How should I manage my elevated HbA1c of 10.7?

Hi,

Welcome to icliniq.com.

I have read your query and understand your concern.

Your last lab tests indicate your diabetes control is not as good as it was at your last visit. An HbA1c of 10.7 means that, on average, your blood sugar has been high over the past two to three months — even if some of your daily numbers look okay.

The good news is that your kidney and liver tests are normal, and there is no evidence of kidney damage from diabetes at this time. But if not managed well, sugar in your urine and high cholesterol can increase your risk for heart disease and stroke over time.

There are many reasons your HbA1c can go up. These include missing your meds, taking them at the wrong time, eating more carbs or sweets, not exercising, stress, poor sleep, weight gain, infections, using steroids, or your diabetes getting worse over time. Even if your fasting sugars aren’t very high, HbA1c gives you a better idea of your long-term sugar control.

Lifestyle changes may no longer be sufficient at this stage, and your diabetes treatment may need to be altered. But if you are only on Metformin, your doctor may increase the dose if you can tolerate it, or add another medicine such as Dapagliflozin 10 mg once a day. Semaglutide injections and other medicines may also be options depending on your weight, symptoms and what you can afford. Your doctor may discuss using insulin for a short period of time if you are taking several medicines and your blood sugar level stays high, especially if you have symptoms like being very thirsty, urinating a lot, feeling very tired, blurred vision, frequent infections or losing weight without trying to.

Your cholesterol is high, too, especially the low-density lipoprotein (LDL). Diabetes patients must control their cholesterol very well. Over time, high blood sugar and high LDL increase the risk of heart problems. Changing your diet will help, but many people with similar results also need to take a statin medication as recommended by their doctor. Cut down on oily foods, fried snacks, bakery stuff, sweet drinks and heavy late-night meals to bring down blood sugar and cholesterol.

Your Vitamin D level is very low and needs treatment. Vitamin D: Low Vitamin D can cause tiredness, body aches, weakness, and low energy. Your doctor says that taking vitamin D supplements should help.

The blood work also shows a mild eosinophilia that is often associated with allergies, asthma, sinus issues, skin allergies or sometimes parasitic infections. While it’s not directly related to your diabetes, if you experience symptoms like itching, wheezing, a cough that won’t go away, allergies or stomach troubles, you should tell your doctor.

I hope these suggestions are helpful.

Take care, and feel free to reach out if you need further guidance.

Thank you.

Hi,

Welcome back to icliniq.com.

The following medications are recommended for better control of your diabetes, cholesterol levels and Vitamin D deficiency:

• Metformin 1g BD if tolerated.
• Dapagliflozin 10 mg once daily.
• Linaglastin 5 mg OD.
• Rosuvastatin 10 mg at night for cholesterol control.
• Vitamin D supplementation. Colecalciferol 50,000 units once weekly initially, then 800 units once daily.

I hope you are still following that advice given earlier. In addition to medications, the following are very important steps to achieving better diabetic control:

• Follow a strict diabetic diet and avoid sugars and refined carbohydrates.
• If you are medically able, exercise daily, such as brisk walking, for a minimum of 30 to 45 minutes.
• Take your medication exactly as prescribed and at regular intervals.
• Check fasting and post-meal blood sugar levels regularly.
• Get your eyes checked. Get your diabetic feet checked if you haven’t had them done recently.
• Recheck your haemoglobin A1c in about 3 months after you make treatment adjustments.
• See your doctor or diabetologist early for review and adjustment of medication.
• If you haven’t already, get your eyes checked and your diabetic feet evaluated.

Once you have made improvements to your medication, it is recommended to retest HbA1c levels around 3 months later.

The elevated HbA1c should not be ignored, but don’t panic either. The good news is that your kidney and liver functions are still preserved, so this is the right time to gain control before the complications develop.

With proper medications, diet control discipline, regular physical activity, weight management and consistent follow-up, you can usually significantly improve your HbA1c levels over the next few months.

I hope this clarifies your concern.

Please feel free to reach out if you have any further questions.

Have a great day ahead.