A1C - next steps

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Thanks for all the replies and input.

I have started using a CGM/dexcom (last 20 days) and it has been helpful for me to see the blood sugar after I eat my meals. I have a hard time with making good food choices when I am stressed (kids whining, long meetings at work, etc). So I'm trying to replace the habit of eating when stressed with something else...but it is a work in progress.

Before being focused on making improvement, I was only walking for exercise. Getting 6k average steps a day, sometimes more, sometimes less.

In the last 6 weeks, I have joined a studio and I do pilates 2 times a week (50 minute classes). I've started to walk 20 mins in the morning. I have started to do a light arm workout (10mins) once a week - this is via video/peloton app. If I try to do too much, I end up not doing it.

You need to do cardio 5X a week for at least 30 min.

"Need" isn't the right word here -- particularly given the perfectly normal dynamic OP describes of not doing it once she gets too ambitious.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. Thanks for all the replies and input.

I have started using a CGM/dexcom (last 20 days) and it has been helpful for me to see the blood sugar after I eat my meals. I have a hard time with making good food choices when I am stressed (kids whining, long meetings at work, etc). So I'm trying to replace the habit of eating when stressed with something else...but it is a work in progress.

Before being focused on making improvement, I was only walking for exercise. Getting 6k average steps a day, sometimes more, sometimes less.

In the last 6 weeks, I have joined a studio and I do pilates 2 times a week (50 minute classes). I've started to walk 20 mins in the morning. I have started to do a light arm workout (10mins) once a week - this is via video/peloton app. If I try to do too much, I end up not doing it.

You need to do cardio 5X a week for at least 30 min.

"Need" isn't the right word here -- particularly given the perfectly normal dynamic OP describes of not doing it once she gets too ambitious.

Yes, it is.

https://diabetes.org/health-wellness/fitness/weekly-exercise-targets

[Anonymous]

Count carbs. No more than about 125-150 a day. And never more than about 35-40 in a meal.

[Anonymous]

Anonymous wrote:I've been on the pre-diabetic range for A1C since my early 30's. It was 5.9 back then.
I'm now 45, and have an A1C of 6.1 back in sept 2024. Got it down to 5.8 as of feb 2025. But not very confident that I am able to get it lower nor that I won't go back to whatever habits cause it to be higher.
I had gestational diabetes with all of my pregnancies. I'm 10 lbs overweight and 20lbs to what I think would be a healthy weight for my 5.5 ft frame.

What else should I explore? GLP meds? Nutritionist? I want to get this down and not keep the risk of diabetes and other comlications.

Nutritionist. This 99.9% can be dealt with with nutrition. Start following a diabetic diet. Or rather simply a Whole Foods diet where you cut out all added sugars, you start your day with protein and healthy fats, and you avoid flours, grains, carbs that don't come from veggies or fruits.
You do NOT need bread and extraneous sugars and carbs. If you eliminate those unnecessary carbs and limit the others (you cannot eat 400 grams of fruit and veggies a day, follow the diabetic guidelines) you can and will loose weight. You will feel 1000% better and you can keep it off by eating healthy.

You don't need meds to manage this, you simply need to eliminate sugars and starches---they are not healthy for you---eat whole foods and you will feel so much better

[Anonymous]

Anonymous wrote:Count carbs. No more than about 125-150 a day. And never more than about 35-40 in a meal.

Yes, and ideally make those carbs from veggies and fruits. You do NOT need bread or other grains.

After 3-4 days of this, your sugar cravings will go away.

my breakfast is a hash of ground meat (turkey/chicken), sweet potatoes, zucchini or other squashes, any other veggies you like and serve it with a healthy service of guacamole (or simply avocado). Or do eggs with veggies and some fruit on the side.

Eat that and you will be powered for 4-5 hours, the traditional breakfast is not healthy, is too carby and not much nutrition.

[Anonymous]

Lift Weights!!! My A1C was a little lower but hit 5.7 for a few years when I was in my mid-40's, and I was not overweight at all.

