I lost 20 lbs. 12% of body weight, so why did my A1C go up again?

Posted by annewoodmayo @annewoodmayo, May 11, 2023

Hi folks!
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!

Interested in more discussions like this? Go to the Diabetes & Endocrine System Support Group.

Hi everyone!
Can you-all suggest some really, really easy-prep snacks?

Besides nuts. I've eaten so many nuts that I feel like I'm going to start to store them in my cheeks like a chipmunk.

Is skipping meals really bad?

THANK you all, again!!!!

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@scolio

Someone I met who is very interested in alternative and preventative medicine told me that fasting insulin is as important as glucose levels. She said the way it was explained to her is that your glucose can be okay, but it may be because your pancreas is working overtime to pump out enough insulin to keep it that way, but sooner or later, your pancreas will start to wear out, can't keep up, and that's when the glucose goes up.

https://headsuphealth.com/blog/self-tracking/low-carb-lab-testing-part-3-homa-ir/#:~:text=Ideally%2C%20the%20doctor%20will%20create%20a%20lab%20order,to%20consider%20ordering%20this%20test%20on%20your%20own

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Be careful with information garnered from someone said that someone else was told...

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Hello, @annewoodmayo, yes I can see how all of that is a lot for one person (your husband) to juggle. Do you feel like it would be feasible for you to make some special requests for ingredients and do more of your own food prep? What is getting in the way of your getting to the store yourself sometimes? Can any of that be overcome?
I'm not a great cook; you probably don't want to come over for a meal with me! But I try to have some healthy food on hand for myself. I find that by the time I'm hungry, I don't have the energy or willpower to prepare healthy food, so I have to cook when I'm not hungry. My basic formula is some sweet/starchy veggies (root veg like sweet potato, parsnip, carrots, onions; also squashes like kabocha as well as things like corn and sweet peas or even green beans) combined with one or more leafy greens-- my favorite is bok choy; also chard, endive, escarole, mustard greens, rapini, and if you can find them any of the specialty asian greens like yu choy or baby bok choy.
I put the starchy veggies in a big pot with an inch or less of water, bring to a boil, maybe simmer for a minute, then back to a boil and add the greens, stirring till they are cooked through. If it's too bitter, some tomato in a can (even paste) or other goodies like salt, pepper, vinegars, spices, even peanut butter ( you can make a sauce with it by slowly adding 1 tsp of water at a time to a tablespoon of PB, mixing carefully after each addition) or all of the above!
This is not 5-star fare, but I enjoy it, knowing it is good for me and knowing exactly what is in it! If you want to add some protein to it when you sit down to enjoy it, you can always add whatever high-protein option you have on hand, even a can of beans! Also can be good with a bit of whole-grain bread.
Which reminds me, maybe you could ask your sweetheart to try buying some of the higher-quality whole-grain breads such as the Eziquiel brand? You can keep it in the freezer and use as needed. Also boiled barley can be a nice thing to have on hand to use as you would rice, if you make a batch and freeze in small portions to take out as needed.

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Easy-prep snack:
1. Heat up frozen veggies like broccoli or
frozen kale mixed with frozen spinach (sold in separate bags but taste good together IMO)
OR rehydrate some dried cut wakame

2. Add some flavoring(s) like
a splash of balsamic vinegar
some black pepper
a small bit of curry powder
a dash of garlic powder
a spoonful or two of jarred salsa
a squeeze of orange, lime, lemon

3. If you like tomatoes and/or beans, add some of those, too. They are easy to find canned, which is convenient.

4. Maybe some olive oil, too. Or a spoonful of tahini (ground sesame seed paste, like PB but more runny and 'pourable')

5. Maybe a small piece/portion of fruit for 'dessert'. Fresh is nice, but even a single dried apricot is a nice treat.

Re: skipping meals
My own experience is that when I skip meals one or more of these is likely to follow:
--headache (partly from dehydration probably, since not being able to stop and eat sometimes goes together with not taking time to get enough water either)
--overeating when I do eat
--eating things that aren't really that good for me, when I do eat

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@scolio

Easy-prep snack:
1. Heat up frozen veggies like broccoli or
frozen kale mixed with frozen spinach (sold in separate bags but taste good together IMO)
OR rehydrate some dried cut wakame

2. Add some flavoring(s) like
a splash of balsamic vinegar
some black pepper
a small bit of curry powder
a dash of garlic powder
a spoonful or two of jarred salsa
a squeeze of orange, lime, lemon

3. If you like tomatoes and/or beans, add some of those, too. They are easy to find canned, which is convenient.

4. Maybe some olive oil, too. Or a spoonful of tahini (ground sesame seed paste, like PB but more runny and 'pourable')

5. Maybe a small piece/portion of fruit for 'dessert'. Fresh is nice, but even a single dried apricot is a nice treat.

Re: skipping meals
My own experience is that when I skip meals one or more of these is likely to follow:
--headache (partly from dehydration probably, since not being able to stop and eat sometimes goes together with not taking time to get enough water either)
--overeating when I do eat
--eating things that aren't really that good for me, when I do eat

