hoping its better as i’m working very hard to get it down!!! It’s very hard work!!! all the best to you!!!
Thank you ladies for all your comments! The school year just ended for me (I am a teacher) so I am hoping to take my summer to really focus on my self and my diabetes. I feel like I have 25 years of bad habits to break in a very short while!
I wholeheartedly agree with all the replies below from ladies who really know this stuff, and this predicament. My story is not unlike Melissa’s in terms of my lifelong A1c ranges and struggles. That I’ve gotten this far (29 years…Hmmm, was JUST my anniversary!) with pretty much all systems in check has been rather remarkable; I take little credit, mind you, but feel grateful.
My endo knew we wanted to start trying. I worked my tush off trying to get my sugars down. The visit I expected him to say, “ok, you’ve done it, congrats!” I was told my A1c was still above 7. I was devastated. Being the very competent physician though challenged-to-make-sense-of-emotions kind of person, he asked me flatly why I was crying. 
When I explained my understanding that it would push back our timeline at LEAST another 3 months, and how awful that was because we had been so eager, he actually came through with, “you know… it’s really ok; you can start trying,” He partnered with me and said we’d get the next half a percent together, agreed to support my plan to have more regular visits with his NP and other support staff, not to make changes, but to keep our spirits in the right direction and offer support for what I was doing well, and not so well. When we finally did conceive, my A1c was 6.2, and its only gotten better throughout my pregnancy.
What worked for me:
- monitoring WAY more frequently.
- getting CGM. I think these two (including number 1) helped tremendously since I could see exactly what was happening and when, and begin to track patterns more scientifically that could inform better changes. It also helped me realize what kinds of foods, activities, etc just weren’t worth it based on what they did to my sugars. my endo thought I was nuts, but it was what I needed.
- realizing that there will NEVER be a stress free time in my life, that the “stuff” will invariably hit the fan one day or week or month, and I’ll have to roll with it. I know stress takes a toll, but I realized if we waited for my stress to come down, we’d never have babies.
I have a high demand job and I, myself, trend toward a little, well, neurotic. I decided that the monitoring and extra support from my endo’s office would help me pick a focus that was bigger and more important than whatever stressor I had at the moment.
And the truth of the matter is, now that I’m pregnant, this journey seems WAY more fun and interesting than all those other things that used to get me stressed out.
Deep breaths, and some solid perspective… keep your chin up and hopes high. And to echo Melissa, there are DEFINITELY folks here to help you do just that.
Good luck!
Hi Andrea - I’ve had it for 27 years and found that I had to make the same changes that others have noted, during my pregnancy. Something else that I noticed that was a big change for me was to really analyze what I eat & CHANGE. I had to cut out things that I used to just take for granted, or scale back on things that are known to be triggers. Adjusting for pizza when you are pregnant takes a lot of extra insulin and quite honestly, just doesn’t work. Same with a Dunkin Donut’s muffin, certain cereals, breads, etc. Had I left those things out of my “diet” while I was TTC, I am sure my #s would have been even lower. I have noticed a trend over the years that diabetics are told you can eat more like everyone else, as long as you “correct” with insulin boluses and extra shots, since they are available now and were not when I was initially diagnosed… back in the day, we were encouraged to just stay away from the trigger foods and I think that would be the best thing to do to try to keep pregnancy blood sugars lower … easier said than done when you have cravings!!!
amen.
After reading all the comments that you have all posted (THANK YOU) I have been writing everything down since Thursday and have checked my blood about 15 times Thursday and Friday (I usually check 8-10, so it’s not a big stretch to add in those extra checks). My average BS yesterday was 112 with my highest number of 192 (my fasting morning number-definitely elevated because of my high carb dinner the night before). I also went really low carb yesterday which helped a great deal.
My plan is to email my endo my numbers after 5 days of writing it down, especially because I notice when I eat really low carb I notice that I am much much more susceptible to lows and I would like to adjust my basals accordingly. I love my endo-I just don’t utilize her enough…which is something I need to start doing, My next appt with her is in July.
