How I Lowered my A1c to 5.0%
Before I get into my experience with my A1c, I need to start with a huge disclaimer. As someone living with diabetes, your hemoglobin A1c can often feel like a pass/fail marker of how you’re doing with both your management of diabetes and as a person, with a lower number automatically meaning that you’re doing better. While your A1c is a great tool to help you determine how things are going overall, it is NOT the only metric that matters, and having a higher A1c does not mean you are failing (in any sense). Diabetes is so hard and unique to everyone. Please do not read this post and walk away feeling bad about yourself if your A1c is not whatever your goal may be (which was the case for me for 99% of the time I’ve had diabetes) or not yet at the range your doctor recommends. Repeat after me: I am more than my A1c, and I will not compare myself with strangers on the internet. My aim with this post is to share some strategies that helped me lower my A1c and better manage my diabetes in hopes that they can help you too. Okay, let’s get into it!
For some background context, I’ve lived with diabetes for almost 20 years and my A1c—and diabetes overall—has run the gamut from being “well controlled” (sidenote: I hate that word) to the hottest mess you could imagine. In terms of numbers, as a teenager my A1c was anywhere from 7.5% all the way up to 13%, usually hovering around 9% or 10%. This went on for about 10 years, from the ages of 10 to 20. When I hit my early twenties, I went through a series of changes (more on that below!) and over time, I was able to regularly bring my A1c to the 5.0-6.0% range, with my most recent A1c being 5.0% on the nose. If you want to read more about my story with my diabetes, you can check that out here. Without further ado, here are some of the ways I was able to make changes to bring myself to a 5.0% A1c.
Mindset
The first thing that had to change with my diabetes management was my mindset, and why I wanted to lower my A1c in the first place. I hated having diabetes as a teenager and basically did everything I could to blend in and not draw attention to my condition, including things like avoiding taking insulin in public, avoiding checking my blood sugars for days on end, and intentionally missing appointments with my healthcare team. When I hit my early twenties and realized that the short-term gains of not managing my diabetes would eventually turn into long-term pain, I started taking baby steps to looking after my diabetes better. It wasn’t something that happened overnight, but reminding myself that I was facing the uncomfortable now (which was really hard at first!) to hopefully stay happy and healthy in the future kept me motivated.
2. Changing one thing at a time
I’m an all-or-nothing gal, and more than once I’d vow to change all of my habits overnight and finally become the “perfect” diabetic. Spoiler alert, that doesn’t exist, and making a million changes at once always set myself up for failure. I started small, focusing on things like eating a consistent, blood-sugar balancing breakfast (check out my favourite breakfast here!) which allowed me to see if my basal rates and insulin to carb ratios in the morning were actually working for me and make small adjustments, one at a time. Once I made those adjustments, I moved on to lunch and dinner, then my overnight blood sugars, and so on.
3. Finding the right healthcare team
This was a big one for me. As a child and teenager, I didn’t have the best relationships with my healthcare team. My quarterly check-ups often felt like scoldings, and I quickly developed a lot of dread and anxiety before visits and would find any opportunity to delay or cancel them. I carried this mindset with me through university, sometimes going almost a year without seeing my healthcare team, and cycled through a few different providers when I aged out of the pediatric program.
When I finally settled in Toronto after school, I knew I needed to find a new doctor. I read reviews online and looked in the diabetes communities in my area to get some recommendations, and had my family doctor refer me to someone she thought would be a good fit. My current doctor’s approach is so much more empathic and he has zero judgment, which cured a lot of my anxiety before appointments and allowed me to admit when I needed help. Knowing I had a provider who believed in me and wouldn’t judge me was a huge game changer in making me feel safe enough to explore new things with my diabetes management. After switching to this new doctor I was able to lower my A1c from about 9.0% to 6.5% in just a year, which I credit largely to feeling trusted and supported instead of going it alone.
