I lost 20 lbs. 12% of body weight, so why did my A1C go up again?
I'm hoping you might have some ideas about my situation. I've lost a lot of weight but my A1C still went up. I would be very grateful for any insights/suggestions you might have. I included a lot of details below. Thanks in advance!
My A1C is 6.
A year ago, it was 5.9. A couple of years ago, it was 5.8. It's been slowly rising for years.
I weigh 144 now. A year ago, I weighed 165. So, I lost a bunch of weight, and my A1C is still going up! I'm pretty sure that my BMI is in the normal range now.
I am 60 yrs. old and I am 5'5''. female.
I lost weight by cutting out sugar and doing physical therapy. I do still eat too much bread and pasta, probably.
My primary care doctor is not concerned about my A1C. I am concerned because I don't want "pre-diabetes" to become diabetes. My friend has diabetes and she suffers. I bet you-all hate it, too.
My rheumatologist IS concerned about my A1C continuing to go up. She thinks that I may have a genetic predisposition to diabetes, but none of my blood relatives have or had diabetes. I have a really big family so there is lots of history to negate the genetic theory. (I have 2 biological children, 12 "blood" nieces and nephews, 5 siblings, 2 parents, 4 grandparents, 3 aunts and uncles, and 5 first cousins. That's 33 relatives with NO diabetes.)
I have an autoimmune disease. I have been on medications since 2014. I have taken: disease-modifying medications; tumor necrosis factor inhibitors; assorted biologics, both infused and injectable. I have been on duloxetine (an anti-anxiety/depression) for about 5 years now for pain. I started Crestor but that was after the A1C started to climb. I started an IL 23 inhibitor but also after the A1C started to climb.
My cholesterol is super high (low on the good and high on the bad), but my triglycerides are good.
Does anyone have any suggestions/insights? I would be really grateful for any ideas…Thanks! and I hope you are having a good day!
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My kid has type 1 and the A1C jumps around. The difference you are describing is so small I cannot believe it has any signficance at all, but my experience is with type 1. I get that it is inching closer to 6.4 but it is a spectrum, not a line. Does your rheumatologist say why they are concerned?
I know thin people with type 2 (and type 1 of course, which is an autoimmune disease not related to weight or exercise).
Do any of your meds cause a rise in blood sugar? Do you test with a meter, before and after meals, when you wake up etc? The A1C is a 3 month average so you cannot always tell what is going on with just that info 🙂
I am Type 1 diabetic, and my A1C rises when I take steroids for RA. Considering you have other autoimmune disease(s) it seems reasonable for you to ask for the blood tests like C-Peptide, GAD65, and others that indicate T1D. Even if I had to pay out of pocket for those tests, they are invaluable for detecting autoimmune diabetes early. Type 2 diabetes can be genetic and you don’t have to be overweight or have the classic metabolic disorder symptoms to develop insulin resistance (T2D).
Long term use of duloxetine can raise A1C. Anxiety can as well.
I am 69 and 134 lbs and have been struggling with A1C readings hovering around 6 for the last 5 years. I finally asked to be put on Metformin and it came down by .3, only. My mom did have T2 but carried extra weight most of her life. She lived until 91 and was on Metformin for her last decade.
Thanks, folks! I really appreciate your taking the time to reply!
Looks like I need to learn about this crap, too, in addition to the stupid autoimmune stuff. And I have covid again, now, too.
Can you suggest a good place to start to learn about the very, very basics? As I wrote, none of my family have diabetes so I am a complete novice, no second hand experience at all. Do you-all use any websites/organizations? There seems to be a lot of "sources" but which ones are good? I did look at the link about duloxetine. Thanks!
What kind of doctor? How would I get tests? Are the tests you mentioned blood, or urine, or something else?
Do you have a blood glucose meter? I use One Touch but there are many. It helps to get patterns in relation to food and exercise and stress.
An endocrinologist would be helpful 🙂
I don't have a meter. Are they by prescription? (I am a complete ! newbie)
I'll keep the endocrinologist in mind.
I agree with @windyshores. An endocrinologist appt and an OTC BG meter. You will be poking your fingers for a drop of blood. The main BG numbers to record for your Dr or observe for yourself are:
– fasting first thing before you eat
– 2 hours after you start your morning meal
-before your next meal and then 2 hours after
The sites I trust the most for T1D are Beyond Type 1 and Diatribe. Not sure about the Type 2 diabetes sites. The treatment is similar for all types of diabetes, but they have nuances and it’s easy to confuse when the author doesn’t specify T1 or T2.
Another thing to consider is hypothyroidism.
@annewoodmayo you can just buy meters over the counter. Test strips, alcohol swabs and lancets for pricking are also needed. You can certainly get a prescription if it saves money. The meters themselves are not expensive.
Absolutely an endocrinologist. They often have a wait for an appt. so maybe call next week!
A solution worked for me. You and I could be twins weight, height, I am 57..but I cut out pasta, starches, breads, etc..completely during the week, and exercised vigorously 5/6 times a week, was mostly nuts, beans, greens etc. but had light meats on weekends. I was upset that my A1c went up slowly.
My John Hopkins endriconologist had no answers..she was fine because my A1c was under 5.9..usually 5.8..
But I wanted to prevent it going up, so I was referred to a John Hopkins dietician who took great notes into my daily diet. He explained to me his belief was I needed MORE protein with every meal (not just on weekends). So he had me buy Whey protein, Gold Standard, naturally flavored, and take 30 grams with my unsweetened almond milk daily. Then he added chicken or fish to my huge dinner salad (spinach, walnuts, tomatoes, peppers, avocadoes, etc.) and I snack on nuts and plain greek yogurt and cut back on fruit to one green apple a day.
He explained the diet impacted the pancreas ability to regulate or produce insulin,,etc.
anyway, he had me test my blood sugar daily with a finger prick and record it with a device I got at walmart.
I did this from augusst 2022 to November 2022, got tested again and A1C dropped to about 5.5..and remains there..so increased protein, and maintaining daily exersise and cutting back almost entirely on pasta, rice, bread, during the week, and having just a little on weekends, preferable a sweet potatoe..WORKED for me..good luck