Help with lowering A1C

Hi all, I would like some advice on getting my A1C down my last one was 7.7%. I seen my dr last week and I have to do IVF to get pregnant. He said that I will be seeing the dr at the IVF clinic in about 3 months. So I would like to get my A1C in the 6% range. I’m on shots I have hard time once my blood sugar goes below 6.7. So I don’t know what to do. I’m exercising and I’m on metformin to help with lower sugars and lose weight.

I have found that the dexcom really helped me. I dropped my A1C from the 8/9% range to 7.6% after two months on the dexcom which is the first time I had gotten my A1C under 8.2% in two years. I found out I was pregnant a month later and my last A1C when I was 3 months along had gone down to 6.5% because I tightened the alerts on my Dexcom to mark me as low if i’m below 4 and high if I’m above 7 to match my pre/post meal targets. If you have the ability to get one, I would highly recommend looking at the CGM options in your country!

I also got a iBG meter that attaches to my iphone. It’s so small that it’s not as much of a pain to carry around and actually use, so I started doing the 2hour post-meal tests more often than I did beforehand. I can plug it into my phone whenever to download the log which I can then e-mail to myself or my endo to print off, etc.

One thing that really helped me was re-training myself for low treatments. I used to treat if I was below 5, now I don’t treat unless I’m below 4 (for pregnancy, they told me it should be treatment when 3.3 or lower but that’s muuuuch to low for me). When I treat I drink a small glass of juice and when it’s done, I test 15mins later before eating or drinking anything to see if my level is going up. If it is, I wait another 15mins and test again, if not then I drink another small glass with a few crackers and repeat every 15mins if my level isn’t going up. Before I would just grab a big glass of juice and whatever starch I could find and not stop eating until my level started going up which then resulted in spikes. I’ve had D for almost 21years and got lazy over the years/rarely did go low so I felt so sick when I was I wanted to over asap.

I had CGM from Medtronic it was not very accurate. My benefits didn’t cover it so I went off it. I had to retrain myself to on how to treat lows. I hate the feeling. I have had diabetes for 19 years it hard to get out of old and bad habits. I try to treat my lows before they hit 3.9. I treat my lows with fruit snacks. Are you on a pump or shots?

I have no experience with Metronic so I can’t speak to it but I have experience with their customer service along with their reps and I can say I’d never go with them for anything haha

I find my Dexcom’s accurancy is totally dependant on the site location and then how long I’ve used it. If I make the site last 14days instead of 7days it’s def less accurate for the last 7days. I use my thighs exclusively due to my growing belly and my left side I find is more accurate than usin my right! It’s weird.

Retraining after sooo long is hard but when you’re motivated it can make it slightly (only slightly lol) easier. I was already pregnant so I had no choice but to try my best. The most important thing is to get tighter control without going low more often which I found was the hardest; in my first trimester, and my insulin needs dropped because the baby was taking so much, even a single unit more than I needed could mean dropping low depending on the time of day, etc.

I’m on shots. I’m not sure how I’d manage the pump considering I’m already taking so much more insulin than before I was pregnant! Right now a 100ml vial of Levemir only lasts me 3 shots!

Yeah I wish I didn’t go with Medtronic. Its crap I didn’t like the pump or CGM I went into more high then I have ever been in. I have better control with the shots, but yeah getting a tighter control is hard. Like today I went into 2 lows before 3 o’clock. But I’m trying.

Wow that’s a lot of insulin your taking.


It def is a hard balance but once you learn it, it’ll get easier :slight_smile: I don’t go low as often as I was when we first were adjusting my insulin up again after my first trimester was over.

Yeah I’m on 30u in the AM and 40u in the PM at the moment, but I feel like that’s going to be bumped up again because I’m still waking up in the 7/8’s even taking 40u. Trying to eat the same amount of carbs (so taking the same amount of novorapid) at dinner each night to see if I need to bump it up or if it’s enough for now. I can’t even sleep in unless I wake up at 6 or 7am to take my levemir shot :frowning: But for a healthy baby it’s worth it haha.

I’m on Lantus which every morning is a different number. I might see if I can go back on to levemir I seem to have better success with it. I seem to be at the 7/8 range sometimes higher depending on the day. Diabetes annoys me sometimes. I have went to bed at 7 wake up at 7 then the day its not the same. Are pretty sensitive to insulin? I’m really sensitive which is real struggle for me. It is definitely worth it to have a healthy baby.

