Tips to Lower A1C
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Tips to Lower A1C
An A1C (pronounced A-one-C) test reflects your average blood sugar or glucose level over the past two to three months. When you check your blood sugar with a meter after fasting and before or after meals, you won't capture all the ups and downs. The A1C, also known as a glycosylated hemoglobin test or HbA1c, offers you an overview to compare with your blood sugar checks.
The American Diabetes Association (ADA) recommends an A1C test at least twice a year if your blood glucose control is stable and within target. You may want to have the test more frequently (such as every three months) if you and your health care provider are adjusting your diabetes treatment plan, you have diabetes and are considering pregnancy, or you take insulin to manage your blood glucose.
The 2013 ADA Standards of Medical Care advise the following A1C levels:
• 6.5 percent or less for people with diabetes who are not prone to hypoglycemia (low blood sugar) or problems from treatment, such as weight gain from the use of insulin or metformin. The more stringent goal may be best for people who are younger, have had diabetes for no more than 10 years, or have no significant cardiovascular disease.
• 7 percent or less for newly diagnosed people with type 2 diabetes. At this level, studies have shown that people with type 2 diabetes have fewer long-term complications such as retinopathy and nerve damage if that target can be achieved and sustained over the years.
• 8 percent or less for people with a history of severe hypoglycemia, limited life expectancy (such as a debilitating illness), or type 2 diabetes for many years.
Follow the Three Essentials
1. Plan to count your carbohydrates and eat foods that are low in saturated fat and high in fiber. Talk with a dietitian about creating an individual meal plan.
2. Engage in 30 minutes of physical activity a day, five days a week.
3. Take your blood glucose-lowering medications on time and in the proper dose.
See a Diabetes Educator or Dietitian
Research shows that working with a certified diabetes educator or dietitian when you are diagnosed can help you drop your A1C level by 1-2 percent. These health care professionals look at your personal needs and help you choose healthful foods and nutritious meals that are easy to prepare. This can also lead to improvements in your blood glucose, cholesterol, and blood pressure levels.
Shop with Your Eye on the Nutrition Label
Keep carbs in mind when you're at the grocery store. Nutrition labels include information about the total carbohydrate grams in each serving of food. Remember that 15 grams of carbohydrate equals 1 carb serving.
Also, beware: Foods advertised as low in fat can actually contain carb-base fat replacers, which up the carb content slightly. High-fiber bran muffins might seem healthy, but they could be packed with fat to make the fiber taste good. And just because bread is a darker brown doesn't mean it contains whole grains. Some breads are made with white flour and molasses, which gives them a dark, rich color -- and lots of sugar. Don't be fooled by 100 percent wheat, look for words like "whole grain" or "whole wheat."
Account for Your Progress
Get a book that measures what you eat, such as The Ultimate Calorie, Carb, and Fat Gram Counter (American Diabetes Association, 2006) and track what you eat. Be specific -- and honest -- about the amount of food you eat. Use a food scale and measuring spoons to help you control your portions.
Take Small Steps
Think you're too busy to exercise? Laura Hieronymus, CDE and coauthor of 8 Weeks to Maximizing Diabetes Control (American Diabetes Association, 2008), offers these suggestions:
-- Exercise while you talk on the phone at home or at work.
-- Park your car a little farther from the grocery store.
-- Keep moving while you're watching your kids play sports. If you have a little one with you, this will also teach him or her to be physically active.
To make sure you're on track with your medicine, link daily medications with a regular activity, such as your first cup of coffee or brushing your teeth. Get a weekly pill box and set aside one time a week -- perhaps during your favorite Sunday night television show -- to organize your medications for the next week.