Climbing A1C

I have had T1D for the last ten years. I have been on MDI and the insulin pump. My A1C used to be around 6.5, but over the last year or so it has climbed up to 9.1. I am super frustrated because I feel like I am doing all the right things with no success. My levels like to spike and drop repeatedly throughout the day, but I just switched to a new endo so we are working on fixing that aspect. Has anyone had any success with the herbal supplement gymnema helping their BGs? What is the best advice y’all have for lowering my A1C? Thanks!

Hi Rebeca! The one thing I’ve learned in my 32 years as a T1D is Diabetes is such a personal disease. What works for one person may not necessarily work for others. I love to post and talk about what is working for me in hopes that maybe someone can take something away from it and it will work for them. I’ve been on MDI for the entire 32 years. I was never interested in trying a pump. For 31 of those 32 years on was on the same N & R regimen taking 2 shots a day. After getting a Dex CGM i quickly realized my old routine wasn’t working. Last year I switched to Humalog and Lantus and saw amazing results but with a cost. I was injecting 6-8 times per day trying to keep my numbers down. I knew there had to be a better option. Earlier this year I switched from Lantus to Toujeo and also added Afrezza (inhaled insulin) and Metformin (Type 2 oral med). Again I saw amazing results. While the improved insulins certainly help eliminating our nemesis (carbs) has been the best thing for my A1C (5.6). I have not totally eliminated carbs, but I am making smarter decisions when it comes to meal choices for me. Good luck!

There are variables that affect blood sugar but you shouldn’t be mystified. If you’ve gained weight you might just need more insulin.

If you’re using a pump your basal rates need to be adjusted. Best way to fix them is to fast and test every hour or 2 to get them accurate.

You also might need a refresher in carb counting.

Any chance you’re dealing with gastroparesis? It’s a complication that usually affects people who’ve had D a long time. Your digestive system is slow so the food doesn’t get to your blood stream until hours after your insulin. It causes a low right after you eat and then a high hours later. If that’s the case, avoid high fat and carb meals. Also try not to eat big meals.

Hope that helps a little. Let us know what you figure out works for you.

hi @Rebeca, it’s so easy to suffer a little burnout after 10 years that I just wanted to mention that what we do, what we have to do takes so much time and thought and the only reward for a painful regimen is you get to feel normal for a little while.

the window for “success” is about as wide as the sugar in 4 lifesavers candies and pardon my mouth but it makes it pretty (*&^%^% difficult to be perfect all the time!

I try very hard not to describe a high a1c or a high bg as failure, it’s not a judgement, it’s not a failure: it’s a feedback like noticing you are 5 MPH over the speed limit. Like all feedback, it can prompt you to do something or change something.

My background is in industrial controls, and there is one thing that cannot be denied, if you want to control something you first need to measure it. how many times a day- and when - do you test? a CGM or upping your bg testing may be a start.

bad absorption might be an issue, people tend to shoot the same area and scarring will make insulin absorption “variable”. I pump now because basal insulin and me do not get along, I was always high or low depending on the difference between my real basal requirement and whatever the basal insulin was doing.

supplements do absolutely zero for me. limiting carbs and regular exercise can cut my insulin requirements by 50%, so I’d say after all these years of having t1, that low carbs and exercise are huge contributors to lowering bg, upping metabolism, flattening out a after-meal spike, etc.

since you said you had big swings, there is always the liver thing. Your liver is designed to store sugar and then release it when you need it. IN the normals this works awesome cool in helping you wake up, push through a wall when you skip a meal, cut a spike or stop a low. In us, it can be very troublesome - if you just shot 5 units for a high and your liver decides it’s time to charge… you can drop 100 mg/dl in a half hour or you might need 5x the sugar to recover from a low. maybe it’s time to work the new endo and see if you are having these issues? other things like stress hormones, overactive adrenal gland or under-active thyroid all come to mind as well. these are not hard to diagnose or eliminate.

I started with burnout and I’ll follow up; a case of even mild depression can stop you from being active or convince you that since you’ve failed, you are a failure and so what’s the point of even trying. This kind of control problem is tough, and for me it only started to turn around when i started taking care of my self esteem and emotional issues with this disease. Please talk to someone and see if you have a touch of depression, or just get the “Diabetes Burnout” book and see if anything resonates, or heck, just say it because there are those of us here who probably felt the same way at some point or feel the same way now.

please take care and let us know how you are doing