Wellness & Education

Low-Hanging Fruit for a Lower A1C

An A1C is a blood test that gives your healthcare provider information about your average blood sugar over the last two to three months.  It is used to diagnose pre-diabetes and diabetes, and to monitor how well you are managing your disease. Diabetes Lab Tests 101 | Rush Memorial Hospital If you have diabetes, your A1C is your “report card”.

Most providers recommend that patients with diabetes keep their A1C below a 7. An A1C of 6. 5 or higher indicates the presence of diabetes (It takes more than one positive test for a patient to be diagnosed with diabetes.) A1C’s are reported in percentages, so a result of 7.5 is one percentage point over a 6.5.

What difference does a lower A1C make? 

Researchers have found that lowering your A1C by just one percentage point helps lower your risk of the following complications by these amounts:

  • Eye Disease  75%
  • Kidney Disease  50%
  • Heart Attack   57%
  • Nerve Damage   60%

When dealing with a disease that can cause blindness, amputations and death, these are some pretty powerful numbers. But what does it take to lower your A1C by a percentage point? And how long does it take?

There is no hard and fast answer to these questions, but there are “guidelines” about how long it takes and what to do to get there.

How long does it take for your A1C to come down? 

If you have a high initial blood sugar, the good news is that if you work at it, your blood sugar is likely to come down faster than if you started with a lower blood sugar. In other words, the higher your initial blood sugar, the faster it will come down with the same amount of lifestyle change.

Since an A1C is a measurement of the average of two or three months’ worth of blood sugars, unlike a single blood glucose test, an A1C doesn’t just drop overnight. It takes time for your lower blood sugar days to overcome the higher blood sugar days that happened before you began making lifestyle changes.

What lifestyle changes do you need to make if you want to lower your A1C? 

The first change you need to make must take place in your head. You have to accept that:

  • Only you can make these changes.
  • You can’t lead a healthy life without them.
  • You may not even be able to live a normal lifespan without them.

If you decide to ignore the situation, you are risking disability, amputation, and, in all likelihood, premature death.

Fortunately, there is some “low-hanging fruit” among the techniques for lowering your A1C.

Low-Hanging Fruit #1

You don’t have to lose a large amount of weight to improve your A1C. As you lose weight, your body begins to use insulin more effectively, thus lowering your blood sugar. Research shows that losing as little as 5 to 10% of your body weight triples the chance you will lower your A1C by .5. If you weigh 175 lbs, that means you can greatly improve your health by just losing between 9 and 18 lbs.

Low-Hanging Fruit #2

Not everyone hates to diet, but people who have type 2 diabetes or pre-diabetes are more likely than most to belong to the “we hate diets” club. Eating less, particularly eating fewer carbs, is not something we relish.

Fiber is a diabetic-friendly carbohydrate. It can’t be broken down or absorbed by the body. By bulking up on high-fiber foods, we can feel full and lose weight without actually having to eat less. High-fiber foods include whole grains, vegetables and fruit. The American Diabetes Association recommends eating 14 grams of fiber for every 1000 calories we eat. (Since even high fiber foods are not all-fiber foods, we still need to watch how much of them we eat.)

The more fiber we eat, of course, the fuller we are, and the less likely we are to have room for binging on unhealthy foods.

Low-Hanging Fruit #3

Sooner or later, watching what we eat becomes extremely irritating. When we finally break down and cheat, is there anything we can do to quickly lower our blood sugar? As it turns out, there is. Exercising after meals is a great way to use up excess glucose, as long as you don’t wait too long after the beginning of the meal, you exercise in proportion to the extra eating you have done and you check your blood sugar before setting out. (Exercise can temporarily raise blood sugar, so you need to make sure your blood sugar isn’t too high before working out.)   Glucose Control and Exercising After Meals – Cleveland Clinic

Low-Hanging Fruit #4

The less clearly we see a problem, the easier it is to ignore it. This is certainly true of high blood sugar, which is why many diabetics don’t want to monitor their sugars. When we overcome this, however, we begin to match up actions with consequences, for better or for worse. We measure the candy bar we ate for breakfast by the level of our midmorning blood sugar. The walk we took at lunch gets measured by our afternoon blood sugar. The more we connect actions with blood sugar consequences, the more motivated we are to make positive changes.

Monitoring our blood sugar is a lot like counting calories. When we first start out, just the thought of cutting back is depressing. Once we find the courage to face how much we’re actually eating, however, we often find the courage to eat less.

The Not So Low-Hanging Fruit

One of the hardest lifestyle changes anyone can make is to stop smoking. Your risk for the most serious side effects of diabetes increases if you smoke. This includes amputation, heart disease, high blood sugar, blindness, kidney problems and nerve damage. There is no easy way to stop smoking. Period. However, for those with diabetes, the reward for ditching the ashtray is enormous. After you get some of the low-hanging fruit under your belt, why not use some of that newfound self-discipline to challenge your nicotine addiction?