A1c

Rainqueen77
Rainqueen77 Posts: 116 Member
Doctor called about my labs done Friday. I haven't seen them but he said my a1c was 4.9 and that was low. So I should only take 500 mg of metformin. Is that low? Is 500 mg even worth taking? Huh....

Replies

  • Sunny_Bunny_
    Sunny_Bunny_ Posts: 7,141 Member
    e8d1hnc3yqwj.png

    4.9 is an average blood sugar of 97. Not low at all.
    Your doctor is probably assuming that you are achieving such a low A1c by dropping to very low levels and that would be dangerous. Most doctors don’t understand how a diabetic can suddenly achieve and maintain normal, non diabetic blood sugars by eating low carb so when they see improvements such as yours they assume you’re going very low and that’s how you’ve got that A1c.
    They will assume you’re running 120-180 or whatever lots of times and dropping by to 50 or whatever so much that your average is then 97. But you’re actually only ranging from 70-110 then you’re actually at a amazingly healthy blood sugar and that’s a stellar A1c!
    Congrats!
    If you tolerate the metformin maybe take it a bit longer because a “perfect blood sugar” is considered 83. Not that your A1c needs to be that low, but your average is still well above that. Without the metformin it will almost certainly rise a bit.
    If anything, maybe just reduce the dosage.
  • Rainqueen77
    Rainqueen77 Posts: 116 Member
    Interesting... when I googled it I saw 80s for blood sugar equal to 4.9. Doesn't sound low at all now.
  • bisky
    bisky Posts: 816 Member
    Is your Dr. aware of your diet changes? Do you check your blood sugar daily? I would talk to him about continuing with Metformin. If you have made permanent lifestyle changes you might not need the metformin.
  • Rainqueen77
    Rainqueen77 Posts: 116 Member
    I've been keto for about 20 months. He hasn't asked what I eat and doesn't seem to care to listen to any answers to any questions he asks.
  • Rainqueen77
    Rainqueen77 Posts: 116 Member
    I test randomly. Fasting is usually around 100-110.
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,479 Member
    An A1C of 4.9 corresponds to an eAG of 94 mg/dl.

    Formula is: 28.7 X A1C - 46.7 = eAG (Estimated Average Glucose)

    Does your dr. understand that you are eating low carb and that your BG's are consistent rather than bouncing between too high and too low? Consistent BG at 94 is a non-diabetic level.

    FWIW, A1C doesn't exactly correspond to BG as there are other factors that affect A1C. Even when using a CGM nearly 24/7 and seeing BG's in the 80-90 range almost 24/7, I still haven't been able to reach an A1C below 6.7%.
  • bisky
    bisky Posts: 816 Member
    renovagirl wrote: »
    I've been keto for about 20 months. He hasn't asked what I eat and doesn't seem to care to listen to any answers to any questions he asks.

    Sounds like you need a new physician. To be perfectly blunt, we are talking about your health here. Your Dr should be your health partner. And you need to play the role of your advocate. You should understand why you are taking meds, not be forced to ask questions on a message board. (please know that I posted this with concern for you :) )

    I agree, I think you are doing great. I saw that you have been very successful with your weight loss. Do you have a glucometer and check your glucose daily? I hope you find a Dr. who is more caring and notices that you have lost weight, exercising and changing your eating habits. There are a lot of side effects to metformin with low blood sugar being one of them.
  • wareshawnta1010
    wareshawnta1010 Posts: 3 Member
    I'm a diabetic whose A1c is finally starting to go down. My last A1c was 7.2, the lowest it has been in a while. My doctor asked if I would consider trying keto. I have checked a couple of sites. It seems like the basic thing about keto is cutting back on carbs. This seems like a hard thing to do cause I LOVE carbs. Any suggestions on how to start keto??
  • T1DCarnivoreRunner
    T1DCarnivoreRunner Posts: 11,479 Member
    I'm a diabetic whose A1c is finally starting to go down. My last A1c was 7.2, the lowest it has been in a while. My doctor asked if I would consider trying keto. I have checked a couple of sites. It seems like the basic thing about keto is cutting back on carbs. This seems like a hard thing to do cause I LOVE carbs. Any suggestions on how to start keto??

    Yes, there is tons of information about starting a keto diet. Are you a type 1 or type 2? Are you taking insulin? There may be confounding factors for you that don't apply to non-diabetics, and those factors depend heavily on how you are treating your diabetes today.

