How to get my A1C down

Hello all,

I have had diabetes for the past 3 1/2 years and recently my A1c has gone up significantly.  For the first year after my diagnosis, my doctors thought I was a type 2 and treated me accordingly.  I got my A1c down to 6.4%....then they realized I am a type 1 diabetic and I am just learning to use insulin.  My most recent A1c is so much higher now, I am embarrassed to say (it almost doubled!!!!)  My husband and I want to have a baby and I need to get it down asap.  We have met with high risk doctor and I am very educated about what is necessary to prepare for a baby.  Mainly to have my A1c down around 5.5%ish for 3 months before we can start trying.

My question to all of you is....what is the fastest/most efficient way to drop my A1c???  




OMG, I would love to know the answer to that as well. My daughter's A1C continuously goes up and down from one visit to the next. As soon as we think we have things under control it takes a turn. We continuously count carbs and she has switched meds at least 3 times within the past year. She's very active in sports (football, basketball and track) so I am still trying to figure out what's going on. Sorry I don't have the answer your looking for but it helps to know that you are not the only one who is having that problem.

This may sound silly but for me it is checking my blood sugar more often. I make it a point to check at very specific times of the day so I can see my patterns. Although my A1C has never been terribly high, I had it at 5.9 prior to pregnancy and kept it there the entire time. I normally am around 6.4, which is actually fine by me because I have a habit of dropping very low very fast. But I have found that logging it all, or using the Medtronic Carelink on their website, helps point out patterns of higher numbers or crashing low. Then I can easily adjust my basal rate and keep my numbers down. Its not easy, and takes lots of dedication and work, but it is certainly worth it. good luck!

For my daughter, the key seems to be lots of testing and managing. Her A1C has been 6.5 for about the last 6 months or so. Her bg goal is 120, and I review and adjust her I:C ratio anytime I see a post meal trend that leaves her higher than her goal for more than three days in a row. I also review her basal insulin regularly to make sure she doesn't need more. For instance, if she's 120 at bed (no insulin and more than 4 hours since last meal), and 150 in the morning, I'll increase her overnight basal slightly until her morning number is close to her bedtime number.

Also, I always test twice at night because sometimes her bg is still rising at 9pm when she goes to bed. For example, last night her bg was in the low 120's at bedtime - which is perfect. But I tested her an hour later and her bg was 174, and I gave her a correction. If I hadn't done that second check, she'd probably have been high all night long.

Jackie I hope this helps you as well as me. This is really good information and practices that I have begun to implement. It seems as though the key to finally becoming in control is increased testing and tracking.

Michelle, your daughter is adorable and I have also noticed spikes at bedtime. I can test her in the evening and around bedtime she has gone up considerably. Once I have given her a correction earlier in the evening I have not given another correction at bedtime because we have most recently switched to the 70/30 mix which I do not like at all.  I know it contributes to the highs and lows periodically throughout the day but I was so much more comfortable with the novalog and Lantus because I knew what to expect. I gonna track this and hopefully I will see a lot of changes as well as a lower A1c.

Have A Blessed Day!


Amie what's the Medtronic Medlink? Is that something your provider offers? It sounds like a great way to track blood sugar levels.

The Carelink is awesome. It is a little Flash Drive you put in your computer and then go to the Medtronic website. It lets you upload all of your pump info such as basal rates and blood sugar readings and put the info into nice easy to read charts. My Endo is over an hour away, so if I have issues I upload all my info and give her my password to sign in and look at my numbers. It lets you see trends and things that you maybe would not realize were going on.  I use it all the time for my daughter as well. It helps me see what is going on with her when she is at school that she may not tell me about.

Stuff that works:

* Keep in mind that A1c isn't as important as the number and severity of the highs and lows you're having.  Make sure your blood sugars are stable before conceiving too.

