Using Insulin to Manage Uncontrolled A1C Levels
The A1C test is a blood test that provides you with an average of the blood glucose levels over a period of two to three months (1). If you are a diabetic, then you know very well the importance of the A1C test. The results are an indication of how well you are managing your diabetes and whether your treatment is working for you or not. A1C test is not the same as the on-the-spot day-to-day home blood sugar tests that you take as these tests indicate only the blood sugar level at that particular time. If your A1C test results are off the charts, then the next step your doctor will recommend is to take insulin for controlling your A1C levels. Let's understand how using insulin can manage uncontrolled A1C levels.
What is an A1C Test Done For?
The A1C test is a commonly used blood test that determines the average of the blood glucose levels over a period of two to three months (1). This blood test is used for diagnosing prediabetes and type 2 diabetes and is also the primary test used to understand how well you are managing your diabetes (2). A1C test is also referred to as the: HbA1c test, Hemoglobin A1C test, Glycohemoglobin test and Glycated hemoglobin test (3).
The A1C test also measures the amount of hemoglobin in the blood which is attached to glucose and thus successfully reflects the average of the blood glucose levels over the period of two to three months (4). The results of an A1C test is reported as a percentage and the higher this percentage is, the higher your blood sugar levels have been in the past couple of months.
What Does Insulin Do? Why Do People With Diabetes Need To Take Insulin?
Insulin is a life-saving drug that is a necessity for people suffering from type 1 diabetes and even for many people having type 2 diabetes as well. Insulin is a hormone that is produced naturally in the pancreas and the primary role of insulin is to help regulate or control the level of blood sugar in the body (5). When there are sufficient levels of insulin present in the body, it prevents the blood sugar from becoming too high. So in people who do not suffer from diabetes, the level of blood sugar is carefully and very tightly controlled by the body itself, thus staying within a healthy range.
People with type 1 diabetes need to take insulin to survive. They either take insulin through an injection or by an insulin pump. This is because, in people with type 1 diabetes, the body is unable to produce insulin or sufficient levels of insulin to produce fuel for the body (6). If the body does not get insulin, then it starts to use fat and protein stores to fuel itself, making blood sugar levels climb to dangerous levels.
People who have type 2 diabetes may also sometimes need insulin if a condition known as insulin resistance develops. In cases of insulin resistance, the body's muscles, liver cells, and fat cells are unable to respond in the correct manner to insulin and are unable to easily absorb glucose from the blood. This results in the body requiring a higher level of insulin to allow glucose to enter the cells. In such cases type 2 diabetes patients may also require insulin.
When Do You Need Insulin For A1C Levels?
If you are having difficulty in controlling the levels of A1C through a healthy diet, regular exercise, non-insulin injectable drugs, and have also tried other oral diabetes medications, then you may require insulin to manage the uncontrollable A1C levels.
What is the Ideal A1C Level/Target?
You can determine your ideal A1C target from your doctor. According to recommendations from the American Diabetes Association, A1C levels should typically be lower than 7%, but the target depends on your overall health and on the duration you have had diabetes (7). There are certain things that you can do to get your A1C levels under control and to the target level. Let's take a look.
Insulin Dose and Timing Matters for Controlling A1C Levels (8)
Your insulin dosage will be prescribed by your doctor, but the actual dose also depends on:
- Your age
- Your weight
- How often you exercise
- Your average blood sugar/glucose levels
- Your kidney function
- What type of diet you are on
Your insulin dose might be adjusted according to dietary changes and if you experience any spike in your blood sugar levels. If you want to find out whether or not you are on the correct insulin dose, then you can try testing your blood sugar level at home once or a couple of times during the day. You should ideally ask your doctor about which time would be ideal to carry out a blood sugar test.
To Get A1C Levels Under Control With Insulin, Follow The Treatment Plan Your Doctor Has Prescribed
If you don't take insulin, then it is of course, unlikely that your A1C levels will stabilize and reach the target level. It is important for you to follow the treatment plan set by your doctor. If even after that you notice that your daily blood glucose levels are still on the higher side, you should again check back with your doctor to discuss what changes you might possibly need to make. It might be that you need to adjust your insulin dose or you may have to change the timing of your insulin injections.
It is very important that you follow your doctor's instructions on things that are going to have an impact on your blood sugar levels and unravel your diabetes management plan. In order to effectively manage your diabetes, you need to eat healthy, exercise regularly, and also maintain a healthy weight.
Importance of a Healthy Diet along with Insulin for Controlling A1C Levels
A healthy and diabetic-friendly diet has a big role to play in controlling A1C levels and your blood sugar (9). However, there is no one diet that works for everyone. This is why it is recommended that you include healthy foods such as: fruits, vegetables, nuts, seeds, beans, whole grains and low-fat dairy.
You should consume carbohydrates from fruits, vegetables, and whole grains. These healthy carbs increase your blood sugar levels steadily and do not cause any sudden spikes. Avoiding refined carbohydrates from sugary, fried and processed foods are also important as these foods will definitely increase your blood sugar levels.
Not Just Insulin, Regular Physical Activity is also Important for Controlling A1C Levels
It is necessary to indulge in a certain level of physical activity every day as this helps your body in using insulin effectively and in a better manner (9). Incorporating half an hour of moderate to intense aerobic or cardio workouts at least three to four times a week will help and also reduce the amount of time you remain sedentary.
If you have not been active in recent times, then it will be a good idea to begin slowly and start with a moderate exercise routine. Increase the intensity of the routine as you become comfortable with the exercise. While you work out, there might be a requirement to adjust your insulin dosage or increase your consumption of extra carbs in order to avoid a fall in your blood sugar levels.
The biggest factor to keep in mind is that in order to manage your diabetes and your A1C levels properly, you need to rely on and trust your doctor. You have to regularly keep in touch with your doctor or your healthcare team, especially if your A1C levels are out of control. There are many apps available today which send your readings regularly to your doctor as well so that your medical team can also monitor your blood sugar levels. However, if this is not the case, then you must bring in your recent readings with you at your next appointment. Do not forget to show up for all the A1C tests, which happens approximately four times a year.
It can take a couple of months to witness a real change in your A1C levels; so do not get frustrated and give up on the treatment plan after just a month or so. Be patient and keep persisting with the insulin regime and your overall treatment plan to manage uncontrolled A1c levels.