    Keep in mind also that A1C may end up higher than average BG would predict. This is because A1C is based on measuring the impact of glucose carried by blood. As your red blood cells carry more glucose, there is more of an impact made on those red blood cells - the glucose leaves a "footprint." Usually they say that A1C measures control over about 3 months, which is based on average life of red blood cells. However, a healthier person is going to see red blood cells last longer. As a result, your A1C can be artificially inflated because older RBC's will have just as many "footprints" as younger RBC's with higher average glucose. Just know that even if A1C's don't reach what you would like to see, there may still be improvements happening with blood glucose. Testing BG can be useful to pinpoint that.
  • nvmomketo
    nvmomketo Posts: 12,020 Member
    @wareshawnta1010
    The mods made a great collection of diabetic discussions and websites in the launch pad. You may want to take a look.
    https://community.myfitnesspal.com/en/discussion/10482542/diabetic-discussions#latest

    I found that once I cut carbs down below a 100g, it started to get easier to keep cutting them.

    First I cut out sugar (anything with honey sucrose (table sugar), agave, maple syrup, and ingredients ending in "extrin" and "ose") and refined and higly processed carbs like flour (baked goods, cereals, noodles, rice).

    After that I cut back on fruit, especially high sugar tropical fruit (bananas, mangos, grapes) and dried fruit (raisins and dates) and starchy root vegetables (yams, potatoes, and to a lesser degree turnips onions and carrots). I limited these foods.

    The carbs many keto'ers enjoy (fairly freely) are veggies, especially the greens, some berries, nuts, olives, avocados and seeds.

    Fung's Obesity or Diabetes Code might help you (also uses fasting. Dr Bernstein's Diabetes Solution is a GREAT book. Keto Clarity and the Ketogenic Bible are pretty good books too.

  • 2t9nty
    2t9nty Posts: 1,461 Member
    For me, it is just a thing like taking my meds. I do it because that is the path to health for me. I have almost completely lost my craving for carbs on this diet. My veggies are leafy greens, broccoli and cauliflower. You can do it.
  • WholeFoods4Lyfe
    WholeFoods4Lyfe Posts: 1,512 Member
    edited June 2018
    I'd recommend a new doctor. Most, if not all, people that I know who follow a low carb/keto diet are able to get off of the meds completely after time. The fact that your doctor won't listen to you and isn't concerned about your diet is very upsetting and also very dangerous.

    ETA: just saw this post was from January, my bad! @Rainqueen77 How are things? Did you find a new doctor and lower/eliminate your meds?
  • retirehappy
    retirehappy Posts: 5,231 Member
    I'm a diabetic whose A1c is finally starting to go down. My last A1c was 7.2, the lowest it has been in a while. My doctor asked if I would consider trying keto. I have checked a couple of sites. It seems like the basic thing about keto is cutting back on carbs. This seems like a hard thing to do cause I LOVE carbs. Any suggestions on how to start keto??

    Be thankful you have a dr. with the sense to know what halts diabetes, you are so lucky that your dr. wants you to go keto.

    I used to love my bread, passionately, but I found I liked losing weight, feeling like I could do anything I wanted again physically and knowing I was not going to get diabetes even better than the grains, starchy,and sugary carbs.
    When you look at what you can eat, instead of what you should be avoiding, it is a very nice picture.

    Check out the Launchpad on this group's web page for all kinds of good info on eating this way and information from those of us who have been down the path.

    Here are a couple of places to get meal planners, so you know what to eat

    https://files.atkins.com/18-03-Atkins-MealPlan-Foodie-20.pdf Just ignore the snacks that call for shake or bars. I started out with this plan, Super easy to follow. I also used the info on their site to slowly up my carbs after the initial getting started phase. They call it a ladder. It really helped me see what I could keep and what I would need to only use as an occasional treat.

    For great graphics of what is good to eat, you can't beat the dietdoctor, there is a 14 day starter plan, the site does have excellent resources that require a small monthly fee, but there is still a ton of info that is free on the site.
    https://www.dietdoctor.com/low-carb/keto/diet-plan

    Good luck on sorting yourself out.


  • lcharpentier2
    lcharpentier2 Posts: 279 Member
    It took me 8 years to smarten up. Finally took bread out of my diet and i'm seeing great numbers in the morning. It was always close to 10 now in the sixes for the last week of no bread. Darn I should of done that years ago.
  • 2t9nty
    2t9nty Posts: 1,461 Member
    It took me 8 years to smarten up. Finally took bread out of my diet and i'm seeing great numbers in the morning. It was always close to 10 now in the sixes for the last week of no bread. Darn I should of done that years ago.

    Sometimes it takes a while to figure out the details. You have this bit down now!