By Amy DeMay, Administrator
You go for your annual lab work and then get word from your doctor that he wants to meet with you to talk about your A1C lab results… those numbers are starting to crawl higher and he is concerned… he has already spoken with you about the risks associated with diabetes, especially since you have a family history of diabetes. Having seen other family members diagnosed with uncontrolled blood sugars due to diabetes, you are well aware that these risks include difficulties with healing when getting cuts or wounds, leaving you susceptible to other types of infections. You also know that there are circulatory issues, with increased risk of stroke and heart attacks. Not only that, it can impact sexual functioning with erectile issues. High blood sugars also lead to vision loss as well as neuropathy in your extremities. Lastly, your physician shared with you a recent finding in the Journal of American Medicine that identifies that the younger you are when diagnosed with diabetes, the higher your risk is for developing dementia.
You decide you need to do something about this, but are unsure where to start. What is an A1C lab result anyways?
An A1C measures the amount of sugar in your blood over the past two to three months. A result between 5.7 and 6.4 is the threshold for diagnosis of pre-diabetes, while a result of 6.5 or above is the threshold for a diagnosis of type 2 diabetes. The test measures the amount of
hemoglobin, or red blood cells, that have glucose attached to them over their months-long lifespan.
Okay, so now you understand what an A1C is, so its time to figure out a way to reduce that number with some small lifestyle changes. Making that plan will require a little education on your part, and a commitment to being open to some new ways of getting a little more active as well as changing a few eating patterns. And there are plenty of ways to learn how to do that!
First, set up a time to meet with a healthcare provider and their team that specializes in diabetes management. This could include an endocrinologist or diabetologist as well as a registered dietician. Together you can work on a plan of changes you can make, as well as a timeline to implement these small changes. Sometimes doing a couple small changes each week or two makes it a bit more manageable. In some cases, one of those changes might include starting to take medication to manage blood sugars and regularly taking your blood sugar readings in order to start to get an idea of what foods increase your blood sugars.
A second group of people that can help you explore changes that you might want to make, include diabetic educators in the community. The Centers for Disease Control with support from the American Diabetes Association and local provider organizations, encourages engagement in one of their National Diabetes Prevention Programs. This course helps educate you on the lifestyle changes you can make to reduce the effects of high blood sugars, and even help reverse the development and even prevent the diagnosis of diabetes. Research has shown that participation in the class AND implementation of some of these simple changes can reduce your risk of developing Type 2 diabetes by half! Locally, there are several organizations that offer this evidenced-based class, including Coalition Member YMCA of the Roses.
Sounds like a game plan, right? So, what might these changes include? Simple!
Exercise 150 minutes a week… that is about 20 minutes a day… a simple walk around the neighborhood… riding a stationary bike while watching a 30-minute sitcom… taking a quick swim on a hot summer day… lifting some hand weights and walking a few flights of stairs…. All
quick and easy ways to get some additional activity daily…
Cut back on sugar, and not just those obvious sweets like candy, cake and cookies. Learn where sugar is hidden, and find alternatives that work and taste good to you. This is where you will need to be open to maybe trying some new recipes. And make it fun! Taking a cooking class that focuses on diabetic diets so you can learn some new ideas and recipes! Coalition Member Penn State Extension offers Dining with Diabetes just so that you can learn some new ways to look at food and create some fabulous tasting meals!
Truly, cut back on all processed carbohydrates too. Simple carbohydrates, like processed white bread, pastas, noodles and white rice, when digested, turn into sugar in your blood stream rather quickly, causing glucose levels in your blood to rise. Minna Woo, M.D., a clinician scientist and endocrinologist at Toronto General Hospital said that “These (processed carbohydrates) are the most deadly culprits that will raise your sugar levels.” Instead, include things like multigrain bread and pasta and brown rice, in moderation, to your diet. Ensure you are looking for foods that are higher in fiber, as the American Diabetes Association recommends 14 grams of fiber per 1000 calories of food for people with, or at risk of, diabetes. Foods like lentils, nuts and fruits with skins, all increase fiber intake.
Lastly, consider taking time to learn about the Glycemic Index of certain foods and track the impact of them on your blood sugar levels after eating them. Aiming to eat foods with a low glycemic index (55 or less), like oatmeal, apples, carrots, green beans, broccoli, nuts, white boiled potato and quinoa while eating foods with a medium glycemic index (56 to 69) in moderation, like cantaloupe, cherries, pumpkin, sweet potato, and a wholegrain macaroni and cheese, will help keep those spikes in blood sugar to a minimum. Also noting that adding a fat or protein while eating these will help slow down the absorption of glucose into your bloodstream.
All of this might seem like a lot. But Remember! This isn’t a sprint… it’s a marathon… And you start training for a marathon with just running a mile! So, make one change this week, and another change each week thereafter… and in 6 months’ time, you will be thrilled with how your A1C numbers have dropped significantly. Your body, your family and many others will be thrilled that you did it!
