Why did my HbA1c rise from 6.2% to 8.3% despite treatment?

Question

Hello doctor,

I am 69 years old and have been a diabetic patient for 12 years. I undergo regular health check-ups. About four months ago, when I had blood tests done, my HbA1c was 6.2, the average blood glucose was 157, and my creatinine was 1.41. I weigh 154.3 pounds.

About three weeks ago, when I repeated the blood tests, my HbA1c had increased to 8.3, the average blood glucose was 192, and the Creatinine was 1.42.

I am taking Janumet 50/500, one tablet in the morning and one at night before food, and Dipizide-M, one tablet in the morning and evening before food. I am a pure vegetarian, do not consume alcohol, and do not smoke.

Please advise me on how to bring these parameters back to normal.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

I can understand why this sudden change is worrying, especially when you have been careful with your health for many years. An HbA1c (glycated hemoglobin) rise from 6.2 to 8.3 over a few months suggests that your blood sugar levels have been running consistently higher recently, even though your creatinine has remained relatively stable around 1.4.

At your age and with a 12-year history of diabetes, this deserves proper medical review soon because uncontrolled blood sugar levels over time can further strain the kidneys.

Common reasons for a sudden rise include reduced physical activity, hidden infections, stress, poor sleep, changes in meal timing, progression of diabetes over time, or medications becoming less effective.

Since you are already taking Janumet (Sitagliptin and Metformin) and Dipizide-M (Glipizide and Metformin) regularly, your doctor may need to adjust the dosage, check whether your kidney function allows the same medications to be taken safely, or consider adding another medication that also protects the heart and kidneys.

For now, focus on steady daily habits, such as following:

Avoid large portions of rice, potatoes, sweets, fruit juices, white bread, and refined flour foods, even if you are a vegetarian.
Increase protein and fibre intake with lentils, beans, chickpeas, tofu, unsweetened yoghurt if you consume dairy, salads, green vegetables, and controlled portions of whole grains.
Eat meals at regular times.
Avoid overeating at night.
Take a gentle daily walk after meals for about 20 to 30 minutes, if your health allows it, as this can significantly help lower post-meal blood sugar levels.

Also, monitor fasting and post-meal glucose levels at home if possible and keep a written record. Because your creatinine is mildly elevated, stay well hydrated and avoid unnecessary pain medications like Ibuprofen unless advised by your doctor.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.