u/erichamion — reddlx

Progress two months in

I was diagnosed in mid-June with 10.2% A1c. The blood draw was taken on June 2, but the A1c test wasn't immediately ordered, and I saw the result around June 16-18.

I was very upfront with the dietitian/diabetes educator that I need specific targets and don't feel that I can (at this point, anyway) follow a qualitative eating plan. So I'm eating low carb, aiming for 100-120g per day (but occasionally dropping into the 80-100 range is fine), with no more than 60g per meal. Ideally at least 1/3 of that is fiber, although I don't consistently hit that goal. I've been performing some light activity after every meal, from 15 minutes walking to 10-15 minutes on a stationary bike to 5 minutes up and down the stairwell at the office.

On the medical intervention side, I've now been on Mounjaro for 8 weeks, including 4 weeks at .5mL. My doctor does not want me monitoring blood glucose, at least for now, and worrying about transient numbers, so I've been somewhat flying blind.

A new A1c test was done today in preparation for a follow-up appointment this Thursday. It's not a full 3 months, but I opted for an earlier follow-up to see what direction things are trending as soon as reasonably possible. I'm down to 6.3%!

https://preview.redd.it/382hwy6nj8kh1.png?width=984&format=png&auto=webp&s=4ef7f03a7f9743df6308539828ac821e5fe2dde1

https://preview.redd.it/2as0v12aj8kh1.png?width=998&format=png&auto=webp&s=fe55c7b121de077a543d1d8bd63a572c47839d2b

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u/erichamion — 2 days ago

▲ 4 r/diabetes_t2

Early status report

I was just diagnosed last week, with A1c of 10.2 (and posted about it here). Now my first follow-up appointment with my primary care doctor is tomorrow. The dietician (also a diabetes educator or diabetes counselor, I believe) is a few weeks out, in mid-July. Until then I'm sort of flying blind.

I know the doctor wants to administer a sample of a GLP-1 medication if they have one available, and he hopes to manage with that and lifestyle, not insulin. And I'll ask about blood glucose monitoring if he doesn't bring it up.

I've been doing some movement after every meal, even if just a lap or two around the interior of the building and a trip up+down the 150 stair steps between my office floor and the cafeteria level. When I'm at home and can't go outside, I have a stationary bike that was purchased in 2020 and has been collecting dust for most of that time.

I've been tracking food intake since Thursday, aiming for low carbs and "good" carbs. At this very early point, there haven't really been any real problems with food cravings or anything (other than once, when it would have been so easy to keep reaching into the bag of pork rinds after finishing the serving i had counted out beforehand), and logging everything seems to effectively prevent boredom eating. In fact, I've been really surprised by not feeling the need to eat more, and the biggest problem so far has been trying to get *enough* calories in. Saturday and especially Friday were really bad in that regard. Both yesterday and today, I had to down two slices of cheese after dinner just to try to boost calorie counts.

I've never noticed anything that I identified as symptoms. But the last few mornings, even if I'm tired, it seems like I don't have the feeling of being about a tenth of a millimeter away from reality that I've come to associate with morning fatigue. It's subtle, and that may just be my imagination.

I'm not a cook. Throwing a plain chicken breast and some asparagus on a baking tray with some type of seasoning blend (and yes, I'm careful about what blends) is about my limit. So it does sort of feel like every minute of my entire life is now going to revolve around food - evaluating, comparing, planning, preparing, consuming, "walking it off", using & washing dishes at an unprecedented rate.

And I have an out-of-state road trip and hotel stay for a weekend-long event this weekend. A fun event, but certainly a challenge right at this moment.

u/erichamion — 2 months ago

▲ 13 r/diabetes_t2

First blood tests in decades found extremely high A1C. How to prepare for any health care provider follow-up?

TLDR: No current or prior diagnosis, first regular medical checkup and blood tests in decades found HgA1c of 10.2%, wondering what I need to do to prepare for any follow-up with my health care provider.

EDIT: Got the call back from the doctor yesterday. Still need a test just to confirm for certain that it's type 2, but assuming it is, the plan is to start with Ozempic or Mounjaro, not insulin. And consult a diabetes dietician and all the other stuff (eye, foot exams), of course.

On June 2, I just had my first regular medical checkup in more than 25 years. Blood was drawn (no intentional fasting first), and after the initial results I was told the doctor was ordering an A1C test. I haven't yet heard back from them after that, but I logged into the online patient portal last night and saw that it had results. HgA1c of 10.2%. Is there anything I should do to get ready for any follow-up?

Obviously any diagnosis should be left to my doctor or provider, and I'm sure they'll have specific advice for me to follow. I'm just looking for any advice leading up to that. Anything specific I should bring up with them, anything I should do right away, anything that I should mentally prepare for, etc.

This is a single test. I have no way of knowing how long my A1C has been elevated, but I assume a reading this high wouldn't be a temporary spike (or if it is, then the "normal" levels outside of the spike would still be dangerously elevated).

The reason for the long delay between doctor's visits is irrelevant, and it won't prevent future visits.

I'm not sure how well I could deal with daily finger-pricking. I only have one hand, and I use the fingertips of that hand both for typing (work) and for fretting acoustic guitar (hobby).

I'm in my mid-forties and live alone. If I end up needing to take some medication, I'm concerned about what would happen if a miscalculation results in crashing blood sugar and there's nobody around to notice.

Exercise:
Prior to the visit, I had already started a weekly 5k walking routine, with the intention of increasing the frequency as my legs/ankles grow accustomed to the stress and as DragonCon approaches. This week will be the 8th week. This is fast walking (average pace 14'44"/mile on the most recent walk), not leisurely. I actually use the "Zombies, Run!" app, but I gave up on running/jogging back in 2020 when I realized I didn't have the discipline to stop when my knee hurt (and have been very sedentary most of the time since). My only other exercise is the 150 stair steps to and from lunch about once a week, which is not sustained cardio. I don't count the stairs from and to the parking garage four days a week because they're only 64 steps.

Diet:
For the last 6 months or so, I've been getting 6 meals per two weeks from Mosaic Foods, mostly from their "veggie bowls" selection (no, I'm not vegetarian, but I do think that some fraction of meals should be vegetarian if there are no health concerns preventing that). I really have no accounting of food intake aside from that. Carb-heavy snacks have always been an uncontrolled problem (uncontrolled as in "no effort made to control", not "uncontrolled despite efforts"). For the last several months (maybe as much as 6-12 months, but not multiple years), high-sugar candies have also had a significantly increased presence. On the other hand, I switched to sugar-free or low-carb (sugar-free preferred) drinks over a decade ago. Not healthy drinks, but at least following the general "don't drink your calories" advice.

I apologize if I'm rambling. I'm just concerned with this test result, inexperienced with this type of thing, and not sure what information is relevant.

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u/erichamion — 2 months ago