The Hemoglobin A1c test, or H-A1c, measures the average amount of glucose in your blood over the past 3-4 months. It is not altered by what you ate for breakfast the day of the test, or what you are the day before. And many doctors are now looking at it much more closely, moving more and more people into the pre-diabetic or “pre-pre-diabetic” range if it gets a little high.
So, a few years ago any number under 6 was fantastic, and a level under 7 was nothing to worry about. The diabetes epidemic in this country has changed those views, and now many physicians want to see their patients with H-A1c levels under 5.6. By making dietary changes at this point, many people can avoid developing Type 2 Diabetes and the health complications that go along with it. Yes, you can lower this number just by changing up your diet a little.
If your levels have come back higher than you and your physician want them to be, the first thing to do is look at your lifestyle over the past three months or so. If you had your test done in January, this result will reflect the months of October, November and December. Not exactly most people’s healthiest time of year. Halloween, Thanksgiving, you get my drift. If that is the case, throw away the leftover candy, cut out the extra breads and sweets, and test again in June. You may be just fine.
If not, or if your levels are too high and have been steadily moving upward, here’s what to do:
- Cut way back on sugar. Candy, cookies, ice cream, all those things. Have an occasional dessert with dinner, but cut out all the little sweets during the day. And the late night sweets. Keep your hands busy, go to bed early, have some herbal tea – whatever works. Sugar is like that friend who pretends to be nice then spreads your secrets around town. Dump her.
- Limit starches like bread, white rice and white potatoes. No more than one starch per meal; and avoid bread when you can. Simple starches in these refined foods are quickly converted to glucose in your bloodstream. Switch to whole grain starches like quinoa, brown rice, farro, wheat berries, and polenta. Sweet potatoes are fine. Their fiber slows digestion, meaning fewer spikes in blood sugar. Pasta is actually fairly easy on the blood sugar (as far as starches go), do you don’t have to avoid it completely.
- Add plenty of vegetables at lunch and dinner. I am not worried about “sugary” vegetables like carrots – that is not what got you here. Try for four or more servings of veggies a day.
- Have two servings of whole fruits each day, and limit juice. While fruit can be sweet and sugary, cut out the added sugars and white starches first. Fruits are so full of vitamins and antioxidants they should be the last things on your list to cut. Apples, pears, and berries are best for lowering blood sugar.
- Cut out sugary drinks. Soda, lemonade, coffee drinks, sweetened tea, and flavored waters can all cause big spikes in blood sugar and significantly raise your H-A1C levels. This is a no-brainer that will deliver big results.
- Add beans and legumes as protein sources. Their fiber can really modulate blood sugar levels.
After three months of following these guidelines, have another test. Your levels should go down, and you will probably be feeling better, too.
If you want the scienc-y details on the test, here you go. Hemoglobin is the molecule in red blood cells that delivers oxygen to the cells throughout our bodies; in adults about 98% of our hemoglobin is Hemoglobin A, and about 7% of that is Hemoglobin A1. Glucose molecules tend to stick to Hemoglobin A1, especially Hemoglobin A1c (we have A1a, A1b, and A1c), and once they are stuck they are very difficult to unstick. This is called glycosylation.
So the Hemoglobin A1c test measures the amount of glycosylated Hemoglobin (GHb) in our blood stream. This value is reflected as a percentage – the percent of Hemoglobin A1c that has been glycosylated. Since our red blood cells have a lifespan of 100 – 120 days, this percentage reflects what has been going on in our bloodstream for the past 3-4 months.
The higher the amount of glucose in our blood at any one time, the more Hemoglobin gets glycosylated. That is why spikes in blood sugar bump up this number. Smaller, steady amounts of glucose in the blood keep it normal.
This test is also used to see how well diabetes treatment is controlling blood sugar levels. It sure would be nice to see that become much less necessary.
Any questions? Let me know. I have answers. Oh, how I have answers.