Why you should aim for a lower HbA1c..?
By lowering your HbA1c you are in effect lowering your risk of developing Diabetic Complications. The further your HbA1c is away from that of a non diabetic the greater your risk. A lower HbA1c should be a primary focus for all diabetics.
What is HbA1c..?
The HbA1c or (Hemoglobin A1c) is a blood test that is used to measure how well controlled your blood sugar levels have been in the past 2 to 3 months. When glucose enters the blood stream it binds to the hemoglobin (part of the red blood cell), this is known as glycation. The more glucose that enters the blood stream, the more glycation will occur (ie. the more glucose is bound to our red blood cells).
The HbA1c test measures the average amount of glycation in the Hemoglobin, or put another way the average amount of glucose stuck to our red blood cells. As red blood cells only live for approximately 4 months before being replaced, the test is usually considered to be a reflection of a 2 – 3 month average. This gives a score of how well controlled your blood sugars have been over this period.
A high HbA1c leads to Diabetic Complications
A high HbA1c indicates poorly controlled diabetes and means that you are at a greater risk of developing serious diabetes complications such as neuropathy, retinopathy, nephropathy, cardiovascular disease, vascular disease and many others. Therefore it is essential that you maintain a good HbA1c score.
So what is a good HbA1c score..?
The American Diabetes Association (ADA) says you need to keep our HbA1c results below 7.0 percent. The American Association of Clinical Endocrinologists have set a target of 6.5 percent. The International Diabetes Federation (IDF) also recommends that most people with diabetes keep their levels below 6.5 percent.
But more aggressive endocrinologists say that a truly normal HbA1c ranges from 4.2 percent to 4.6 percent. No matter what your level is, you can be sure that lower is better, unless you drive it so low with diabetes medications that you run risks of hypos or heart problems.
Concerns with these risks are the main reasons why the diabetes organizations set a goal that is higher than a normal level, even though they know from clinical trials that with higher levels you will probably suffer from the serious complications that result from high blood sugar levels.
How to lower your HbA1c
Below is a set of 8 steps that will all help to improve your blood sugar levels, lower your HbA1c and improve your overall diabetes management and health.
1. Have a plan
There are a number of changes you may have to make in order to achieve a good HbA1c level and these will be a lot easier achieved with a plan. With a plan you can identify your long term goals, set them against a time-line and then break each goal down into smaller achievable tasks. Any changes you need to make in order to lower your HbA1c can be incorporated within your plan. This will give you focus, direction, and a much higher chance to achieving your objectives.
2. Eat healthily
Stop eating fast food such as pizza’s, burgers, fries, etc as they are loaded with carbs, fat and salt. As a Diabetic you should avoid these like the plague..! They are very unhealthy for non-diabetics and even more so for diabetics. Eating home cooked healthy meals without too many carbs will greatly help to lower your HbA1c.
3. Stop snacking
Most people enjoy a snack between meals but for diabetics this should be avoided. Firstly many of the snacks we love are unhealthy and are loaded with carbs, and remember carbs = sugar. Secondly, snacks are usually unplanned and therefore are more difficult to successfully cover with medication.
If you are an insulin dependant diabetic you must take extra insulin to cover your snack. As most rapid acting insulins last 2 to 3 hours in the body, if you then have eat a meal within this time period (and thus take more insulin) this can lead to an issue known as insulin stacking which can lead to fluctuations in your blood sugars and to a poorer HbA1c.
4. Eat low carb
Reduce the amount of carbs you eat at each meal. A great way to know how many carbs are in a meal is to introduce carb counting. Or another good way (though less effective) is to simply eat smaller meals. One great tip to achieve this is to use a smaller plate!
As a diabetic the more carbs you consume the more medication you need to take, and it then becomes much more difficult to effectively manage your diabetes and achieve a good HbA1c score.
5. Frequently monitor your blood sugar
You should be monitoring your blood sugar levels multiple times per day. This will give you valuable feedback as to how your blood sugar levels are during the course of each day. You can then seek to make adjustments based on this information. Talk with your diabetes care team about the best way to manage and use this information.
6. More movement
The human body has evolved for over 1 million years and is designed for lots of movement. But in the past few decades the modern lifestyle for many people has changed in such a way where we don’t move as much any more. For example you may spend your day working in an office at a computer or at a checkout till in a shop where movement is limited.
The less movement you incur the less fuel your body needs. Movement and exercise also increase your body’s sensitivity to insulin. So when you exercise your body will take more glucose from your blood stream (to fuel the muscle cells) in the presence of less insulin. This will greatly help to improve your HbA1c as well as your overall health and possibly reduce the amount of medication you require.
7. Reduce stress
When you enter a state of stress your body induces a stress response. This is where your breathing and oxygen intake increases, heart rate quickens, brain waves alter, blood sugar levels increase, hormone levels change and you enter a more heightened state. Over time this will likely result in a higher HbA1c.
Diabetes requires management and this competes for your already scarce time. You never get a day off and are constantly calculating – when is my next meal, is my blood sugar low, is my blood sugar high, I must check my sugar levels etc. This can add more and more stress to an already stressful life.
When you get too stressed you make bad decisions and this can be detrimental to not only our diabetes management but to many other aspects of your life. For example, you may sit on the couch watching TV instead of exercising after a stressful day.
There are many things you can do to help reduce the stress in your life.
- Talk to someone. As the old saying goes “A problem shared is a problem halved”. If you are worried about something then its imperative that you talk to someone about it. Dont bottle it up!!
If you can’t think of anyone who you would feel comfortable talking to, maybe your family doctor or minister could be an option.
- Introduce effective goal setting and planning to your life. This can help you focus on what is important, improve your time management and thus help reduce the amount of stress in your life.
- Meditation is also a fantastic way to reduce stress and its harmful effects.
- Exercise does has not only have great physical benefits but it also helps reduce stress and calms the mind and body.
8. Routine Routine Routine
Sticking to a routine is another great way to help you successfully manage your blood sugar levels. If you have a good routine where your blood sugars are well controlled then the more you stick to this then the better your HbA1c score will be. It may not sound like the most exciting lifestyle but for diabetics it is proven to be very effective.