Just learned I’m diabetic - what next?

[Anonymous]

I just found out that my Hemoglobin A1C is 6.5%, so I may have diabetes. I need to make some life changes. Please help me know specifically what to do. My aunt just died of diabetes-related complications at age 65.

I’m only 46. I’m 5’8” and 250 lbs. I have loose ankles due to some physical deformations, so I’m mostly sedentary. I can walk, but I have to be careful.

I eat three meals a day and a snack. For breakfast I have two soft-boiled eggs on fresh spinach on bread with a glass of OJ. For lunch I have fresh chopped veggies with hummus and a banana. For dinner I eat whatever. I have a banana and Nutella for a snack before dinner. Sometimes dinner is salmon and broccoli, sometimes it’s hamburgers and sweet potato fries. Sometimes it’s coconut curry chicken. Sometimes it’s Ethiopian or Thai curry.

I take vitamin C, Abilify, lithium, latuda, and Xanax. I’m suicidal without these - I had a lot of trauma as a kid and have an ACE score of 9. I’m in therapy twice a week, making good progress.

Where do I start? I think eating better and getting movement would help, but I’m not sure exactly what. Maybe a 20 minute walk in the morning?

[Anonymous]

First - breathe. 20 mins walk is a good start. Listen to the educators and make sure you have all the supplies you need. You can do this.

[Anonymous]

Anonymous wrote:
I just found out that my Hemoglobin A1C is 6.5%, so I may have diabetes. I need to make some life changes. Please help me know specifically what to do. My aunt just died of diabetes-related complications at age 65.

I’m only 46. I’m 5’8” and 250 lbs. I have loose ankles due to some physical deformations, so I’m mostly sedentary. I can walk, but I have to be careful.

I eat three meals a day and a snack. For breakfast I have two soft-boiled eggs on fresh spinach on bread with a glass of OJ. For lunch I have fresh chopped veggies with hummus and a banana. For dinner I eat whatever. I have a banana and Nutella for a snack before dinner. Sometimes dinner is salmon and broccoli, sometimes it’s hamburgers and sweet potato fries. Sometimes it’s coconut curry chicken. Sometimes it’s Ethiopian or Thai curry.

I take vitamin C, Abilify, lithium, latuda, and Xanax. I’m suicidal without these - I had a lot of trauma as a kid and have an ACE score of 9. I’m in therapy twice a week, making good progress.

Where do I start? I think eating better and getting movement would help, but I’m not sure exactly what. Maybe a 20 minute walk in the morning?

First of all, 6.5% isn't that bad. I think most people who get diagnosed with diabetes tend to learn when their A1C is more like 9, 10, 11. So, try not to panic, although you're absolutely right that you need to make some lifestyle changes to try to manage it. It's a VERY serious disease if not managed well and can cause all sorts of kidney and cardiac problems.

You need to try to get under the care of a endocrinologist. I wouldn't leave this to a GP to manage. Depending on the GC you might be put on insulin for a while if you have insulin resistance. You'll likely be prescribed metformin, starting at a dosage of 1000 mg. At that level maybe not a semaglutide, although maybe they will due to your weight.

You'll want to test your fasting sugar every morning for a while.

You need to increase your exercise with an emphasis on cardiovascular for your heart. That'll help with weight loss as well, although as you noted this is 70% diet. No carbs, no sugar. Skip the banana and Nutella -- that's an obscene amount of sugar, especially the banana. Also skip the juice -- juice is not part of your life anymore, except in maybe VERY small quantities (like maybe 4 oz, and then only rarely).

[Anonymous]

Oh I forgot basically you need to count carbs and know how much is in everything. Aim for no more than about 40 carbs a meal. So that means no more bread and bananas and nutella.

You can do this silly net carb thing -- if you increase your fiber intake it's oK to eat a little more carby. But don't go overboard.

Good news is there are lots more options in this regard than there used to be. You can find low carb tortillas, for example.

[Anonymous]

Cut grains and sugar and fake sweeteners.

[Anonymous]

I’d cut out the bananas and Nutella. Add in lower glycemic fruit like berries. Lots of greens in your diet helps keep blood sugar down. Adding any exercise you can manage throughout day will help.

[Anonymous]

Did your doctor give you any medication such as metformin? Did he give you any guidelines for meals or referrals to a specialist such as a dietician?

You sound motivated which is great. A 20 minute walk is a good start. And remember, diabetes is a marathon, not a sprint. Each new day is a new day, so if you eat something that didn't work for you or get a number you didn't want (lab results or finger stick), then get back on track the next day.

[Anonymous]

If you are serious read the books written by Dr. Mark Fuhrman. He discusses everything you need to know.

[Anonymous]

I would try to get on ozempic or Mounjaro. It will help with the weight loss and your bloood sugar.

[Anonymous]

I have had success with Virta Health to lower A1C and lose weight: https://www.virtahealth.com/
It is basically a low carb approach, but I appreciated the guidance and support.

[Anonymous]

Anonymous wrote:If you are serious read the books written by Dr. Mark Fuhrman. He discusses everything you need to know.

All that comes up in the public library are murder investigation books. Those?

[Anonymous]

Anonymous wrote:I have had success with Virta Health to lower A1C and lose weight: https://www.virtahealth.com/
It is basically a low carb approach, but I appreciated the guidance and support.

If your insurance will cover, Virta or Level 2 is the way to go. They get great results and will guide and support you.

Ask your doctor for a CGM, you should be covered at that A1c.

I reversed my prediabetes with the help of these 2 books and 15+ minute walks after meals. Life changing, so many other health issues also resolved or improved - GERD, migraines, PCOS, bp, cholesterol, etc. Normalizing glucose and insulin resistance will also reduce your risks for Alzheimer's, heart disease and some cancers. You have gotten a wake up call that can change your health for the better with changes that are fully in your control.

https://www.amazon.com/End-Your-Carb-Confusion-Customize/dp/1628604298

https://www.amazon.com/Diabetes-Code-Prevent-Reverse-Naturally/dp/1771642653

For inspo:

https://www.youtube.com/@AdaptYourLife/videos

https://www.youtube.com/@drjasonfung

https://www.youtube.com/@TheFastingMethod

It is reversible, OP. Even the ADA now admits that. You sound motivated. You can do it!

[Anonymous]

Thank you all for your help!

Here’s my plan for now:

20 minute walk in the morning. Maybe a 20 minute walk at night. My sidewalks are so uneven, I worry about this.

I can’t cut out the bread in the morning, but I’ll cut out the bananas and the Nutella. I can cut out the rice at dinner. Maybe I can serve lentils instead of rice.

Would baby carrots and peanut butter be a good replacement for my banana and Nutella snack?

I like frozen berries and yogurt, so that could be a snack.

I see my psychiatrist tomorrow, so I’ll mention all this to her and I’ll look into seeing an endocrinologist. The lab work I had done was at a CVS minute clinic - I went in for a flu test and the nurse practitioner suggested bloodwork. She was so kind and caring, I’ll never forget my appointment with her.

Thank you all for your advice.

[Anonymous]

It sounds like you got bloodwork back from CVS and haven't spoken with a doctor yet? Your first stop is an appointment with a GP.

[Anonymous]

You need a diabetes educator and an endo.