Diabetes Management: Why You Don’t Hit Your A1C Target [Video]

  • The A1C is a blood test used to monitor how well you’re managing your diabetes for the past two to three months..
  • Several uncontrollable factors may play a role in raising your A1C levels.
  • A1C levels higher than your goal may mean increased stress or your diabetes is progressing.

The A1C test is a blood test that measures your average blood sugar level for the past two to three months. The American Diabetes Association (ADA) says that most people with type 2 diabetes should always aim for an A1C of 7 percent or less. Doctors use this number as a basis of how well you’re managing your diabetes.

Dr. M. James Lenhard, an endocrinologist at the Diabetes and Metabolic Diseases Center in Wilmington, Delaware, says a rise in A1C is not necessarily your fault. “Diabetes can be frustrating, and it’s hard work to control it,” he said adding there are still factors beyond your control that contribute to higher A1C results.

Here are some things that can boost your A1C with tips that may reverse their effects.

1. Your type 2 diabetes is progressing.

Type 2 Diabetes

Because type 2 diabetes is a progressive and genetic disease, it can change or worsen over time, says Lenhard.

While a healthy weight and exercise can delay the process, it can’t stop the disease from progressing. That’s why it’s essential to see your doctor to keep your blood sugar and A1C in check and alter treatment if necessary.

2. You’re stressed out.

Stress can also bolster your epinephrine (or adrenaline) and cortisol levels resulting in higher A1C levels. Lenhard noted that when people are stressed, they tend to eat more and consume less healthy food.

The ADA recommends consulting your doctor about managing stress through yoga, mindful meditation or cognitive behavioral therapy,

3. You’re eating way too much healthy food.

A healthy weight helps you manage your carb intake and maintain healthy blood sugar levels, according to the Centers for Disease Control and Prevention (CDC). The agency offers a guide for estimating portion sizes as well as tips on controlling your food intake. Discuss how you can devise a meal plan to help keep your blood sugar in check, with a registered dietitian or certified diabetes care specialist.

4. Your workout routine doesn’t include resistance training.

Exercises with free weights, weight machines, body weight, or elastic resistance bands, improves the body’s response to insulin and strengthens the muscles’ ability to store glucose, which can help with blood sugar control, as per a November 2016 study published in the journal Diabetes Care. Adults with type 2 diabetes are recommended to engage in two or three sessions of resistance training per week, on nonconsecutive days.

The ADA suggests talking to your doctor first about the right exercises for you before adding strength training to your exercise plan.  

5. You have a condition linked to diabetes

Diabetes increases the risk of developing complications like kidney failure, liver disease and anemia, which can affect your A1C, the CDC says. In fact, Lenhard notes that a higher A1C may indicate that you’ve already developed these health complications. See your doctor to check if you’re at risk for any of these diabetes-related complications so they can suggest ways to lower your risks.

6. You’re taking medications for other health conditions.

Opioid pain medications and HIV therapies can ramp up your A1C levels, the CDC says. Discuss with your doctor the changes you can make to your treatment plan and don’t stop taking your prescription medications for type 2 diabetes and any other condition without first seeing your doctor.

7. Your treatment may no longer work.

An A1C that’s higher than your goal may be a sign that your current treatment needs changing to effectively manage your diabetes, Lenhard advises.

If your A1C is being managed with diet and exercise, it may be time to consider taking a prescription medicine to lower A1C, says Lenhard. Or change your dose of oral medicines because it’s not as effective as it once was. You may be prescribed insulin injectables to maintain blood sugar. And once you’re on a new treatment, make sure to diligently follow your doctor’s instructions to ensure that the medications will do the job. 

Source: Everyday Health

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