* Aim for a lower target blood sugar.  When pregnant my goal was 80 at all times (first thing, pre-meal, 2 hours post meal).  I tested a lot to prevent lows.  Low blood sugars are as dangerous to a fetus as high blood sugars. 

* Log your bood sugars, food and insulin.  It's a pain in the butt, however most people have better control when they log consistently.  It also makes you more conscious of food choices.  Iphones have the Track 3 diabetes log app that makes it a little more fun.  

* Take the time to carb count accurately.  Look up what you're eating in the Calorie King book or, again, use Track 3 app to get carb counts.  I've carb counted for 20 years and am surprised how often I'm wrong when I guess. 

* Use an insulin pump.  You'll for sure want a pump when you're pregnant.

* Like others have mentioned, test a lot or use a CGM.

* Eat low carb.  Fewer carbs in, the less chance you have of carb counting or dosing insulin wrong.  At the very least eat a "boring" diet with a lot of the same foods which you can consistently predict carb counts on.

* Don't eat large, high carb, and/or high fat meals.  Makes insulin dosing difficult.

* Avoid having lows.  It's easy to over treat and create highs later on.  Then you have another low, and another high...

All these are great suggestions and they work, however the only time I've been in really good control  was when I was pregnant.  In real life it's difficult to take the time and energy to do this stuff day in and day out.  

Definately monitoring your numbers closely. I use the Controur USB meter and its great for that! Check it out. It shows trends and graphs for your numbers. It really is wonderful.

for me (and your diabetes may differ), it was really getting back to the basics.  I've been diabetic so long I found myself not counting carbs but just guessing based on knowledge I thought I had.  I had grown complacent in checking my blood sugars, only testing 2-3 per day.  I found myself forgetting to give insulin after meals, and then not checking BGs after meals, which lead to highs for a longer period of time.  The complacency is what drove me to join the DOC, which has helped me immensely realize that while we are all sick of this disease and may all feel like we know what we need to know, there is still room to learn and we all help each other try to reach our goals.

Like everyone else has said, the magic for me became testing more often.  I started testing 6-8 times a day, and kept food logs where I actually had to look at nutrition facts to count carbs.  I started realizing I was not bolusing for meals or snacks, and even if I did forget, the next BG check pointed it out to me much quicker.  I am currently looking into getting a CGM to monitor my BGs even more closely.

Lastly, stress plays a big role in my BGs, so I try to do yoga or some form of relaxation for the benefit of exercise and my sanity.  I'm sure stressing about your A1c and trying to get pregnant are not helping to make it any better for you. 

I wish you the best of luck in getting it down and getting pregnant.

I also needed to bring my A1c down to prep for pregnancy.  That was 4 years ago or so.  For me, what worked best is:

1. check AT LEAST ten times per day.  Make your motto: "Check and correct. Check and correct."

2. Never eat if your number is over 7.0 (126) [correct first, wait, then eat]

3. If any meal is spiking your numbers greater than 2.7 (50), then you need more insulin to cover meals

And...for what it's worth...I think 5.5 is a little unreasonable.  My endo always taught me to have it under 7.0% before getting pregnant (and that's the same recommendation by the Canadian/American Diabetes Association).  If my A1c was ever 5.5%, I swear I'd be low all.the.time.


What is the DOC? 


Kerbear - "DOC" stands for Diabetes Online Community. If you're using this site, you're part of it. :)

Hey Jackie, I am a single mother with a four year old son with diabetes and i do have expertise on this matter because i am a medical lab technologist. I am the person who testes you for A1c and etc. To sum it all up its seems to me your body needs more Insulin then usually  give so i suggest going up on your carb insulin ratio and it will gradually come down and if you need to adjust it a little more do so until you make your goal but make sure you have enough carbs to cover that meal.

One other thing that I don't think anyone has mentioned: make sure to bolus 15-30 minutes before you start eating.  That way you have some insulin on board before you start eating (obviously don't do this if you are dropping/low) and you won't spike so much after meals.  Best of luck!!