Tips for Lowering A1C

Janet O’Mahony, M.D. is an internal medicine doctor and a member of Mercy Personal Physicians Downtown in Baltimore. She recently responded to questions from Woman’s World magazine concerning tips for lowering A1C, both naturally and with medication. The A1C test is a blood test used to estimate the average amount of glucose or sugar in your blood over the past three months. 

Why is A1C an important metric for blood sugar control? 
Controlling A1C is an important tool to lower the risk of complications from type 2 diabetes. Type 2 diabetes increases the risk of heart attack, stroke, kidney failure, blindness and poor circulation to the feet. The risk of complications is higher with longer duration of diabetes diagnosis.  

What health conditions does A1C help to predict your risk for?
Reducing these risks requires targeting the glucose, as well as other risk factors. For example, reducing the risk of poor circulation and heart attack requires quitting smoking (or avoiding in the first place), taking a “statin” cholesterol medication, [and] controlling blood pressure along with diet and exercise. Controlling A1C by bringing glucose levels under control will also reduce vascular disease risk. To prevent blindness, it is important to have a thorough eye exam yearly. To prevent kidney failure, you need regular lab work, including checking the urine for protein yearly. 

What role does diet play?
Controlling glucose involves a combination of diet, weight loss, exercise and medication. Monitoring glucose can be an important tool in figuring out which foods elevate the glucose [and] which activities lower the glucose, [as well as] watching out for hypoglycemia. Continuous glucose monitoring (with a tool like Libre3plus or Dexcom G7) is a tool you can use to try to bring down the glucose with lifestyle changes because you can see the immediate response after eating [and] exercise; [it can also help you] to see which foods maintain a normal glucose. Newly diagnosed diabetes patients will probably respond better to diet changes than someone who has had diabetes for years and might need medications. But all diabetes patients need to watch their diet. Hypoglycemia is a complication seen most commonly with insulin and can be dangerous. Ask your doctor or diabetes educator if you are at risk for hypoglycemia and find out what measures to take if this occurs.

Dr. Janet O’Mahony is an advocate for patient health and regularly contributes advice and feedback to media outlets, online resources and publications. She has been featured by Woman’s Day Magazine, Catholic Review and The Baltimore Sun on subjects including women’s health, heart disease, flu vaccine and sleeplessness. Board certified in internal medicine, Dr. Janet O’Mahony received her medical degree from University of Maryland School of Medicine in Baltimore.