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Hi scolio!
Thanks so much for your replies.
Right now, I am discouraged. I have an autoimmune disease that saps energy and causes pain with movement. I was diagnosed 11 years ago. I got Covid in 2020, before vax and medicines. It really got me good. Maybe because I had been taking immunosuppressant medications for 7 years previously. Anyway, by last summer I was able to start PT and see a nutritionist. I was doing better, a very little bit over time but consistently improving.
I got Covid again on May 1 (about 3 weeks ago). Now I feel like I did last Spring, before PT.
By the way, Paxlovid medication for the Covid this time has really helped!
But my autoimmune disease medication can't be taken until I am 100% over the Covid, so that is starting to act up. I am very tired and sore and so not eating well...It's a vicious circle that leads to a downward spiral pretty fast.-- Boy, that's gloomy! Sorry if it brought you down!

Don't ask about my family...They don't understand and don't help. They still think I am not trying enough.

This post turned from a "thank you" to a whine--- sorry about that. I do appreciate your ideas!

THANK YOU, Scolio, and everyone else!

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@annewoodmayo

Hi scolio!
Thanks so much for your replies.
Right now, I am discouraged. I have an autoimmune disease that saps energy and causes pain with movement. I was diagnosed 11 years ago. I got Covid in 2020, before vax and medicines. It really got me good. Maybe because I had been taking immunosuppressant medications for 7 years previously. Anyway, by last summer I was able to start PT and see a nutritionist. I was doing better, a very little bit over time but consistently improving.
I got Covid again on May 1 (about 3 weeks ago). Now I feel like I did last Spring, before PT.
By the way, Paxlovid medication for the Covid this time has really helped!
But my autoimmune disease medication can't be taken until I am 100% over the Covid, so that is starting to act up. I am very tired and sore and so not eating well...It's a vicious circle that leads to a downward spiral pretty fast.-- Boy, that's gloomy! Sorry if it brought you down!

Don't ask about my family...They don't understand and don't help. They still think I am not trying enough.

This post turned from a "thank you" to a whine--- sorry about that. I do appreciate your ideas!

THANK YOU, Scolio, and everyone else!

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Please don't feel you need to apologize! I appreciate your taking the time to explain what you're dealing with. I really don't believe I can fully comprehend being in your shoes, but in trying to hear you, hopefully I can take a step in that direction. In hindsight, perhaps the suggestions I made are too labor-intensive given your current limits on energy? I wonder if there are any options near you for a meals-on-wheels type of program? I know these are usually for seniors, but I wonder if an exception would be made for a situation like yours?
When a relative of mine had surgery, she got offers from a neighbor to send over whatever she was cooking for herself, and that was sometimes helpful. If you happen to know anyone who enjoys cooking, you could possibly try to explain the challenge you are facing and see if they want to make a similar offer? Some people really do enjoy cooking! And they are often thrilled if someone is interested in enjoying the results. Some people even enjoy the challenge of cooking for someone with special dietary needs. And some folks can become real evangelists for 'healthy eating' and are happy to convince anyone and everyone, through their home-cooked meals, that a healthy diet can be enjoyable. It's kind of a long-shot that you or anyone you know would happen to be acquainted with someone like that, but that's another oddball idea I'll throw out there.

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I don't know if this is anywhere near you. If not, maybe a local senior center could give you some leads?

https://wfspa.org/service/isos-oyhs/

The webpage says they do grocery shopping but not meal prep, but maybe even that might possibly help to some degree?

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Hi @annewoodmayo - I would suggest researching your meds online by googling the name of the medication and adding the words "package insert" and then look for either a website that includes the name of the manufacturer or fda.gov. Usually these are pdf files that you can then search for warnings, precautions and side effects. You can look for blood sugar effects.
If none of your medications include the side effect of raising your blood glucose, then you can ask your doctor about intermittent fasting, a fancy term for eating a later breakfast and early dinner and nothing except water between dinner and breakfast. There is a Mayo Clinic group just for this and there is a lot of info online by Dr Jason Fung or Dr Satchin Panda who I find fascinating because he incorporates circadian rhythm science as well.
Hope you figure out how to stop the rise in your HA1C.

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I think you are very wise to want to try to move away from relying on nuts so much! They are a healthy food in moderation, but too much of anything can throw off the balance we need in our diet.

I would know, since for a long time I was also relying too much on nuts and seeds, just because they were so easy to grab-and-go.

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I do not have idabeties, but I do have a weght problem. At one time I lost 50 lbs on weight watchers, but it all came back with a few more. I have tried all the tricks I know, but nothing seems to help at this point. I do know that Pregabolin has a side affect of weight gain. I would be so much more comfortable if I could get a few of these pounds gone. I am 92 so exercise is pretty limited to chair exercise. With regard to family diabetes, I do not think we had anyone in the family with this disease, until my brother suddenly was diabetic, and then his two daughters developed the disaease There must be some change, we are just not fully aware of, that causes this body disruption.
Gina5009

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