A1C increased with weight loss

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jdavin0104
jdavin0104 Posts: 6
in Food and Nutrition
Hello everyone: This is my first time posting, but I wanted to get some opinions about what is going on with my body. I know that many of you might have some knowledge of diabetes.

I am a 27 year-old diabetic. I was told that I have signs of insulin resistance from about age 14. I have been overweight most of my life. I currently weigh about 235 and am a 5'10" . My A1C is currently 11.2. About a year ago, I weighed about 275 and my A1C was about 10.3. I have adopted a bit of an exercise routine, I just started walking and my goal was about 4 hours a week from doing just about nothing when I weighed 275 or more (my highest weight was 294 about 6-7 years ago).

My question, is why am I getting higher numbers now, after watching what I eat more closely, and losing weight, than I did when I weighed more? I have been goggling and trying to find answers, but it doesn't seem that anyone has been talking about it. I really just want to find an answer. I am getting more frustrated every day! Please help!
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Replies

  • runningjen74
    runningjen74 Posts: 312 Member
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    To lose weight how have you changed your diet? To lose weight, you need to eat lower calories - doesn't matter what they are.

    This does not mean an improvement in health markers. To improve health, what you eat is important - eat mainly whole foods - meat/ fish/fruit /vegetables. Limit (eliminate as far as possible) processed foods / processed carbs. I'm not going to mention what proportion of your intake should be protein/carbs/etc... but just say for now, shop at the periphery of the store.
  • BigGuy47
    BigGuy47 Posts: 1,768 Member
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    It's great that you have lost weight and are exercising. Diet plays a critical role with controlling your blood glucose level. Have you lowered your carbs ?
  • yarwell
    yarwell Posts: 10,477 Member
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    the A1C represents the average blood sugar over the last month or so, so the implication is you've been running higher blood sugar levels for some reason.

    Exercise should tend to reduce them, eating more carbs especially higher GI ones will increase them. Your diary isn't open.
  • changing4life
    changing4life Posts: 193 Member
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    Your A1c is an average of your last 3 months of blood sugars. You should check your blood sugar daily -- first thing in the AM and before and after random meals to see how the foods you are eating are affecting your blood sugars. Lower your carbs, stay away from processed foods and simple carbs (cookies, cakes, white rice pasta, etc.) and try and have a bit of protein and fat with your carbs at every meal and snack. Exercise is key, but make sure if you are exercising outside that you have some sort of snack with you in case your blood sugars drop too fast.
  • rdianemu
    rdianemu Posts: 132 Member
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    You are doing well. Don't get discouraged. Your weight loss and exercise is definitely improving your health and slowing the progression of your diabetes despite similar/higher A1C levels. A lot of how much control you can get with just diet and exercise is genetics. My husband was diagnosed with diabetes in his early thirties and was overweight but not obese and normal weight most of his life whereas I have been really obese off and on my whole life and have been lucky enough (so far) not to have blood sugar problems. You may need to be more careful with your carbohydrate intake. How often are you getting monitored by your doctor and are you on any medication? I think your A1C should be around 7 to be considered well controlled diabetes. Keep working at it. You are doing great:flowerforyou: .
  • donnat238
    donnat238 Posts: 309 Member
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    The advice I received from a dietician that works with diabetics - Make sure you keep your carbs under control - more lean protein and carbs from veggies and fruits. Cut out processed carbs, soda's and high fat items. Exercise daily.
  • acpgee
    acpgee Posts: 7,656 Member
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    My experience with losing weight is along the lines of the Newcastle University study linked below. After losing weight my hba1c came down from 10+ (unmedicated) to 4.9 with minimal medication (a single 500 mg tablet of metforming every other day) so I was advised to stop medicating completely.

    http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm

    The only thing I can think of is what other posters have already mentioned. Perhaps you are eating more carbs and high Glycemic Index foods causing blood glucose to spike? Perhaps you need to get a test kit and test more frequently (fasting in the mornings, and 2 hours after the start of each meal) to find out what foods are raising your blood glucose and eating to meter.
  • jdavin0104
    jdavin0104 Posts: 6
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    I didn't expect so many responses right away! :D WARNING: This is a wall of text!!!

