August 26, 2004
A1c (Glycohemoglobin, HgbA1c), Weight and Weight Loss
Question from Cincinnati, Ohio, USA:
I alternate exercise between weight training and a treadmill on a daily basis, alternating, while adding extra walks and golf into the mix. I weighed about 175 pounds before and now am about 158 pounds. I lost most of the weight within three weeks. I am 5 feet, 6 inches tall. My three meals a day are 60/60/75 grams of carbohydrates with snacks of 30 or more carbohydrates three or four times a day at two to two and half hour intervals.
I find that, now, if I don’t pay big attention to eating all my carbohydrates, I have to worry about maintaining my weight. My fasting blood sugars in the morning are 110 to 120 mg/dl [6.1 to 6.7 mmol/L], sometimes less, but not often. In the evening, they run about 120 to 130 mg/dl [6.7 to 7.2 mmol/L] with some spikes now and then. I take no medication.
Why am I having so much trouble maintaining my weight? I guess if my blood sugars remained high all the time, that would probably mean that I need medication to help, but the doctor seems to think they are okay with an A1c of 6.7. Do you have any ideas?
Answer:
You have already intervened and lost a moderate amount of weight. Great job! Your sugars have responded. If you add medication, I would suggest you use a medication like metformin that would not cause lows if you took it. The key is normalizing the A1c. The exercise you do utilizes the total calories your body takes in. If you don’t eat those calories, your weight goes down. There is a point where too much weight loss is not healthy. Talk with your dietician about your calorie intake. It may be helpful to increase your total daily calories with monosaturated fatty acids or some protein, in addition to the carbs you eat as snacks.
JTL
