A1C from 5.3 to 6.4 in a year and a half

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I am new here and worried about what seems like a fast increase in A1C. Two years ago, my doctor contacted me about a result of 5.9 A1C, which he said was prediabetic and too high. I made changes to my diet, lost weight, and 6 months later tested again. This time it was 5.3, which he said was normal.

Well, I got lax and also got pretty busy with some things in life, and started back with old eating habits. I regained the weight and here I am a year and a half later, I now have an A1C of 6.4.

I have restarted dietary changes. I’ve also started checking bg again, which I was doing before when the doctor first told me to make changes 2 years ago. Morning reading are typically in the mid-120s, which is higher than I’ve ever seen them. Back 2 years ago when I was checking, they were normally in the high 80s or low 90s.

I have noticed that my daytime readings after meals and such don’t seem high at all - usually under 140 or so. So that part seems good.

I think what shocked me was just how quickly things went up higher than ever before. A year and a half doesn’t seem that long to me. I am worried about becoming type 2 diabetic at that rate and want to understand more about this. Several of my (now deceased) relatives have had it.

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@lajean

Welcome to the site :smiley:

Seems you are heading back in the right direction doing your tests to see where you are at & eating better.

I wish you the best & I think you have come to the right place. Site seems a little slow today maybe because it’s a weekend but normally there are many helpful people here that are glad to help.

Take a look around & search the posts. There is a wealth of information & ask all the question you wish.

Cheers :smiley:

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@lajean

Here is an example of a search for pre-diabetes. Had some interesting post so I thought I would point you to it.

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@SobeiT - Thank you so much for the welcome and looking up information for me. I really appreciate this!

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@lajean

You’re welcome :grin:

I did that quick search & when I saw the A1c was close to your starting 5.3 I thought it would be a good starting point. There is a lot more on this site you can search for & when ready ask your questions.

Cheers :smiley:

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Hi @lajean,
Welcome to FUD!

Actually a year and a half is a long time for an A1C to change.

The A1C uses the lifespan of your red blood cells to measure your blood glucose. Red blood cells generally last 2-3 months.

So a year and a half is quite a long time for things to change.

If your blood glucose control changed drastically in a few months, you could see things change for better or worse in only a few months.

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Interesting to know, @Eric. I’m curious to understand more about A1C and how it works as a diagnostic tool to determine an illness if it can be easily changed in either direction in a short period of time.

I’ve also seen some suggestions that pre-diabetes isn’t all that meaningful, since it’s still normal (non-diabetic) numbers, and many people never actually develop diabetes despite pre-diabetic A1C or glucose readings.

I guess there is a lot to understand, and it makes me wonder if I’m concerned for little reason. But, higher numbers seemed concerning to the doctor. Besides, it’s not like I couldn’t stand to eat better and lose weight no matter, since I’m not at a healthy weight.

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Don’t forget exercise. I’m a T1D and I’ve found that exercise has the most impact on my blood sugar relative to diet or medication.

Also, it’s great that you can keep testing. Diabetes onset can be rapid and you will be able to see it (if it happens) way before people who don’t test.

And congrats that you have a medical team that cares … not true for everyone.

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Hi @bostrav59, Fortunately, I do manage to stay pretty active, mainly because I’m 60 and don’t want to experience physical capability decline as I age. 30+ min walks around the neighborhood (try to do 5-7 times a week) and riding my bicycle are my main forms of exercise. And gardening/landscaping projects. Seems I’m always coming up with new projects for the yard :smiley: And, I live in an area where outdoor activity can be enjoyed most of the year. Good to know that being physical is also good for stable sugar levels.

I don’t necessarily enjoy testing, but I do like having the data. Given my 60 extra pounds that are mostly around the belly, my family history, my high blood pressure, fatty liver, and higher A1C and fasting bg levels, I know my risk of type 2 diabetes is higher. And, the past 2 years have shown me that all my efforts can be easily undone and then some if I don’t pay attention and if I become lax in my lifestyle choices.

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@lajean welcome! FUDiabetes is my favorite diabetes discussion forum.

First, I’m sorry to hear of your struggle, and your family before you.

Next, you’re taking this seriously and that’s awesome! Some forms of T2D (genetics) are extremely stubborn and take a lot of maintenance, diligence, and willpower. Good for you for making all these habits part of your lifestyle.

Finally, don’t get yourself down if the numbers creep up or fluctuate. A1C values are only useful every 3-4 months or so. If your Dr will prescribe a CGM, given your family history, that could be useful info on the response you have to certain foods, activities (strenuous exercise temporarily raises BG, the drops it for 24 hours), stress (raises BG), and medication (e.g. steroids raise BG).

Don’t fear support like metformin. Look up discussions on it, you’ll see I call it the “magic little pill” originally extracted from the French lilac. Do what you need to do to live better/longer.

Keep us posted on how you’re doing and what you’ve learned!