    I have lowered my caloric intake. I am eating way less fast food now. Last year, I would eat it daily, sometimes several times a day, and not just a normal meal, but multiple items. (For example, my go to for breakfast was McDonalds: a bacon egg and cheese Griddle, and a breakfast burrito meal with a large caramel frappe or iced caramel mocha with whole milk. A lunch or dinner would be like 2 cheeseburgers, and a giant sugary beverage, and maybe fries or a mcchicken). Seriously, it was ALL processed foods that I ate. I never really cooked at home and when I did, it was frozen crap. As I mentioned, this was almost every single day. It is no wonder my weight was so high...

    So Now, I don't eat fast food very often. When I do, it is usually subway. I know that is not as healthy as it is disguised to be, but it is a significant improvement. Even then, I generally only have subway a few times a month, and usually then, its only during the time when they have $5 sandwiches. I save a lot of money by not buying fast food!

    I think I was eating too many carbs, just not watching my diet. I indulged in binging on sweets and carbs too often. Of course I never documented this stuff, so it is hard to know HOW much I was eating. I am currently trying to track it all on MFP and get my exercise a few times a week.

    So what is my diet like now? Well, after getting my blood work done 2 weeks ago, I am getting pretty drastic in my changes. I am trying to shoot for like 60 carbs a day. I am trying to stay away from traditional carbs like bread, rice, pasta, potatoes, etc. I am incorporating MORE veggies and trying to eat a huge salad with some lean meat and cheese. I am noticing, that if I eat more fat, and less carbs, I am feeling fuller. The carbs I am getting are all in natural foods. I want to try this diet for the next 3 months, to see if there is a change. I don't even care if I lose weight anymore, I want to, but my main goal is reducing my blood glucose and dependence on CARBS. (Delicious, amazing and tasty carbs.... :( )

    Maybe this answers some of the questions. I am not sure how to make my food diary public, but I can look into it. I appreciate ALL of your responses. I will keep you updated if you want, I just wondered if anyone had any idea of what could be causing it to go up. As far as the nutritionist and Dr. told me, is that if I lost weight, I would see improvement. Its just frustrating and disappointing to see that even though I THOUGHT I was on the right track, I am still way off base.

    I am aware of where my blood sugars SHOULD be, but I am thinking that maybe my diabetes is so advanced that I need to just realize I can't sustain being an obese person anymore. My goal for the end of the year is to be under 196 lbs, because that is when I will no longer be OBESE, just overweight. I am getting closer by the day, I know that if I keep up the reduced calories, I will be hitting my target way before the end of 2014.
  • IVMarkIV
    IVMarkIV Posts: 116
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    A1c accounts for average blood glucose from the past 120 days, which is approximately the lifespan of a RBC. You do need medications to lower your A1C in conjunction with BOTH diet and exercise.

    I've seen a similar situation with a women who lost over 100 lbs and stopped taking her metformin (type 2 DM patient) with an A1C around 12% correlating to an avg. BG of 300mg/dL

    Are you type 1 or 2 and how compliant have you been with meds?
  • arrseegee
    arrseegee Posts: 575 Member
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    HbA1C is a 3-month measure. Has your fasting glucose come down with the increase in exercise and increased physical activity?
  • jdavin0104
    jdavin0104 Posts: 6
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    I know that It is genetics! I just want to shuffle my cards and try again for a new set. I am glad to hear someone else understands my struggles.
  • jdavin0104
    jdavin0104 Posts: 6
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    A1c accounts for average blood glucose from the past 120 days, which is approximately the lifespan of a RBC. You do need medications to lower your A1C in conjunction with BOTH diet and exercise.

    I've seen a similar situation with a women who lost over 100 lbs and stopped taking her metformin (type 2 DM patient) with an A1C around 12% correlating to an avg. BG of 300mg/dL

    Are you type 1 or 2 and how compliant have you been with meds?

    I was always under the impression that I was type 2 because of my weight. I am working on getting more testing done because of the way my numbers are increasing. I hope to have more information soon. How compliant have I been while on meds? NOT VERY! :) I was previously taking NOTHING when I had a blood glucose of 10.3 or something. However, after taking metformin 500 1x daily I am still increasing. I just need tighter control of my diet, and to break my carb dependence. I WANT to be a success story because I don't want to face the reality of being riddled with disease. I am still young, that if I turn my habits and change my life, that hopefully I can be a "normal" person.

