Getting your A1c down?

I just got my A1c back and it is elevated. 8.2! The one before that was 7.9 and before that was 7.4. I am wondering how you all get your a1c down when it is elevated, and are any of you a steady 6.0 or below at every test and how do you do it if you are? 

In 10 years, I have never posted an A1C above 6.3. And in the early days, I was just overshooting, but now it has more to do with the way I structured my life. I eat at regimented times practically the same things. I have a piece of fruit (a peach, an apple, a banana) in the morning at the exact same time every morning; I have coffee and iced tea all afternoon, 2 pieces of fruit (usually 2 fuji apples for lunch) precisely at noon and then for dinner I have certain dinners I make myself (I make an Indian spiced spinach dish and put it over rice with a glass of milk), usually after I work out. Because I know how my body reacts to all of the same foods at the same time periods, my monitor numbers are wildly consistent and because I (Still!) have a thing about overmanaging my disease (I think in my heyday I'd check my blood 15 times a day, its down to about 8 times a day now) I don't ever let any number above 200 mg/dl stick around too very long. And my endocrinologists are elated...the doctors at Northwestern here said I'm the best controlled diabetic they've ever seen (then they offered advice on how to take my foot off the accelerator a bit because my type A compartmentalization of everything I do seemed to unnerve them a little bit). But structure and diligence is the best advice I can give. It's not sexy, but it's got teeth. 

You may need to do some extra tests.  a1Cs raise as your blood sugars raise.  get them back down and your A1C will come down to.  I would kill for an 8.2 though, the lowest i have ever been in my 14 years was 8.4....hence my post in another forum about me not being the only one with control problems.

I think a key is to identify the major causes of your high blood sugars, then work your best at changing that habit. For example a couple reasons that could make me run high are stress (which I try to work on by working out more or deep breathing or something), being lazy in terms of bolusing (not counting properly or forgetting), waking up high in the morning (likely meaning I was high most of the night, either from eating too much before bed, basal being too low, or over eating if I was low in the middle of the night), or meals that are too high in carbs (If I eat meals with over 100 carbs or so I almost always get high, regardless of what I bolus). I think it's also a good idea to test a lot (~8 times a day?) to catch the highs as soon as they start, and hopefully see patterns.

 

Do you record all of your moniter readings now? I would recommend recording them in a log book, then reflect on them every day, and try to figure out what caused the readings to be in or out of range (I find if you focus on the good ones too, e.g. my blood sugar was great because I bolused perfectly for how many carbs I had at dinner, keeps the motivation up). Hopefully if you do that you can see a pattern. Also, if there is something bugging you (mentally) I think that can contribute to poor A1C's because it makes it difficult to focus on diabetes. 

My daughter has had a1c of 7.2, 7.9 last one was 8.3.  They said children should be a little higher but I find that if I adjust her insulin and it stays around normal that her a1cs are lower.

HI Gina,

I have only been Type 1 for about  2yrs now and since then I have always managed to stay between 5.7 and 6.5.  What I believe works best especially for those of us that like (sorry love the carbs in your case, lol) need to exercise routinely!!  On top of that as we all know we should but probably dont is to test pre and post meals to catch those highs that we are not recognizing.  I personally am not a pumper so this is especially important.  It is true that there are some meals that just launch me regardless of bolus.  Possibly, many of your meals are doing this.  For example, if my food is high in fat, and of course the carbs along with, I notice that I tend to have problems maintaining.

Another time I notice problems is when I have stopped exercising.  I just returned from a few days of boarding in Mammoth, and almost immediately after I got home I had some problems keeping my sugars down.  When I am active, I have no problems but for some reason my body has to adjust everytime I mellow out regardless of whether or not I am sticking to a routine.  Hmm, I hope that made sense. 

green tea =)

The lowest my A1C has ever been has been 8.4 on a good time other wise i am 8.6 my last one was 9.5 so i could use some tips to

 

Once my endo said that the A1c varies on each test, so if they did 2 separate tests, one might come out higher that the other one by a max of .7 sometimes. Thats what he said..

When I first got Dx, almost three years ago, my very first A1c was 10.5. For the past two years, it hasn't been over 5.8, usually around 5.5. The thing that helped me the most was keeping a journal of everything that I ate, and every time I tested. That way I could see how different foods affected my bg levels, and I learned what foods to avoid. It takes a lot of discipline, but I feel that its well worth the effort! J

your most recent blood sugars affect your a1c more than older ones. so to get it lower you just have to have lows before your a1c. i know this because after i was diagnosed, before my first a1c i started having lots of lows after being high all the time before that. and the doctors explained that was why my first a1c was 6.2. this is horrible advice. dont follow it. just thought that it might help explain why your a1c is higher if you have lots of highs before