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Discouraged by A1C jump
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jmtrice posted:
I am Type 2, only diabetes medication is Metformin.
I am extremely discouraged, as my last bloodwork showed by A1C rose from 5.8 to 6.1. I have been trying so hard to eat healthy and get my A1C down to the healthiest possible level. My doctor thinks that level is fine, and she actually reduced my Metformin from 2000 to 1500/day. I have read so much about nerve damage beginning at levels even under 6.0 that I had hoped to get my A1C down to below five.

Another discouraging result was that my triglycerides were at 28! They were already low and are continuing to drop. The things I have read about that mention a low-fat diet and possibly some other things. My other numbers were fine, so I don't think I have liver disease, etc. And my diet is certainly not low-fat! I eat almonds, cashews, olive oil, sunflower seeds, etc. I am a vegetarian. Any ideas?

Thanks, from a newbie to this forum.
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nutrijoy responded:
Welcome to the forums, jm. You didn't mention how often (or if) you test your blood glucose levels as a way of monitoring your day-to-day control over your diabetes. You are correct that some people can suffer nerve damage at levels as low as the mid-fives. Dr. Richard K. Bernstein, a well-known and highly respected (though somewhat controversial) diabetologist mentioned on one of his monthly webcasts that he had a female patient who had severe neuropathy and her A1c only measured 5.6 at the time. Although uncommon, it serves as a pointed reminder that as diabetics, our bodies are all different and unique.

Different things, including foods and medicines, affect each of our bodies differently. For example, the highest A1c measurement that I personally ever tested for was 6.1, barely two tenths of a point above high normal. Yet I suffered significant nerve damage in my feet including foot drop syndrome. In addition, I had all of the classic symptoms of full blown diabetes at an A1c level that most doctors would have dismissed as being just mildly pre-diabetic. I enlisted the aid of one the top endocrinologists in the County and dutifully followed his advice and took all of his prescribed medications faithfully without experiencing any symptomatic improvement. After four months, I had a C-Peptide test performed that indicated my pancreas was no longer producing much, if any insulin. A second C-Peptide test was done three weeks later with no change in the results.

My endo changed my meds numerous times but the net result was not much different than if I had been taking starch pills. I was already a vegetarian at the time but did increase my exercise/activity level since I was already retired and could devote the time to it. To make a long story short, I eventually went on insulin and managed to reverse my symptoms (but not my diabetes). My current A1c is 4.8 and holding (for over 18 months to date) but would not have been possible without going on insulin, fine-tuning my diet (an ongoing and continuous endeavor), and varying my exercise/activity levels. I also experimented with high protein (meats of all types), high fat (lots of cheeses, nuts, and eggs...up to five per day), and ultra low carb (some would label it ketogenic) eating plans. I recently ended my food experiments and went back to a vegetarian diet but still include cheeses and eggs but in much in smaller amounts. One notable change: I replaced the use of all oils in my cooking and salads with coconut oil (cooking primarily) and avocado oil; the latter has replaced olive oil and I use it in salads primarily but also for cooking.

I would strongly urge you to test your blood glucose levels more frequently and possibly increase your exercise/activity levels (for me, it is six to seven days per week and not the three times/week that IMHO really only applies to under-30 "youngsters"). Start (if you don't already) keeping a journal of your BG test results as well as the types/amounts of foods you ingest. Try avoiding processed foods (I consider them to be food products and not "real" food) and replace the cashews with walnuts. Reserve the cashews for special occasions because they have one of the highest carb content of the nut family and walnuts one of the lowest (and walnuts also have a superior nutritional edge). For best results, keep the carb content of your meals to 20 to 25 grams or lower and, at least initially, ignore the advice of those who recommend that you can "safely include" 45 to 60 grams per meal (different strokes for different folks but until you get a handle on things, reduce carbs to the 20 grams range and maintain a daily log/journal.

Hope that this helps for starters.
 
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jmtrice replied to nutrijoy's response:
To NutriJoy:
Thank you very much for your detailed and very helpful response. I appreciate you taking the time.

I don't test my glucose at all. My doctor (she's an internist) told me that testing would be counterproductive because I would become so anxious about the ups and downs that I would just give up. So, I've never actually tested my blood at all and don't own a meter. I truthfully wouldn't know what to do with it if I did.

As for the carbs advice, I guess I need to really learn more about the carbs stuff. I thought I was eating fairly healthy. The nurse at the doctor's office told me not to eat bread more than twice a day, and other than that, I haven't really gotten any advice on how to eat. I decided on my own to cut out gluten, all sugars, dairy, soy, and I already didn't eat meat.

So, I can definitely increase the exercise I get. I will concentrate on that and see if it makes a difference in my A1C. I will investigate how many carbs I'm eating, and see what I can cut down on. I just don't want to get too restrictive because I remain worried about that triglycerides at level of 28. The labe reference was 30 was the low end. Mine dropped from the 70s to the 60s to below the normal level.

I see the doctor about my stomach issues soon, so I will ask her what she thinks.

Thanks again for your help, NutriJoy!
Have a peaceful weekend.

J


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