I recently got my A1C test done. My results were 5.5 and mean was 118. Last month during my routine physical, my fasting sugar was 111 so my doctor advised me to do this A1C test for the first time. Do these results mean I'm close to being diabetic or that I may develop diabetes in the future? I normally eat healthy, no caffeine alcohol or smoking and a strict vegetarian diet. For the last two months I've been exercising routinely; at least 5 miles a day fast walking (1 hour 25 minutes) Can anyone explain what exactly these test results mean. What else can I do to help stay fit. How can a low carb diet help?

Fruits are a hue part of my diet. Would minimizing fruit carbs help me keep my sugar down. Thanks

First, waking up with a number over 100 is not such a good thing, whether you're diagnosed diabetic or not....

Normal A1C range is 4.2 to 5.8

That 111 you mentioned is known as an FBG (Fasting Blood Glucose) reading. Readings are considered FBG when its been over 8 hours since you've eaten at the time you take a reading.

Optimal FBG readings are 70-85 according to some sources and normal is 70-110 according to some of those same sources, but many believe you start getting into trouble with FBGs' at 100 or higher.

If your BG stays between 80-120 most of the time and you have an A1C of 5.5, I think you're doing good, but if you're having hypoglycemic episodes and your BG stays between 60-150 most of the time and you have an A1C of 5.5, then you're probably in trouble or heading for it for sure....

I hope this helps. I kept it as simple as I could in my explanation... If I were you, I would start monitoring my BG regularly and instead of cutting out real food for now, I'd cut out refined sugars, pre-packaged/mixed foods, reduce white foods, artificial sweeteners, eliminate soft drinks, limit coffee to a cup a day, limit alcohol and keep proteins around 15%-20% and carbs around 20%-30%.... If BG numbers don't improve, you better get involved with a Doc and get a proper diagnosis..... Also, it won't hurt to get active if you're not and start learning about metabolic disorders and effects food have on our metabolism....

edited to add: I noticed you don't drink coffee or alcohol and probably already don't eat a lot of what I suggested to eliminate or reduce... I also noticed your weight seems to be in normal range. It might be a little tough for you with just diet adjustments, so you need to monitor and possibly consider adding some supplements if diet and exercise alone are not keeping you below that 100 mark most of the time.. At 1 hour after meals, a good BG reading is about 140 or less....

Good luck!

Hello,

Cajunboy has said many good things to you.

I take a more conservative stance based on sources as well. So here you will see that even those in the know have different opinions.

According to Dr. Bernstein's Diabetes Solution normal A1C of a non-diabetic is 4.2-4.6.

That I remember vividly. The average non-diabetic would have FBG below 100 and usually in the range of 70-85.

I believe anything over 5.0 is a warning signal.

I am a T2 diabetic. My last set of A1C's were 5.6, 5.2, 5.6; so you see that the A1C by itself is one indicator, but not enough to say anything one way or another. I keep my A1C in the 5's by diet control, exercise, some meds and now on rare ocassion some basal insulin. I have dropped a lot of weight so that is helping me. From you information, you do not seem to have the weight issue. But....

If I were you I would take it as a warning.

Do start to monitor your BG during the day. You can choose 4 times a day by this schedule:

FBG upon getting up in the morning.
2 hours after breakfast
2 hours after lunch
2 hours after dinner.

A non-diabetic would see an FBG under 100 and readings between 70-90 or so at the 2 hour post priandal readings (after breakfast, lunch and diner).

As a T2 diabetic I look to keep my bg readings under 140. This is the number that most experts will tell you that damage to your organs begin to occur.

A true indicator for you that you HAVE diabetes is if you have a carbohydrate rich meal and about 1 hour later you BG is way up; well above 140 and after 2 hours your BG is still up there above 140.

For example, I love sushi and I have had to give it up. Ocassionally, I will indulge anyhow with my bolus insulin pen ready to counteract the BG surge I wll definitely get. If I just went along and had my sushi and did nothing, my 1 hour BG would be 200+ and this is NO GOOD. Even after 2 hours it would still be up there since a T2 diabetic has lost their phase I insulin response, which you can learn about by buying some material and also searching around on the web.

Here is one good site http://www.phlaunt.com/lowcarb/

Also, with the current numbers you are indicating most Doctors would ignore it. I am happy to see your Doctor asked for the A1C, but since it is still below 6.0 he/she is not likely to think anything about it. This is the ADA's guidelines or mis-guidelines that are influencing his/her thinking.

Also, buy a book. Educate yourself. There are a few books out there. You should/can educate yourself and be more expert on the topic then the typical Doctor. And buyer beware of Endo's. They are notoriously hooked to the ADA guidelines, which need much improvement.

I bought Dr. Bernsteins' "Diabetes Solution". Now others here may recommend other books. I know there are a few.

Here is the URL for Dr. Bernstein's Book http://www.diabetes-book.com/

Ok, enough from me. Others may chime in as well.

Ralph

Here are my *opinions* to what I see as your essential questions:

#1 - Yes, you are close to being diagnosed as diabetic.