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Welcome, @lajean. Anytime I hear of an adult being diagnosed as diabetic my first question is have they undergone a good differential diagnosis? Are you sure you aren’t a Type 1 diabetic? The reason I ask is because a significant percentage of adults initially diagnosed as Type 2 are really Type 1. The bottom line is the testing is easy, inexpensive, and it can save you years of flailing while numbers continue to deteriorate. If this testing hasn’t been done ask your doctor to look at the four markers that are the signs of beta cell autoimmunity. If your doctor is confused or says “no” then see an endocrinologist. Best of luck!

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I just read an article about Congress providing for a $5M program for CDC to get the word out about testing for T1, and another about two studies by different orgs regarding T1 testing, one free and one with a small cost, to help publicize the need for awareness and relative inexpensive nature of testing for T1. Here’s hoping for it to continue!

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@TomH: do you have a link? Traditional T1 testing has been elevated BG for some a significant time with elevated ketones. HbA1c is something of a crock in this regard but the real test is the antibody test and that has always been difficult to get.

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@jbowler I knew someone would ask! I went back and tried to find the links but could not. I think it was via Apple News and T1Exchange, but not positive. The testing was for a blood test other than A1c, ala GAD or IAA/IA2.

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Probably someone using google to sell something. I hate this but it is what we must live with; I can go and say anything anywhere and, curiously, people will believe me!

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@jbowler Found this today while looking for something else. It refers not the $5M program for CDC to carry out the education and testing program I mentioned previously: Congresswoman Schrier Introduces Bipartisan, Bicameral Legislation to Enhance Type 1 Diabetes Screening | Representative Kim Schrier.

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Thanks for that link. I’ve been following Rep Schrier for a while but had not heard about this. Pretty sure she us Type 1 herself although it’s possible I am mixed up on that.

The press release is a little confusing though. At one point it says “Approximately two million Americans live with Type 1 Diabetes” and further on the other Rep says 1.1 million Type 1s live in Pennsylvania?

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Thanx. That’s the missing link. Yes, @John58, she is (well, she says she is; she’s a politician first) a T1. Quoting from her own statement (shrier.house.gov; a real US rep, not some screwball):

As a person with Type 1 Diabetes, I know personally the challenges that come with managing this disease and the importance of screening for this condition. Early detection makes new-onset T1D easier to catch and means that kids won’t end up in the hospital with life-threatening diabetic ketoacidosis. Early diagnosis means they can be treated in the doctor’s office rather than in the ICU,” said Rep. Schrier, M.D. “My bill will improve public awareness about the importance and value of screening for Type 1 Diabetes and help patients get early treatment, mitigation, and management.

So, yeah, she uses the third person to quote herself (please, everyone actually reading this, never do that.)

I wasn’t treated in the ICU; my mother was a nurse and when I finally confessed that I had to take a [censored: emit urine] half way through the bus journey from school she gave me a bowl of canned rice pudding (last I ever ate) and booked an appointment with our doctor.

Everyone knows this now (even our representatives) but the point that matters, the OPs point, is that it isn’t just kids. Docs don’t test for the antibodies just because of higher HbA1c, or even excessive urination (my now T2 wife had that and the doc just told her to hold her legs together; I was there, it was humorous yet…) They do test kids.

I hope the funding for more widespread testing will help solve the OPs problem. LADA is a serious and consistently undiagnosed problem.

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The press release is a little confusing though. At one point it says “Approximately two million Americans live with Type 1 Diabetes” and further on the other Rep says 1.1 million Type 1s live in Pennsylvania?

NIH (the US National Institute of Health) has this to say in The Prevalence of Type 1 Diabetes in the United States:

There are few data on the prevalence of type 1 diabetes mellitus1,2 and no estimates for the entire US population.

That’s the NIH, the “final form” of the document is here.

So the US has adopted the “don’t ask don’t tell” approach at least until 2013. A selective quote:

Although type 1 diabetes mellitus may develop at any age,5 estimates of the prevalence or incidence in older adults are limited.6,7

(Actual links are in the ‘here’ document.) But the point is in the next paragraph:

When age of diagnosis was not included in the definition (ie, when we include everyone with diabetes who started taking insulin within 1 year of diagnosis), the prevalence was 5.7/1000, representing an upper bound of prevalence. Ideally, diabetes status should be determined based on data collected at or before diagnosis, particularly data on diabetes autoantibodies.8

Read the last sentence again. This is where @schrier might help. It is not her fault that the data is stuck here the sun does not shine, although it is her fault that she doesn’t proof read her web pages. I proof read almost every one of my posts. :slight_smile:

I have to quote the last paragraph of that paper then give a paraphrase, [evil wink]

Our prevalence estimates of type 1 diabetes mellitus in the entire civilian noninstitutionalized US population (2.6/1000 for definition 1 and 3.4/1000 for definition 2) are reasonable given current available data. However, the limitations of these data highlight the need for more comprehensive national data collection, both to fully understand the burden of diabetes and to plan healthcare response.

Paraphrase:

We’re guessing and we don’t know.

2.6/1000 is 900 thousand and 3.4/1000 is 1.1 million (to 1sf). No one has checked.

EDIT: I should add that 5.7/1000 is 1.9million and that I do not view the need to take insulin as in any way a requirement for T1; it’s the autoimmune response, the antibodies. They don’t always kill you.