HbA1c

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Nayshiftin

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I’m trying to put this in a way it’s easy to understand . If you have a high HbA1c and they put you on medication . My Bmmols have lowered with the medication but will my HbA1c still be high if I eat the wrong foods. 0r does the medication override what you eat? If I don’t eat I’m scared it will go too low but then that’s surely defeating the purpose? I don’t get my readings at all with whatever I do my blood sugar has it’s own mind .
 
It is going to depend on what medication you are talking about. I think override is perhaps not the right term.
Each medication has it's own mode of action but it is going to be a matter of balancing what you eat with what the medication can do.
An analogy I saw was that if you have an overflowing sink = your blood glucose being too high then you can get a jug and bail out some water = taking medication but unless you turn off the tap = reducing carbohydrates then the sink will still overflow. How much of a flood you will get all depends on that balance.
Even with insulin it is still a balance between the insulin you inject and the food you eat.
Don't forget that your HbA1C is an average over 3 months so lower finger prick readings day to day should be reflected in a lower HbA1C after a three month period.
If you don't eat then your liver will release glucose to keep your organs functioning so your blood glucose may increase.
Do you want to give some examples of what you are finding with your readings?
 
Hi , it’s me . So yes I am all over the place but my blood sugar is all over the place. I tend to go on the morning figure . As all day it’s hard to keep track snd I am trying to be good all the time. It’s now 6.5 ish every morning that's from 11.5 . I am on a very low dose of Sitagliptin 25mg once daily . Ah if I don’t eat it goes up then lowers after I eat. I discovered that too with the coffee. That would make sense . The other day I felt awful it was 2.8 so I ate a digestive biscuit but the it went back
Up to 7.5 so I’ll try half next time . I just don’t want to eat biscuits to keep stable then find my HbA1c is still up because it’s only lowered by my meds.
 
Nayshiftin said:
Hi , it’s me . So yes I am all over the place but my blood sugar is all over the place. I tend to go on the morning figure . As all day it’s hard to keep track snd I am trying to be good all the time. It’s now 6.5 ish every morning that's from 11.5 . I am on a very low dose of Sitagliptin 25mg once daily . Ah if I don’t eat it goes up then lowers after I eat. I discovered that too with the coffee. That would make sense . The other day I felt awful it was 2.8 so I ate a digestive biscuit but the it went back
Up to 7.5 so I’ll try half next time . I just don’t want to eat biscuits to keep stable then find my HbA1c is still up because it’s only lowered by my meds.
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If you try and keep your 2 hour after meal level to below 8.5mmol/l and your morning reading of 6.5mmol/l is looking on the right track for a decent HbA1C if you are keeping that up for a period of 3 months.
The medication you are on encourages the pancreas to make more insulin so you do need to eat some carbohydrate otherwise you could get low blood glucose hence the 2.8mmol/l and feeling awful. It is probably worth having a quick acting glucose tablet or jelly baby or a small full fat coke to hand if that happens again rather than something which would not act particularly quickly like the biscuits.
 
Maybe see if you actually need the medication - perhaps if you tell your GP or nurse about going low they might agree to let you try diet control. An ordinary type 2 is usually making too much insulin rather than too little, but the pancreas can become exhausted if pushed too far. If you are being cautious about carbs and seeing lows you might be advised to eat more carbs to counteract it - which would not do for me, as I am determined to sort it for myself.
Eating low carb can be powerful - I was at a Hba1c of 91 at diagnosis and was sorted in a few weeks eating low carb.
It is something you need to get professional advice about though, and some do not see how a non medicated type 2 can succeed.
 
Drummer said:
Maybe see if you actually need the medication - perhaps if you tell your GP or nurse about going low they might agree to let you try diet control. An ordinary type 2 is usually making too much insulin rather than too little, but the pancreas can become exhausted if pushed too far. If you are being cautious about carbs and seeing lows you might be advised to eat more carbs to counteract it - which would not do for me, as I am determined to sort it for myself.
Eating low carb can be powerful - I was at a Hba1c of 91 at diagnosis and was sorted in a few weeks eating low carb.
It is something you need to get professional advice about though, and some do not see how a non medicated type 2 can succeed.
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@Nayshiftin has resisted medication for quite a while but seemed to be struggling with trying to stick to a low carbohydrate dietary approach so this may be a way her GP is trying.
 
Definitely do not go low carb now, Drummer advises this for everyone regardless of their situation mostly.
Sitagliptin will cause hypos if you do not balance it against a carb intake.

Sitagliptin is usually a second line med prescribed after Metformin, and works well for many people.
 
Just re-read your post.
7.5 is a perfect number.
6.5 morning is excellent as well from11.5.
To use @Leadinglights sink analogy, sitagliptin is like an automatic bucket.
It'll keep bailing regardless.
And empty the sink.
Even after your liver dumps everything, it'll keep going, which is where the 2.8 came from, so again, as Leadinglights has said, it's about balance.
There is nothing wrong with that.
Have you been prescribed a meter and strips while you are on sitagliptin now?
 
Congratulations on getting your waking levels down to 6.5 @Nayshiftin - that should hopefully be reflected in a reduction in your next HbA1c.

The A1c is a reflection of how much glucose has been in your bloodstream during the past 120(ish) days. The higher your glucose levels have been, the more red blood cells will have been ‘flagged’, which is what the HbA1c measures.

So any meds you are taking will only be improving your HbA1c through improving your time spent in range.

Fingers crossed you get an encouraging improvement at your next check to reflect the effort you have been putting in.

Do have a chat with your nurse about that 2.8 though, to see if you can work out what caused it and how to avoid the situation in the future. 🙂
 
travellor said:
Just re-read your post.
7.5 is a perfect number.
6.5 morning is excellent as well from11.5.
To use @Leadinglights sink analogy, sitagliptin is like an automatic bucket.
It'll keep bailing regardless.
And empty the sink.
Even after your liver dumps everything, it'll keep going, which is where the 2.8 came from, so again, as Leadinglights has said, it's about balance.
There is nothing wrong with that.
Have you been prescribed a meter and strips while you are on sitagliptin now?
Click to expand...
No I have my own but my body tells me more so I’m aware of how I feel but sometimes shocked both ways. I’m not well again and it’s rocky so might need to see Gp.
 
Thanks for replies . I struggle with low carb and meds too so just need to try and balance all round
 
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