Ask the Expert: What can I do if my A1c is steadily rising?

“Thank you in advance for your willingness to help. I have many highs and lows even when I am not sick. I am type 2 and control my blood sugars with diet and exercise. I do not get much exercise due to a recent knee surgery. I am not on meds for my diabetes and I see my doctor for a check up every 3 months. My A1c is steadily rising. Do you have any suggestions?”

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Answer:

The answer to this question depends on how “high and low” your blood sugars are. If your blood sugar is falling in the range of 70-140 mg/dL your doctor probably won’t add a medication. If you are running lower than 70 mg/dL without medication, you may want to make sure you are getting six small meals instead of three larger ones, and make sure you are getting protein and fat with a small amount of carbohydrate at each meal to keep your blood sugars a little more stable. If you are dealing with hypoglycemia, I would also recommend that you meet with a dietitian to discuss appropriate meal and snack options. If your blood sugars are running higher than 140 mg/dL, I would recommend that you first discuss medication options with your physician. Certainly diet and exercise are a critical part of diabetes control, but with a surgery leading to difficulty exercising, your ability to control blood sugars is lessened. If you have never tried medications, it may be time.