I started lifting weights to build bone density in perimenopause (casually - dumbells using Peloton weight training classes - at first just Bike Bootcamp 2-3 times a week then weight training 2-3 times a week) and somehow my A1C dipped down to a normal range. Lifting weights was the only thing that I changed. Google the medical literature - it's totally under-rated and yes, absolutely eat a healthy diet, but this is a game changer. Having a higher % of muscle mass can do the trick.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Get on Metformin and continuous glucose monitoring device first.

Then get with a nutritionist and come up with a diet.

Start walking (wear a smart watch or use some tracking app). Every day, aim to increase around 100 steps, so that you can reach 3000 steps by end of month. Don’t be in a rush to do too much because you may end up injuring yourself.

Stick to 3000 steps for a month or so and then start increasing steps by 100 steps again, until you reach 6000 steps.

5000 - 10000 steps are more than enough for your health.

This is pretty decent advice. Metformin is pretty benign and may actually have some non-diabetic benefits. And “start slowly” is really important for exercise. If you hurt yourself you lose your progress and more. CGM’s are expensive but it looks like Abbot is coming out with a “consumer level” OTC version at somewhat lower expense. You probably wouldn’t need it very long — just until you found out how that baked potato, for example, impacts you. Regular glucose monitoring with a finger stick meter is less pleasant but again you probably wouldn’t need it for too long at any given time.

What is the likelihood of being able to stop Metformin once on it?
I hit diabetes range a few years ago and my doctor wanted me to start Metformin. We agreed to give me 3 months to see what I could do on my own first. I was able to lower my A1C to 5.7 with better eating habits and walking, losing 20#. I'm mid-50s and didn't want to start medication until I absolutely have to, afraid once I started I wouldn't be able to stop. Do people actually get to stop? and how do you know you if/when you can?

[Anonymous]

My cousin whose dad has diabetes was pre-diabetic at 14 even though she was 5'5 125 lbs, so genetics play a ginormous role in this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I've been on the pre-diabetic range for A1C since my early 30's. It was 5.9 back then.
I'm now 45, and have an A1C of 6.1 back in sept 2024. Got it down to 5.8 as of feb 2025. But not very confident that I am able to get it lower nor that I won't go back to whatever habits cause it to be higher.
I had gestational diabetes with all of my pregnancies. I'm 10 lbs overweight and 20lbs to what I think would be a healthy weight for my 5.5 ft frame.

What else should I explore? GLP meds? Nutritionist? I want to get this down and not keep the risk of diabetes and other comlications.

Nutritionist. This 99.9% can be dealt with with nutrition. Start following a diabetic diet. Or rather simply a Whole Foods diet where you cut out all added sugars, you start your day with protein and healthy fats, and you avoid flours, grains, carbs that don't come from veggies or fruits.
You do NOT need bread and extraneous sugars and carbs. If you eliminate those unnecessary carbs and limit the others (you cannot eat 400 grams of fruit and veggies a day, follow the diabetic guidelines) you can and will loose weight. You will feel 1000% better and you can keep it off by eating healthy.

You don't need meds to manage this, you simply need to eliminate sugars and starches---they are not healthy for you---eat whole foods and you will feel so much better

Eliminating sugars and starches is completely unsustainable for most people

[Anonymous]

I’m doing the Noom pre diabetic plan and it’s decent so far. My insurance covers it.

[Anonymous]

Op here. Thanks for the additional nutritional considerations and exercise suggestions.

I'm going to try to make more progress in these areas and have repeat labs scheduled in mid May to see where my A1C is then.

[Anonymous]

OP here with an update. Not what I was hoping for, but my A1C came back at 6.0. I'm so bummed because I'm struggling to break out of this cycle.

[Anonymous]

Stop eating crap and do serious cardio, or just take diabetes meds.

[Anonymous]

I’m not OP but I just had blood work and mines 6.2. I’m 52 5”7 and 175lbs.
I know I need to lose weight but it’s hard. I have a terrible sweet tooth.
My Ferratin/iron is low too.

[Anonymous]

Sometimes you just can't fight the genetics. My DH was way too skinny when he was eating basically no carbs and his A1C was within normal range. Just eating some carbs puts him up a few pounds to look more healthy but the A1C is in almost diabetic range.
His mother is Type 2 since her 40s.