#2 - When you eat carbs it means an increase in glucose in your blood. That means more work for your pancreas to do to create insulin, whether or not you are diabetic. Undesireably high glucose in the blood means you might not be producing enough insulin, or your body isn't using it effectively, or both. Less carbs consumed, less insulin required, and less variation in your blood glucose. Your body can manufacture all the glucose your body needs even if you never eat another carbohydrate again.

#3 - Yes, Yes, Yes! In particular, minimize the "tropical" and warm climate stuff -- bananas, mangos, pineapple. I would suggest limiting yourself to 1 to 3 small servings of fruit per WEEK, and largely composed of berries at that.

You are asking the right questions. My immediate advice to you would be:

a) severely cut back on fruit if this is a huge part of your eating - put protein-rich stuff in its place, not just other starchy stuff like rice.

b) read Dr. Bernstein's Diabetes Solution book - either his old or new edition would serve you well in quickly learning a lot. I bet your library has a copy. You'll learn about normal ranges, and what your test results mean.

c) read Dana Carpender's "How I Gave Up My Low-Fat Diet and Lost 40 Pounds". I know you don't need to lose weight, but Dana easily and quickly covers most of the "low carb" eating plans that are out there (there's quite a range!), and has a chapter on Low Carb for Vegetarians. After you've learned the basics of what low carb is trying to accomplish for your body & health, I'm sure this chapter would help you tremendously. If you are going to do vegetarian low carb, you're going to have to figure out how to boost your protein grams up to the 70 - 100 gram range (more protein, less fruit and starchy veges) which most likely means more seeds, some fermented soy products, and nut butters. If you eat eggs and dairy, so much the easier for you to increase protein.

Good luck!

Thank you Cajunboy 47, dincinbr,and amyaz for your response. Your input is very valuable to me. I will try to educate myself more by reading suggested books.After my first visit to the doctor and before my a1c test I did some changes in my diet like eating in small portions and started exercising more,and my FBG is most of the time below 100. But this is very overwhelming and I am getting to the point where I am almost afraid to eat anything. I guess after reading more information I can help myself better.
Do I need to see endocrinologist? Also after knowing my FBG test I am so worried that I can not fall asleep in the night, Can anybody suggest me home remedies for better night sleep?
Thank you again. God bless you.

One way to get your BG down on average from 5 to 10 points is to lose the fear and stop worrying? I'm not saying this to be funny, I'm serious. I went through this for a long time. Diabetes, once you know what to do, can't hurt you!

Melatonin 300mg, available over the counter at Wal-Mart comes in a bottle of 120 pills and costs about $5 or less... Take 1 at bedtime, after the lights are out, and relax. In about 30 minutes, you'll be yawning and you'll get a good night's sleep. It is subtle so, it might take 3 to 5 days to start working better for you. Melatonin is a substance that your brain already makes, but as we age, it makes less. It is perfectly safe to take, however, more is not better. Taking 2 or 3 if 1 didn't help will also not help, so just keep taking 1 each night and before you know it you'll be resting and sleeping better. Google up melatonin... It beats taking actual sleeping pills that can be harmful and have side effects..

Part of the concern of being diabetic is the long-term (years) effects of excessive glucose in the blood. Generally, readings under 120 aren't considered in the "damaging" range. And for damage to occur you need to have sustained levels, not just a single reading. So, you might relax a lot knowing that although you need to adopt changes, you probably aren't in the range where you're damaging your body. You have time to learn at an evolving pace. The really neat thing is that getting your glucose/insulin cycle optimized for your body will let you feel physically great and emotionally triumphant. When I'm in a learning phase like you are, I'm excited about being able to make a near-term positive change which over-rides my momentary panic over a recent test reading. Maybe that perspective will help quiet your mind and allow better rest.

You said "I did some changes in my diet like eating in small portions" - you don't say how frequent. I'm guessing you mean instead of 3 meals per day, you're having lots of small meals/snacks. For me, I cannot eat many small meals. What that would mean for me - and that I cannot stand - is a fairly constant demand for insulin production in my body. If I tried to do the 5-6 small meals/snacks per day strategy, I'd have a roller-coaster-like mood and blood sugar cycle. I'm much better off giving my body an insulin-demand rest of many hours between meals, rather than a constant bath of insulin in my blood. I don't snack. I eat until I'm not hungry anymore, then I quit until I'm hungry enough again for a regular meal. Oprah once said something to the effect that the moments when you are hungry are also those moments when you're losing weight. Biologically, I have no idea if it is true, but it does give me a playful perspective when I'm a bit hungry and a reminder that a bit of hunger for an hour or so is a regular part of daily life, and I don't need a snack to survive. And, if I'm hungry sooner than 4 hours after a meal, I'm eating too many carbs in proportion to fat & protein.

As for exercising more - I am cautious to keep my own effort below the true cardio/aerobic level. If I exercise too hard, I stimulate hunger which is a signal to me that I've screwed up the insulin balance I'm trying to create. If you're hungry after exercising out of proportion to the timing of your meals, you might see what happens if you back off the intensity so that you can exercise without wanting food after.

