Hi all. Just a friendly reminder. We MCC members shouldn’t diagnose or prescribe. As @scottrl said “we aren’t doctors”. As a 50+ year diabetic I would be VERY cautious about starting insulin (synthetic or otherwise, prescription required or not) without the supervision of a medical provider. This is necessary to get the dosing correct and to prevent any unpleasant unanticipated interactions with other medications you may be taking such as Metformin. As @grrranny said you should definitely ask your provider about insulin. In regards to the A1C test it is an indication of how your blood sugar has been over about a 3 week period of time. Whatever changes you make it will likely take at least that long to change the A1C number as @carbcounter suggested. The reason it is used as to whether or not you can have surgery is because it is helpful for your surgeon to better understand how well you will tolerate and heal from the surgery. Higher blood sugars cause added risks of complications and prevent healing as well as your providers hope for. My recommendation is to ask your provider about insulin and see if you can get a referral to a dietician who specializes in diabetes.