    The best part, is that due to Obamacare, I can actually GET insurance now. I know a lot of people are upset about this, but for a person like me, it is a godsend. It means I can go to the Dr. It means I can get my medications, blood work, and be able to take the step in the right direction.

    I know we are all struggling with our own battles, so I really appreciate all of your responses.
  • DiKoehler
    DiKoehler Posts: 65 Member
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    Congratulations on a GREAT start. What a change in your life. You are right that your body cannot do the fast food thing. my husband's A1C also increased after he started losing weight--he was so disappointed. The MD says it is insulin resistance and put him on metforamin. The new MD put him on the sustained release version. His came down 1.1 over 6 months but we also changed our eating patterns significantly. Sounds like you are moving in the right direction and the next one will be better. You may need to adjust your meds too. When you exercise you do release insulin from your muscles too so timing your carbs can work well with that. Did you see a dietitian too or did your MD give you a specific calorie level to keep within? I think I saw a new recommendation for diabetics to have 20 minutes of exercise every day--this does include walking and strength programs.
  • 4realrose8
    4realrose8 Posts: 117 Member
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    I would try increasing your good fat intake and decreasing your carbs below 60 (maybe shoot for 40?) and then see if that helps. If you remove carbs and replace them with healthy fats, your numbers on the A1C should improve.
  • dicoveringwhoIam
    dicoveringwhoIam Posts: 480 Member
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    In my opinion you probably need to eat 5-6small meals a day protein first,carbs second, fat third. If you eat every 3-4hrs and keep your calories between 250-350 and protein being the biggest portion of each meal tour body should reach a state of homeostasis. This will help keep your blood sugar stable.
    I would also suggest strength training to help lose body fat and retain some of the muscle you already have.
  • yarwell
    yarwell Posts: 10,477 Member
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    Go to http://www.myfitnesspal.com/account/diary_settings scroll down the left to change diary privacy settings, then Save changes.

    Metformin is worth about 1 off your A1C
  • themedalist
    themedalist Posts: 3,212 Member
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    I am very impressed with your ability to transform your eating habits in such a monumental way. I know you are frustrated and puzzled by the A1C numbers, but you are on the right path. You have your whole life ahead of you and you will reap countless benefits by choosing to act now.

    Your future self is very grateful!
  • CrusherKun
    CrusherKun Posts: 353 Member
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    Diet is key in our case. Fast releasing carbs were a huge downfall for me, that and alcohol. My Doctor diagnosed me as diabetic with a A1c of 7% a fasting glucose of 179, BP of 142/105 and triglycerides so far off the chart my cholesterol readings were difficult to determine. One month before that, I demanded he put me on metformin. I didn't like the idea of losing this battle, so right after I was diagnosed, I kicked it into high gear and made a mad dash for a better lifestyle. Walking 15 minutes a day to start....the up 35 a day during my lunches and on the nights my wife was off and the weekends, I would bump it up to an hour or longer. Now with living in north central Wisconsin, snow was bound to make me struggle to hit my walks, so to counteract that, I made a promise to myself to not once take my snowblower out of the garage. Along with all of this activity, I began focusing on eating a much healthier diet. I already had been eating salads on lunch but only a few days a week, but I ramped that up and made sure that was my lunch option of choice and cut out fast food almost entirely. Since my cholesterol was so bad, I focused on more fish and poultry, leaving red meat as an option only once a week.

    Now about 2 months after my diagnosis, I decided to take only 1 of the 2 pills a day of metformin as my blood sugars were low at times and some medical journals had made correlations between increased exercise and metformin causing falling blood sugars on a regular basis. So while checking daily I began to take half the prescribed dosage.

    My diagnosis was on 10.21.13 - I was 367 pounds and for all intensive purposes, one foot in the grave at 32 years of age, with a wife and 2 young kids at home. Today I am at 315 pounds, my A1c dropped down to 5.5% on my first round of tests, my BP is 130/89, my cholesterol is within healthy ranges for bad, good is still a work in progress though and my triglycerides, while still higher than normal, we cut from the 600-700 range down to the 300-400 range.