I also need to say that having this level of support from you ladies is helping me to stay focused and write things down and think before I eat…so thank you!
keep up the good work, Andrea. It’s totally worth it.
Andrea… and everyone. I seem to be in the same boat as you. Just can’t seem to get below 7 and just dying to have a baby. After reading all of your thoughts and comments, it makes me feel better. I have a cgm and my endo just put me on symlin… so, I’m doing everything I can. I just wanted to add a comment that it is so nice to have a group of women who are going thru the same sort of things I am… makes me remember that I am not alone. Hope you are doing well and I wish you luck… looking forward to reading more of what is working for you, and maybe implementing some of your ideas (ladies) into my plan!!
So, it has been a little over a month since I wrote this original post and I feel like a lot has changed. I am feeling a lot better about myself recently with the help of a yoga retreat that I went on with my mom. I have started to do yoga and meditation a lot more and see a new wonderful therapist! I also started wearing my Dexcom again and that had been a tremendous help-especially through my workouts. I haven’t had another A1C since insurance only covers them every three months, but my 31 day average on my pump is 136 which feels like a good number to me. I know it is only averaging the blood sugars I take, but I am checking my blood at least 10 times a day, so I feel like it may be pretty accurate. I have been doing my best not to over treat (I am so bloody sick of glucose tabs right now) because on my last appointment with my CDE we discussed that most of my highs were coming in response to my lows. Which is nice because I feel like I have more control over the highs now. I am excited to get my A1C done in September to see where I am.
Thank you all for such wonderful comments. I love having this forum to share my issues and myself.
It’s amazing how those small changes start making you feel more empowered. For me, a weight loss program did what your yoga/meditation is doing for you. It helped me relax as I could see measurable results along the way. I reached my A1c goal a month before I got my cgm, before I switched to a new pump, etc. So I couldn’t blame any of the cool new tech gadgets for my success. I had to give the credit to the incremental changes I was making to the way I was approaching my health, one good habit at a time.
Congrats on reducing your stress level and testing more and bringing your average down. All wonderful changes!
there is a program in California call sweet success its for women who are pregnant that are diabetic and they have a sister program called preconception consulting for diabetic women who are trying to conceive. Its basically a team, a diabetic educator, a nurse, a dietitian/nutritionist and a social worker who is a counselor. They help set up a basic eating plan and goals to help you get healthy and you bl levels under control so you can conceive. I know they have similar programs in different states.
When i was 3 months pregnant my doctor referred me to sweet success cuz my a1c was 8.5 and my levels were not in the best shape. the day before my apt i had a miscarriage and had to have a d&c when i called to cancel my apt with sweet success thats when they told me about preconception consulting. Since i have been going to them i have brought my a1c down to 5.7 and my levels are under tight control. I lost 15 pounds! last night i felt weird and this morning i took a pregnancy test a faint line appeared im going to take another one in 2 days. fingers crossed and good luck to u
Thank you for posting, Andrea! I’m in a similar situation, and it has been frustrating. When I saw a high-risk OB in March for pre-conception counseling, she told me she wants my A1c to be under 6, “ideally 5.” She then said (with a straight face), “that should be easy for you to do.” My A1c in April was 6.7, then in June it was 6.6. I eat very well, count carbs carefully, exercise about 3 times a week, and I have a very active job.
After reading a lot of the posts on this site, I decided to try to lower my carb intake. It’s still nowhere near the 30g/day that some people do, but I think it’s helping anyway. (Now I’m eating 30g for breakfast and 45g for lunch and dinner). I have also (pretty much) cut out refined carbs and am eating more protein and vegetables. What do your endos/dietitians/OBs tell you about carb intake? My dietitian wants me to eat between 190-285g of carb/day, and probably more during pregnancy (if/when I get there!)
Thanks for all the info and suggestions, everybody!