Getting my A1C down before knee surgery

It's doable, but it will take discipline on your part.

You have identified the issue yourself -- "I have not been very compliant on diet/exercise/meds."

For the next couple of months, *comply*. I know it's tough, especially through the holidays, but take it one day, one activity, one meal at a time. If you're tempted by something and just can't say no, say, "Not so much." Or eat an apple instead of a piece of apple pie...a la mode.

If exercise seems too daunting, tell yourself you'll just do a little. (For me, the hardest rep is the first.) You'll be amazed that that it feels good to move. And in colder weather, movement helps me stay warm.

You *can* do it! You will, too.

@scottrl offered lots of great advice. As a diabetic of nearly 50 years I have a few additional tips. Diabetes is not going away. You need to start with commitment and an attitude adjustment. The upcoming surgery adds a goal with a deadline to get the A1C down but it should also be a lifelong lifestyle goal that you do for yourself. You will feel so much better and be healthier if you can achieve and maintain the A1C of 7 or less.
Diet / eating - It is better to think of eating than dieting. Everyone has to eat. You probably already know what you should eat and what should avoid. Focus on portion control and less on deprivation. My Dr. told me that if there’s something I really want to eat have just 1 teaspoon of it. Take your time to really taste and savor it.
Exercise - Is there any form of movement that you might find enjoyable that won’t cause more problems for your knees? I’m thinking swimming, dancing, chair aerobics, yoga ….. etc. Anything is better than nothing.
Meds - I’ve never heard of the med you mentioned. That is a question for your Dr. People often view medication as a “magic bullet” to solve health issues without putting in the work of other lifestyle changes. You will be busy with the other changes you will be working on. If your Ozempic is working well I would leave it and focus on the other things. But it doesn’t hurt to ask your provider about the other med.
Spiritual, psychological, emotional - Last but not least have you considered improving these areas? You are way more than just the physical. Perhaps a faith based group, counseling, support group, family and friends can uphold you in ways physical things can’t.
I am a Christian believer and I will keep you in my thoughts and prayers.

Thanks for this

8 years ago I was told I was prediabetic on my way to having diabetes w/ Alc of 6.2. Altho I was thin, I was a big sweet eater and would often forgo eating normal foods so I could have a big plate of freshly baked choc chip cookies rather than a main meal. Also ate baked potatoes w every dinner & loved pasta.
With the prediabetes diagnosis, my doc said dont eat anything that is WHITE - no pasta, no rice, NO potatoes of any kind and no fruit that is juicy like oranges. I googled everything I could about diabetes. Not wanting to go blind or start having digits or limbs cut off, I followed the docs directions including eating very little fruit. After a month, I had lost so much weight that friends came up to me and asked me if I was dying -- they were serious.
I have gained weight back and am glad of it but today I met w/ my doc to go over results of annual blood testing and Alc was 5.5 - my lowest. BUT that is w/ taking metformin. I started taking 500mg Extended Release a day, then increased to 1000 mg/day and now doc suggests going back to 500 mg. Since I hate taking any kind of drug, am happy to lower the dose.
It doesnt take long to lose weight eating low carb foods and little to no sugar. Before I buy anything at the store, I look at the number of carbs/gram and number of fibers. I try to eat the lowest amount of carbs I can, staying under 40 NET carbs for all meals per day. A net carb count is one that subtracts the number of fibers from the carbs.
Here''s what I do. Every morning I have coffee w/ monk fruit sweetener & one tsp of sugar because the artificial sweeteners including Stevia/Truvia are terrible for you. If I didnt use the monk fruit, I would have to use 3 full teaspoons of sugar so I could drink the coffee.
When I get hungry I eat a Dark Chocolate Mocha & Almond Kind bar 15 carbs minus 7 fibers = 9 NET carbs . There is also a Kind bar that is Dark Chocolate, Nuts and Sea salt w/ same net carbs and calories. And other varieties of Kind bars but be sure to look at carbs and fiber. I get them delivered every month from Amazon Subscribe and Save.
After dinner, I eat another Kind bar and another one late at night when working at my desk. Good way for me to satisfy my sweet tooth and the 25 fibers you are supposed to get each day . Also eat the peel of a Honeycrisp apple where all the nutrition and fiber is, and some of the inside to get another 4-5 fibers. Fiber also feels you up.
I take a cardiolite class at the local YMCA 3 times a week which is not that strenuous but keeps me busy and getting steps. Quite a few men take it. I esp like it cause I go 1/2 hour early and walk briskly around the room. By the time the class is over, I have walked 2 miles. Get Pedometer ++ app to track your steps. I have also used up time that I might have spent grazing thru stuff in the fridge. Days I dont have the class, I walk outside or in the house. I keep cherry tomatoes in the fridge at all times so if I am looking for something, a pop a few in my mouth and close the door.
After the class I get home about 3 and have lunch of plain yogurt w/ cut up kiwi and the rest of the apple. I try to get organic kiwis but always rinse them off and use a vegetable brush (from Amazon) to brush the outside if it is particularly hairy. LEAVE the skin on - it's good for chewing & texture and is rich in so many nutrients plus fiber. Throw in a tablespoon or two of plain no fat greek yogurt or any plain yogurt - no sugar - and about 8 almonds.
You can google how to tell when kiwis are ripe. The Zespri SunGold are extremely sweet if you can get them. Those might not be in season now.
Dinner is always a big salad w/ either chicken or chick peas in it for protein, tomatoes, bell peppers, maybe celery, cucumber and always some uncooked broccoli. And of course the 2nd Kind bar of the day for dessert.
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I hope you can try walking even if not briskly and will try watching carbs, fiber and calories too. To me, for diabetes, calories is important too but carbs are most important.

@persia Interesting that you are already taking Ozempic 2mg as a weight loss drug as 1mg is the diabetic dose. Diabetic docs, as I am aware, typically do not manage those on 2mg unless prescribed by another physician.
Endocrinologists do manage diabetes, and not weight control. Farxiga as well has a diabetic dose and one for CKD managed by nephrologists.

I also take Ozempic 2mg for weight control after have taken previously 1mg for type 2 diabetes. A functional medicine doc put me on 2mg, and my A1C is now about 6.4 since previously hit a max A1C score of 8. You may wish to get an insulin resistance score and C Peptide test with your next labs. I would further consult regularly with a dietitian. It may also be the time to track your meals and snacks as well. If you are on diabetic insulin, you may qualify for a Libre 2 or 3 to take better control. Sound advice from others on this issue.

Thanks. I need to be compliant. I know what to do, just need to do it and stay at it.
Good advice.

I am taking ozempic 2.0 for diabetes, not weight loss. It is prescribed for diabetes management.
I posted about getting my A1C down before surgery, not my weight.
But thanks anyway.

A friend got titanium knees and his dr told him they will wear out faster with more weight. He doesn't want to do knee replacement ever again so he lost 60 lb. That was a big motivation for me and I lost 20 lb in 2 months.