    So why did I feel telling you all this was relevant to your post??? Well I think the increased activity is AWESOME....4 hours a week is a great start, but, where is your activity level in comparison to the start of your 4 hours a week? Have you only maintained that same amount? Doctor told me that a healthy activity level should increase 10% weekly to ensure productive losses for weight and improve overall results (like bp and other tests). Along with that, I think as others have said, your diet may be the key to this also. Diet AND Exercise is the key....just doing one or the other will not be able to give you the results you are looking to achieve....not at this point in the game for you. This brings me to my last point.....

    I don't wish to be negative in these forums ever, but, the truth is....Everyone's bodies are different. What worked for me or others here may not work for you. You said it yourself, Insulin Resistant since your early teens....that's a lot of time to be fighting an uphill battle. For me, I think my results to date as far as A1c dropping was the result of me taking action right away.....cause I know that if I let it go on too long without being more conscious of my health, I would be in your same shoes right now.

    Just be strong and stick with it. Don't give up cause of a test result, make it a positive and use it to do even more!

    GOOD BETTER BEST, NEVER LET IT REST, TILL THE GOOD IS THE BETTER, AND THE BETTER IS THE BEST!

    -CK
  • IVMarkIV
    IVMarkIV Posts: 116
    Options
    A1c accounts for average blood glucose from the past 120 days, which is approximately the lifespan of a RBC. You do need medications to lower your A1C in conjunction with BOTH diet and exercise.

    I've seen a similar situation with a women who lost over 100 lbs and stopped taking her metformin (type 2 DM patient) with an A1C around 12% correlating to an avg. BG of 300mg/dL

    Are you type 1 or 2 and how compliant have you been with meds?

    I was always under the impression that I was type 2 because of my weight. I am working on getting more testing done because of the way my numbers are increasing. I hope to have more information soon. How compliant have I been while on meds? NOT VERY! :) I was previously taking NOTHING when I had a blood glucose of 10.3 or something. However, after taking metformin 500 1x daily I am still increasing. I just need tighter control of my diet, and to break my carb dependence. I WANT to be a success story because I don't want to face the reality of being riddled with disease. I am still young, that if I turn my habits and change my life, that hopefully I can be a "normal" person.

    The best part, is that due to Obamacare, I can actually GET insurance now. I know a lot of people are upset about this, but for a person like me, it is a godsend. It means I can go to the Dr. It means I can get my medications, blood work, and be able to take the step in the right direction.

    I know we are all struggling with our own battles, so I really appreciate all of your responses.

    FYI you are a type 2 if prescribed with Metformin for improving insulin sensitivity. Type 1s can only use insulin and amylin mimetic (Pramlintide) since they can not produce ANY insulin physiologically.

    I would highly suggest telling your physician about not being compliant with Metformin since by ADA guidelines, you would be a candidate for requiring insulin since your HbA1c exceeds 10% (those on Metformin and Hba1c would also be insulin candidates if your Hba1c was 9% with Metformin titrated to the maximum effective dose of 2000mg/day; 2550mg is the max but doesn't have any more efficacy). Yep FYI, I'm a pharmacist (nerd) and have a type 1 DM brother and a parent who is also a pharmacist.
  • jdavin0104
    jdavin0104 Posts: 6
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    IVMARKIV, I was originally put on Metformin for PCOS. I am sure you are familiar with this. I have had that since I was about 14, the same time that I was officially told that I had insulin resistance. I know I have probably been a diabetic for about as long. I actually went to my Dr. and ASKED for the A1C test about a year ago. Other than that, I have always had good statistics. I was a lot more active growing up, I kind of wonder if the atrophy of my muscles helped to decrease the sensitivity of my cells to insulin. I have never been on the highest dose of Metformin. I was on insulin for a short while, but due to circumstances, I lost medical care and could not afford to go to the Dr. and had to switch to oral medications, then I couldn't afford those either and just stopped. (This is all solved now, and I am finding ways to get creative with funding.)

    My BP is 122/78 as of last week. I have maintained my weight of 233 and am moderating my intake of carbs to be less than 60 a day. I would like to continue my diet for about 3 months, to see if there is any difference.

    I have three appointments this Wednesday. We will go over some test results and kind of find a way for me to get healthier, speak with the nutritionist and a behaviorist. I really hate going, but I know it is going to be good for my success.

    I really appreciate your input. I am kind of on my own with this battle, and i am finding it easier to try and get healthier when I have such an accepting group of people to encourage me and keep me on the right path!

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