Best wishes!

In additional to all of the above, it's important to get the amount of insulin you produce measured. Doctor's tend not to test for this number. Blood glucose is kept in check by insulin production, you may be producing 10x what "normal" people produce, yet it ain't quite enough to keep your level low enough. When you read Bernstein and some of the other sites pay attention to this detail and go and insist on this test.

Define "eat healthy"? When I was a vegetarian, I gained tons of weight and developed high blood pressure.

What's your insulin level?

High Insulin Levels indicate an Insulinoma condition, which have some or all of the following symptoms:

Symptoms
Sweating
Tremor
Rapid heart rate
Anxiety
Hunger
Dizziness
Headache
Clouded vision
Confusion
Behavioral changes
Convulsions
Loss of consciousness

Also, high levels of insulin will cause hypoglycemia....

The OP does not refer to any of this. Doctors dont' test for this often because it is not that necessary.. Eat low/no carb and you won't have the problem as insulin is produced in response to a rise in glucose levels which is caused by carbohydrates....

I'd say that at this point Nautica is most likely becoming insulin resistant, but that is pure speculation based on my own experiences and what little I know from studying.

As a type 2 myself, diag. last Nov. I have to agree with what is being said and that I know myself that when I limit the amount of fruit in my diet my bs stays closer to normal and i feel better. I'm not going to get tech. I can't claim to understand how it all works, but since doing atkins my levels are dr approved.

After a 110 FBG level about 2 years ago my physician said, "OH I guess we should start with metformin, " I was very surprised. I was already lowcarbing (for weight loss ) so I had already started to read 'bout diabetes in a new light. Until then, I had always been told I was "normal". Checking records backwards, I had one FBG of 130 (long before low carbing)-- inside the normal range for the time.

Anyway, I was referred to an Endo, and I made an appointment and went that week. I bought Bernstein's book at a local shop and I barged into my Endo's office with Berstein's book and theory's. Endo said that they didn't do (or didn't like to do) the Glucose tolerance test -- as it didn't tell them much, and then mentioned some of the pancreatic stimulants they like to use. "Er, um, I thought you wife went to med school with Bernstein?, I asked. He replied something about Bernstein "theories" not being proved.

He did the insulin test and it came up 6 - I forget the units now, but he said I wasn't making much insulin and he didn't know why. He "allows" me Levimer, which now brings the FBG to low hundreds (instead of 120-30s) and that's where I'm at these days. I have tried ALA, resveratrol (worked great for 2 days) and few other things. I suppose I should just eat less.

Most endo's are ADA biased.

The fact that he said Dr. Bernstein's ideas are not proven proves that for sure.

In any event, low carbing, exercising after meals when you can and if you are overweight as I am getting the weight off help tremendously.

It took me awhile to get it going with the weight loss, but now I am making progress; albeit it has slowed. Time for another push.

At the beginning of this year I was 288; now down to 248 needing to get down to 210 and then go on from there.

As the weight comes down for me insulin resistance becomes less, BG stays more normal; definitely in the 100-120 range.

Keep your carbs around 60 grams a day or less if you can. Definitely, keep them below 100 a day.

Best wishes,

Ralph

Thanks to all of you for your replies! I am not great with computers and haven't been getting any sleep at night so I was slow to respond.

Cajunboy47-- thanks for your suggestion. I tried Melatonin (3 MG) and the last 3 days, I was able to sleep for a few hours. Hopefully I will be able to get back to my normal routine without taking Melatonin in next couple of days. I also show some of the symptoms as you mentioned, like anxiety,behavior changes, rapid heart rate.

I haven't started to check my daily sugar after each meal and write a log yet. But my FBG is below 96. I have checked my sugar 2 hours after meals few times and it was between 113 to 127, (once 157). Checking it more often will give me proper idea but I haven't figured out how can I do it at my work yet.

I will also insist on doing an insulin production test as squarecube suggested. Is that the name of the test?

Wifezilla - to answer your question, my typical diet in last 2 month has been 1 liter water on empty stomach. Around 8AM, several walnuts or edamame and around 10 AM, about 1/3 portion of avocado salad (1 avocado,about 1.5 cup of spinach, half medium tomato, 1/4 large onion, salt, pepper, and lemon) For lunch, 2 Indian homemade Chapati with curry or some lentil soup. At 4, around 3 cups of at least 7-8 types of freshly cut fruits. Around 6, 2 Chapati and curry or rice and lentils. In the night, a small portion of fruit if I feel like it. About 2 and 1/2 liter more water throughout the day. I Have been vegetarian all my life.

Amyaz- I have also experienced that after intence exercise, I get hungry, but walking about 5 miles in 80 minutes after dinner doesnt make me hungry,

Dincinbr-my goal is to reach less than 110 pounds. As you suggested, I can try low carbs but I think I am already doing that. So I guess I should just try to do a little more exercise in the morning also or after every meal.

Thank you all again