Kock Pouch with pre-diabetes: Anyone tips on lowering A1c?

I think a consult with a nutritionist who is familiar with how a kock pouch functions would be your best bet. You have to intubate the pouch to empty, correct? And manage the consistency of you output?

I believe conventional advice is to decrease processed carbs and increase high fiber foods, but I'm not sure that would work for you.

@jean4, it is always challenging when dealing with 2 separate issues - separate in terms of consulting specialists. There are dietitions who specialize in diabetes and those who specialize in ostomy care. But you need guidance so that both work well together.

I found this online:
- I have a stoma, now I have diabetes – what can I eat? https://www.colostomyuk.org/wp-content/uploads/2023/06/dear-nurse-diabetes.pdf

Have you had a consult with a dietitian?

Thank you so much for going to the trouble of helping me out! I haven’t had a consult with a registered dietician yet. Not sure how to go about finding one knowledgeable in both areas.

@jean4, I might suggest requesting a consult with a dietitian at the hospital where you get care and ask for the 2 specialties.

Below you will find my A1C results, over a 2-month period.

Dec 8, 2025, AIC=169mg/dL - Body Fat Estimated = 26%
Feb 17, 2026, 123mg/dL - Body Fat Estimated = 18%

And here is the story:

On December 13th my doctor very firmly told me in many words, take the results very seriously, and provided glucose monitoring and all kinds of advice. Starting December 16th, I decreased my sugar and food intake to minimize carbs, joined the local gym and started a 1.5 hour exercise routine, daily.

1) 45 minutes treadmill walking at 3 to 3.6 mph and adjusting the incline so as to make it as difficult-and painful as possible, but not to exceed 75% of my tolerance level. 2) 45 minutes weight training, at 75% resistance level. I followed my experience -real-exercise must be real-challenging, just the same as the old school phrase -No Pain No Gain.

When I stated walking my tolerance was was 8-minutes at 5% incline 3MPH, today I do 45 minutes at 12% to 15% incline, daily with plenty of reserve in the tank, to keep going.

As for the diet! Dieting is way easier then exercising. My advice is -keep the exercise challenge and the diet will come easy. Warning, Don’t forget to be nicely hydrated. I find Hydration to is 100% essential.

@er314, congratulations for prioritizing your health. Those are encouraging results. And an inspiration to others like @jean4.

@er314, do you also have an ostomy?

Thanks to everyone who has responded to this post. Last March, I signed up for a CDC sponsored, year
long, preventing diabetes class. Happy to report I’m no longer pre diabetic . I think upping my exercise was the single most important thing that worked for me.

@colleenyoung
Hi, and Good Evening to you.

No!, I do not have an ostomy.

Best-ER

@jean4, that is amazing news. Good for you. Now that the year-long class is over, do you feel you've been able to adopt the behaviors you learned about as your new normal? What physical activities do you like to do that help increase your exercise component?