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Need to lower A1c



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Surgery is scheduled for March 30th. Was told I need to lower my a1c by two points between now and then. I am monitoring glucose levels closely and adding in more walking. Any other suggestions? I do not want to have to postpone this surgery.

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Are you taking medication like metformin? Are you changing your eating habits? I would say it would be unlikely to lower your A1c significantly in two months as it usually takes between 2-3 months to change it at all. Did your doctor suggest if this would be possible? remember, the surgery is just one part of your journey, and postponing it for a few months until you're in better shape physically will be better in the long run. In the grand scheme of things, a two month postponement is NOTHING

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Lizonaplane is exactly right. You are being asked to do something nearly impossible within that time frame. A1C lowers over a 2-3 month period. But very high A1C's (e.g., 10) will lower faster when treatment is provided.

Postponing may seem very disappointing but it would give you a chance to drop to an acceptable A1C by being extremely strict with your diet, exercising, and taking any medication prescribed to you.

The only other possible option (and maybe not a great one) is to consult with an endocrinologist about whether the endocrinologist believes you could safely undergo the procedure with your current A1C. But he or she would have to consult with and get the approval of your bariatric surgeon for this.

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That doesn't sound like a reasonable request or something that's within your control in that time-frame.

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Agree with the others, that is a very significant ask. It might be possible with an extremely low carb diet (think, very strict keto), but that's quite a commitment. I would have a follow up conversation with the surgeon to get clarification on why, how, etc. And, as others have said, if it does result in a delay of surgery that isn't the end of the world, despite the frustration and disappointment. Its just a step in the process and you will get there!

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My story took place over three months (not just two), but...

In early June, my A1C was 10.8. It was one of the lab results that made me decide to pursue surgery. My doctor added evening insulin to my existing diabetes meds, and I immediately made changes to how I ate -- but mostly just when I was home (I live alone), Whenever I was out/with friends, I would still have carbs, Desserts, etc. I indulged a little at home, but I emptied the fridge and pantry of junk food and most of the time I ate better when I was in the house. Because I was still doing whatever I wanted some of the time, I never felt deprived at all. My next lab work was scheduled for early September, and I didn't learn until 2 weeks before the appointment that I wouldn't be approved for surgery unless my A1C was 9 or less! Talk about panic!! I figured there was no way it could go down almost two whole points in just three months -- especially when I could have done much more. I spent the next two weeks very stressed out...but, my new A1C wound up being 7.5! My doctor assured me there was no way the change could be attributed to just the added insulin.

Anyway, my point is that you don't necessarily have to make super-drastic, super-restrictive changes in order to see significant A1C reduction within just a few months. Hang in there! :)

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Yes, there's a lot of science that very high A1Cs of 10 and above can drop more quickly than lower A1Cs.

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I don’t know much about lowering A1C or how long it will take but I agree that if it holds your surgery back a little it may seem like the end of the world now but in the whole scheme of things a few months is really not a big deal. In the end it will all be worth the wait and the work it takes to reach your goals.

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Crazy thing to ask of you. It'll lower with a zero carb diet. But you can't be asked to do this on a deadline, it's not how the body works.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

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        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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