New DM onset - a1c is 7.8 - please help

[CorvetteGirl 78]

I had bloodwork done at my initial consultation last month. Prior to this my a1c was close to 6....I was borderline diabetic. The results of this current a1c were 7.8.

Immediately after I had the bloodwork before I even knew the results, I started a low carb high Protein diet, which I have been on for 4 weeks now. Already feeling much better and healthier.

My question is this: my surgery is scheduled for 7/22...that's less than 3 weeks away. Do I really need to worry about DM meds at this point? I've been eating so much better and I will be having super low carbs during my 2 week pre-op diet, which will begin Monday, 7/8.

Also, with an a1c at this level, won't it get even better and end up resolving itself after surgery?

This really has me kinda worried. Any thoughts and suggestions are appreciated.

[JoiaRox 430]

Honestly, whether or not to go on medication is at the discretion of your doctor. Your logic is absolutely sound on this, but your doctor may have a different opinion.

[makemyownluck 785]

This is a decision your doc should make. Considering you are having surgery so soon, I think it would be okay not to start on medication... but even if your doctor is of the opinion that you should be on meds, you'll likely resolve the issue fairly soon post-op, so would it be so bad if you DID start taking something now? Even a few weeks of being unhealthy is not good - and if your blood sugar is way off when you go for surgery, your surgery could get cancelled or something...

[shoopaie 26]

Yes, there is a high probability that your surgery will be canceled. I am a medical coder, and I just reviewed a chart yesterday where a gentleman had only a high HgbA1c, and all he was going for was some orthopedic joint work. They canceled his surgery AND would not even consider rescheduling it for 6 weeks. If you want your surgery, take the meds and get your labs under control. The last thing you want is to be all happy going in to surgery only to have it canceled and postponed for weeks. good luck to you.

[CorvetteGirl 78]

Thanks for the replies! I did see the surgeon yesterday for my consult and he said I should talk to my PCP about it, but he did not indicate that the surgery would be postponed with that number. I believe that it has to be over 8.0 before they would postpone.

The hard copy of the bloodwork results was sent to me with that item highlighted saying that I should talk to my PCP. They DID put me on the surgery calendar after the bloodwork came back, and the dietary and psych consults were completed.

In any event, I will contact my PCP tomorrow and ask her for expertise. I'm thinking that the change in diet over the last 4 weeks could only make some kind of improvement with that number, yes?

[makemyownluck 785]

Thanks for the replies! I did see the surgeon yesterday for my consult and he said I should talk to my PCP about it, but he did not indicate that the surgery would be postponed with that number. I believe that it has to be over 8.0 before they would postpone.

The hard copy of the bloodwork results was sent to me with that item highlighted saying that I should talk to my PCP. They DID put me on the surgery calendar after the bloodwork came back, and the dietary and psych consults were completed.

In any event, I will contact my PCP tomorrow and ask her for expertise. I'm thinking that the change in diet over the last 4 weeks could only make some kind of improvement with that number, yes?

It might improve, it might not. Why take the chance?

Fasting blood sugar is more likely to change dramatically. However, A1c is designed to look at the erythrocytes in your blood, which have a life span of about 120 days. Therefore, A1c is actually measuring an average glucose concentration over the last 8-12 weeks, so it's not as likely to drop that quickly, even with diet changes, without prescription intervention.

For example, my bw a year ago, my a1c was 5.9.

Now, a year later, an aggressive change to my diet and exercise, post-op VSG, my A1c is only down to 4.2. In a YEAR. And I was never pre-diabetic/diabetic...

You seem quite determined not to take the medication. Is there a reason for that?

[huligoo 75]

My A1c prior to my sleeve was 9.2 and during surgery my sugar was 243 and as of today my A1c (one week post op) is 8.0

I am healing fine and walking around like normal today. My staples were removed and my incisions are closed up and looking healthy!

I have lost 11 pounds since my surgery last week! My sugars have been between 123-148 since my surgery last week! I'd say I'm doing pretty good! Before surgery my sugars were easily in the 250's on a daily basis. I feel like a new person and waaaay less moody too! lol

[CorvetteGirl 78]

I will take the medication if I my doc says to....I guess it just kinda feels like a step back. I'm looking forward to getting off of my HBP med after surgery and adding a med now just feels like a setback.....I guess that's what it is.

[ItsMe2033 143]

I haven't been sleeved yet, but I will be in a few weeks. I was diagnosed (HGbA1c=12.8) as a diabetic about 15 years ago, and initially with medication and exercise my A1c would only come down to around 8. Over 12 years ago I started on a low carb diet which has been awesome for controlling my diabetes, and now my A1c runs between 4.5 and 5 with diet and exercise only, and no medications. Although no one can say for sure, if you are on a strict low carb diet, your A1c will probably come down, although as makemyownluck posted, it will take a while to come down because A1c measures your average blood sugar over a period of a few months.

In my opinion if your fasting blood sugar is below 95, then you should make a strong case to your doctor that you don't need any meds to help control it.

[tenderstorm 0]

Yes, please follow the advice of your peers and pcp. And know that surgery is trauma to the body. And the body responds by trying to kick back into gear. So, glucose increases! It will likely come back down in a few days or weeks, but it's the body's normal response and coping mechanism. That's why so many have high bgs the day of and right after surgery. Be good to yourself and your body. Good luck on your upcoming surgery!