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[quote=Anonymous][quote=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?
[/quote]

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).[/quote]

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