How is your pregnancy going if you don’t mind me asking? I’m nervous about getting pregnant and IVF procedure.

I wasn’t before my pregnancy, but I think at times I am more sensitive or was for a little while? Either way…even when I started on Levemir, I was taking 20u of Lantus in the AM/PM but my endo upped that to 28u of Levemir in the AM/PM because he said it’s weaker than Lantus so I’d need more.

Other than the adjusting and such, really well. No concerns so far and pretty typical pregnancy symptoms but not all of them. I’m only supposed to gain 15-25lbs based on my pre-pregnancy weight and I’m already around 10lbs of that at 23w (today) which has only gone to my stomach, thank goodness! My mom only gained 25lbs with each of her pregnancies, only gained in her stomach, and had a pretty easy time, so I think that might be part of it…good genes? haha.

I’ve been hearing horror stories for so long that I wasn’t expecting this at all. Even a friend of mine, whose been a diabetic a few years longer than I have, was really encouraged to hear neither my endo or OB have any concerns about my pregnancy despite my diabetes because she had also been told all the horror stories and stuff.

Yes, stuff can go wrong and just because I’m having an easy go doesn’t mean that every pregnancy is going to be easy…but even without diabetes a lot of women have hard pregnancies! You kinda just gotta do you best, remind yourself that no one is expecting you to be perfect and every pregnancy is different regardless of pre-existing conditions and can be hard even without them!

I’m on a medtronic minimed pump and chm and I love it. I gotta say it actually irritates me alot that it took so long to get put on a pump…I’ve been t1d for 23 years now, and when I was first diagnosed my endo tried to put on a pump but I was only 5 and scared of a needle sticking in me constantly (that was back when they were an actual hook shaped needle) so I refused then when I was 13 I wanted a pump but he made it impossible for me to get one. But I’m pregnant now and my ob/gyn referred me to the endo I’m seeing now and things are going great.I found out at four weeks that I was pregnant and my a1c was really high, 9.3! But two months later it was at 6.0 and that is exactly where it is has stayed ever since and all my Dr.s are thrilled, all it took for me to get it down was testing more often and just tighter control in general. I also was on Lantus but was having a hard time with it until my endo split my dose in half and started having me take it twelve hours apart instead of once a day, and that worked alot better.

I meant CGM

I wish that was my experience with Medtronic pump. I struggled with it my numbers where all over high in the morning fight all day to get it down. I have better control with the shots don’t like it but its easier for me. I have to do blood work to see what my A1C is but I’m hoping its getting better. I will talk to my doctor about splitting the lantus dose. Just hoping that my A1C is in 6% range I want to start the IVF process as soon as I can.


When I was at my endo’s office last week the nurse said they recommend under 7% so even if you’re in the 6’s, I wouldn’t worry too much. :slight_smile: Of course I’m not sure if IVF works better if you’re under a certain number or something but anything under 7% is recommended for pregnancy. :slight_smile:

Yeah I want to be in the 6-7% range just because I don’t want them to tell me that I have to get it in that range. I haven’t talked to the drs from the IVF clinic yet but I have to travel 12 hrs to get to the clinic. So anything that I can do to get this ball rolling I’m willing to do.

Four months before I was pregnant my A1c was 8.5, I was on a Medtronic pump but not the Cgm. After three months on the CGM my A1C went down to 6.5. This was at my appointment the week I found out I was pregnant. My doctor said I had nothing to worry about if my A1c was under 7. I went to my endo last week, and my A1c is 5.9. The average on my CGM is 99 and the average on my meter is 92. So overall I guess it isn’t that far off.

I couldn’t imagine being pregnant with out the pump. I still struggle with my CGM quite often. I am considering getting rid of it after the baby comes. But I can’t imagine life with out the pump, and I was terrified to start pump treatment after 12 years of injecting. Now, I could never go back. I know everyone is different though.

Meghantk, just out of curiosity, how long did you stay on the pump? Because I know I had days at first where I wanted to throw it out of a window. And I still feel like that towards the CGM.

I was on the pump for 2 years and struggled. I had more highs then I do now being on the shots. In the mornings I would be 35 the highest I have been in the morning now is 13. And the CGM is garbage waste of money. Medtronic was no help either.