4. Focusing on diet and exercise
It’s a tale as old as time, but I’m here to report that having a good diet and exercise routine does truly make a difference when it comes to happy blood sugars. Now, “good” can mean different things to different people, but for me it meant adopting more of an 80/20 mindset for eating, with 80% being fresh, minimally processed foods and 20% being things like eating out and processed food. I’ve never followed a specific diet, but cooking more at home with fresh food meant less guesswork when it came to carb counting and insulin, which allowed me to bolus accurately and avoid the stubborn highs or lows I would usually get after a lot of meals. I also started using a kitchen scale to accurately carb count, which helped a lot. I’m going to be adding more of my favorite recipes here soon, so stay tuned!
With exercise, I slowly added in doing some sort of movement every day, whether it was an organized workout class (spin, pilates, and weight lifting are my favs!), an at-home strength session, or a long walk with my dogs. I found that the best time to exercise was in the morning when I didn’t need to worry about any existing insulin being on board, and having a consistent schedule really set my blood sugars up for success during the rest of the day.
5. Advocating and asking questions
On the topic of eating out, I began working on feeling comfortable asking questions and making substitutions when eating out, and it made a world of difference in preventing highs and lows. This was a sore spot for me before and it took some courage, but I now have no problem asking exactly what’s in a dish before ordering, to swap out sides, or for things to be prepared differently (within reason!). On that note, I’ve also gotten better about advocating amongst friends and family about where I want to eat depending on my blood sugars or if I need to do something to prioritize myself (e.g., going for a walk, stopping for a quick snack, etc.). If my blood sugar has been high, I’ll ask to eat somewhere I know will have lower carb options, or I’ll just get my own food if we’re ordering in so I don’t have to struggle later on (something I used to always do). My friends and family are always super accommodating, and I honestly wish I started prioritizing my diabetes when hanging out a lot sooner than I did.
6. Tried out new technology
Another big game changer for my diabetes management was trying out the new technology on the market as it was released. I used to avoid all the fancy new gadgets because they seemed a bit overwhelming or too cumbersome, but getting the Dexcom G5/G6 and Tandem T:Slim X2 pump a few years ago allowed me to really hone in on what was working and what wasn’t with my diabetes management. Wearable tech has a lot of pros and cons, but continuous glucose monitoring definitely allowed me to get a great idea at how food, exercise, my period, etc. were impacting my blood sugar and making tweaks to my insulin dosages. If there’s one tip I can give to lower A1c, it would be getting in depth knowledge of your body’s patterns as they relate to diabetes and blood sugars, whether that’s through technology like a CGM or really consistent blood sugar checks with a meter.
P.S. Make sure you don’t just try out one thing and trust that it’s the best for you! Ask for demo kits for any items you’re thinking of buying and try them out for a while to make sure it’s right for you.
7. Take ownership
When I was in the process of lowering my A1c and building a better relationship with my diabetes, a big (and hard) thing was taking ownership. It’s my diabetes, not my doctor’s or spouse’s or anyone else’s. That meant being actively involved in suggesting and trying new things, adjusting basal rates on my own, and doing my own research between appointments. It’s great to use your diabetes care team as a sounding board and for help when needed, but don’t rely on them to do all of the work for you. It took me time to figure out my body’s patterns and how to apply the advice I was given, like what recipes and exercise worked well for me vs. not (for example, running is not for me. It might be someone else’s key to excellent blood sugars, but it’s not mine!). It takes a lot of trial and error to figure out what works and that’s something only you can do. Once I took full ownership of my diabetes and the outcomes of the decisions I made, it was easier to stay invested and get excited when I saw positive results. Seeing a few positive changes helped to build momentum to keep making good decisions, and then my A1c followed as a result.
To summarize, making changes to lower your A1c is not an overnight process, especially if you want them to be sustainable. My A1c has been below 6.0% with 80% time in range for the past two years, but that’s only because I took my time and really learned the ins and outs of my body. I honestly never thought I’d be here writing a post like this as a former “non-compliant diabetic” (there’s no such thing, so don’t let anyone tell you that you are, just FYI!). If you’re on a similar journey, you’ve got this!
