Lost 4.5 stone in 18 months but H1AC still high

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Diyboy

Diyboy

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Relationship to Diabetes
Type 2
I always believed losing weight could reverse my type 2 diabetes or put it into remission. In Aug 2019 I was 15 stone 6 lb and had H1AC of 7%.

In April this year I was down to 13 stone with updated H1AC of 6.1%. Great move from diabetic to prediabetic.

Today I am 10 stone 10 lb but my latest H1AC is reduced to only 6.0%. I am so disappointed as still prediabetic. Seems a lot of effort for little result.

I am only on sitagliptin as I can not tolerate Metformin. Also, my diet is low carb 100g per day.

I am due to see diabetic nurse in 2 weeks but really I am at a loss to know what to do and feeling so down. I can't lose any more weight.

Any thoughts greatly appreciated please.
 
First of all, well done on the terrific progress - sorry that you are a little disappointed with your HbA1c having plateaued at 6%.

It’s a little unusual to get HbA1c in those numbers these days, it is more commonly expressed in mmol/mol which would be around 42, so pretty much optimal. All these lab measures have a degree of flex and variability, but it’s hard not to be focussed on the digits when you are right on the boundary.

Keep doing what you are doing! It will have taken your body years to gradually move towards diabetes, you can’t expect it to bounce back instantly 🙂
 
You can only do your best. I personally think weight loss is only part of the puzzle. The research in Newcastle that focused on weight loss not all the participants achieved Reversal/Remission. On follow up not everyone maintained and they don't seem to know why.
 
Your Hba1c is an indication of your average blood glucose levels over the last few months.
Do you know what your usual blood glucose level after meals is? That would help you to assess just what various foods do to your levels and you can then make changes to your diet to reduce spikes.
 
Thanks for the comments. I appreciate your support.
I think this just proves there is a lot more to diabetes than I thought!!

My fasting results are typically anywhere from 5.4 to 6.2 mmol/L. Typically 2 hours after food the results are 6.2 to 6.9mmol/L. (Using both Contour and a Code Free devices). This led me to think my H1Ac would be continuing to improve.

The comment on my GPs website said 'Abnormal but as expected'. I was upset at this as they know I am losing weight and I expected better results.

I'm due to see the diabetic nurse in 2 weeks so will discuss further. I want to avoid extra medication. My surgery was insisting at end of 2019 that I move to empagliflozin (Jardiance) but, looking at possible side effects, I refused. I don't think they liked this....hence the 'as expected' comment.

At least I am no longer obese and now classified as 'normal' weight.

Thanks again and stay safe.
 
Hi, welcome to the forum.
Havea look at this Hb1ac conversion chart ,from the old % to the not so new mmol/mol measurement.
Also check out the colour coding for your latest Hb1ac, I hope it will go a long way in reassuring you,

You have done great congratulations,
I am no medic but I would be very surprised if they wanted to put you on even more meds.

Edited. Oops I forgot to add a link to the conversion chart, all sorted now 🙂
 
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I would be suprised if they were to suggest more medication too. They only tend to add more if your HBAC1 was higher and rising.
 
Diyboy said:
Thanks for the comments. I appreciate your support.
I think this just proves there is a lot more to diabetes than I thought!!

My fasting results are typically anywhere from 5.4 to 6.2 mmol/L. Typically 2 hours after food the results are 6.2 to 6.9mmol/L. (Using both Contour and a Code Free devices). This led me to think my H1Ac would be continuing to improve.

The comment on my GPs website said 'Abnormal but as expected'. I was upset at this as they know I am losing weight and I expected better results.

I'm due to see the diabetic nurse in 2 weeks so will discuss further. I want to avoid extra medication. My surgery was insisting at end of 2019 that I move to empagliflozin (Jardiance) but, looking at possible side effects, I refused. I don't think they liked this....hence the 'as expected' comment.

At least I am no longer obese and now classified as 'normal' weight.

Thanks again and stay safe.
Click to expand...

Hi there - whilst I can tell you are pretty deeply disappointed by your recent HbA1c, you are in a much better place than your starting point, relating to your overall health.

I think the Abnormal but Expected status just marks out that this isn't the first time you've seen an A1c in that region. Personally, I'd stick my tongue out at the screen, and move on.

It could be worthwhile trying to trim your carbs back a little more and just see if you can achieve any marginal gains.

If you have been keeping a food diary as well as testing your blood sugars, in your shoes, I'd be taking a good look at that to see if I could identify and specific foods or meals that might be my personal blood sugar rocket fuel. Many people have them.

Some folks report being able to eat, say, porridge without too much issue, bit potato/pasta/rice of whatever, amounting to the same total carb returns quite a different blood sugar response. Some also find carbs early in the day are not their friends, by comparison to the evenings. That sort of info allows you to do some finessing of your diet, and make marginal gains, without toooooo much discomfiture

I doubt at 42 your medical team will want to add more carbs, but if you haven't been keeping food records - along with the matching blood numbers, that'd be my starting point now.

Good luck with it all. This condition plays with our minds as well as our bodies.
 
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