5 Things That May Help Lower A1C That Go Beyond Diet
Lowering the risk and frequency of complications is one of the many important parts of leading a healthy lifestyle for people living with diabetes.¹ One focus for many living diabetes is lowering their A1C over time. For most, the recommended A1C levels rest around 7 percent or less.*,² While there are many lifestyle considerations that they can try to help to lower their A1C, below are a few research-backed strategies to help create a more holistic diabetes management plan.
For those thinking of making big lifestyle changes, it’s recommended to always consult their healthcare professional first. A healthcare professional can give them insights into what can help them manage their glucose levels and create a strategic plan that can stick.
1. Adding Some Movement Throughout the Day
According to the American Diabetes Association, exercise increases insulin sensitivity which helps muscle cells use available insulin and uptake glucose.³ During physical activity, muscles contract and relax, allowing cells to take up glucose and use it for energy. This happens whether insulin is available or not, helping to lower blood sugar levels in the short term.³
For those wanting to increase their physical activity to better manage their glucose levels, using data from a real-time continuous glucose monitoring (rtCGM) system like Dexcom G6 can help guide their decisions. Tracking glucose levels before, during, and after exercise is one way to see the benefits of activity and how it works for their body. The length of activity, as well as personal health factors, can also change the effect physical activity has on glucose levels.³
For those experiencing hypoglycemia during or after exercise, it is recommended that they treat it according to plans they have with a healthcare professional. Diabetes patients should talk to their doctor before going forward with or intensifying an exercise plan.
2. Being Mindful of Stress
Research has shown that stress increases hormones in the body, which can impact blood sugar levels.⁴ When the body feels stressed, it enters into a “fight or flight” mode, which releases adrenaline and cortisol into the bloodstream and causes heart, breathing, and respiratory rates to increase. This then causes blood to be directed to muscles and limbs. During this response, the body may become unable to process the glucose released by firing nerve cells. If this glucose can’t be converted into energy, it can build up in the bloodstream and cause glucose levels to increase.⁴
Long-term or ongoing stress has the potential to affect blood glucose levels over time.4 Stress can also impact mental and physical abilities, which can affect diabetes management.4 For those who are concerned that stress may be impacting their glucose levels, it may be helpful to keep a personal log to see when they are most stressed and how they feel during that time may be helpful. It may also help to check their glucose levels when they feel stressed to see if there are any significant changes.
It’s important to remember that everyone experiences some form and level of stress - it’s a natural part of life. When diabetes patients are feeling stressed, they may take some time to acknowledge the feelings and give themselves credit for doing their best. They can also try creating a plan to help reduce or buffer their stress levels when they increase. Activities like meditation, breathing exercises, and light physical activity (like going for a walk) can be used to manage stress in their daily life.
If your diabetes patients have recently noticed changes in their current stress levels, they can talk to you about steps they can take to manage them.
3. Paying Attention to Glucose Patterns
The Journal of Diabetes Science and Technology has found that paying attention to blood sugar levels, and knowing what triggers changes, can help patients better manage their A1C.5 For example, if they find their blood sugar levels are highest during work hours, it may be a sign that work-induced stress is affecting their glucose levels. Similarly, if they notice their levels are lower after a bike ride, hanging out with friends, or time spent doing activities they enjoy, that is a good indication that they may be able to manage their levels with these activities.
Diabetes patients can use the readings from a real-time continuous glucose monitoring (rtCGM) system, like Dexcom G6, to view their glucose levels in the moment and gain insights into managing their diabetes. If they notice any trends, they may try creating new strategies to tackle problem areas or increase behaviors that positively affect their glucose levels.
It is recommended that they discuss any changes to their diabetes management plan with their healthcare provider to ensure they’re right for them.
4. Tracking Time in Range
Time in range (TIR) is a modern diabetes management metric that allows you to see the percentage of hours in a day patients spend within and outside their target glucose range. TIR can give you a broader view of your patient’s diabetes management and quality of glucose control. By using TIR, you can better understand the way their glucose levels change throughout the day, which can help inform other lifestyle decisions such as exercise, diet, and stress management. Research has shown that people who spend more time in range feel better, healthier, and more confident to pursue their passions.6
When using Dexcom G6, glucose readings are uploaded to Dexcom Clarity, which can show patients their TIR. The customizable alerts can also warn them when their glucose levels spike high or drop low so that they can make adjustments accordingly which may lead to greater TIR. Patients who want to start tracking their TIR should speak to their healthcare provider about what their ideal target range should be and what percentage of time they should spend in their target range.
5. Using Technology to Inform Habits
Thanks to the innovative power of rtCGM systems, there are many ways for patients to gain insights into their glucose levels and patterns. Dexcom rtCGM has been proven to lower A1C for people with type 1 and type 2 diabetes,7,8 and provides real-time glucose data up to every five minutes. This added information allows patients to gain additional insights into their glucose levels and what may be impacting them, which may help them to proactively manage their diabetes.
Your diabetes patients can sign up online to see if they qualify for a free Hello Dexcom sample, or you may request to have Hello Dexcom samples provided to your office.
* Patients should always consult with their doctor when setting A1C goals.
1 Glycemic Targets: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2017;41(Supplement 1): S55-S64. doi:10.2337/dc18-s006
2 Diabetes Canada - Clinical Practice Guidelines - Chapter 8: Targets for Glycemic Control. Guidelines.diabetes.ca. http://guidelines.diabetes.ca/cpg/chapter8. Published 2021. Accessed November 23, 2021.
3 Colberg S, Sigal R, Yardley J et al. Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association. Diabetes Care. 2016;39(11):2065-2079. doi:10.2337/dc16-1728
4 Mitra A. Diabetes And Stress: A Review. West Bengal, India: School of Medical Science and Technology, Indian Institute of Technology; 2008.
5 Greenwood D, Gee P, Fatkin K, Peeples M. A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support. J Diabetes Sci Technol. 2017;11(5):1015-1027. doi:10.1177/1932296817713506
6 Dexcom U.S. data on file, November 2020
7 Beck RW, Riddlesworth T, Ruedy K, et al. Effect of continuous glucose monitoring on glycemic control in adults with type 1 diabetes using insulin injections: The DIAMOND randomized clinical trial. JAMA. 2017;317(4):371-378.
8 Gilbert, T et al. Change in Hemoglobin A1c and Quality of Life with Real-Time Continuous Glucose Monitoring Use by People with Insulin-Treated Diabetes in the Landmark Study.” Diabetes technology & therapeutics vol. 23,S1 (2021): S35-S39.