Raised A1c

[Mstiles]

Good morning everyone, at least it’s morning here in Northern California. A beautiful sunny spring day.

I was diagnosed with PMR/GCA in January 2918. Put on 40 mg of pred, currently on week 4 of DorsetLady’s taper going from 10 to 9mg. No problems at this point except for hip and knee pain, recent x-ray shows “mild” osteoarthritis in both hips and sacrum.

I’ve had my A1c tested about every 3 months and it has always been at 5.6. (4.8-5.6%). Non-fasting Glucose has a few times been a little above range but then settled.

In April the A1c was 5.7, just above range.

In Feb. non-fasting glucose was 101, (70-99 mg/dL)

Sed rate has remained pretty constant, but CRP has risen. How do you read <? Always confused about that!

11/18, 0.1, (<1.0 mg/dL)

2/19, 0.5

4/22, 2.9

Until the Christmas holidays I was pretty strict about low-carb, except for occasional chocolate, and some steel-cut oatmeal. An occasional beer. I walked most days for 20-30 minutes. Lot of stress since then and I haven’t been as strict about everything.

My question - how concerning is this? Is it possible to bring the A1c back in line by being more disciplined about diet and exercise and without medication?

Thank you O wise ones for your assistance.

[PMRpro Ambassador]

Simple answer: YES! Try and see what happens.

[Hidden]

Definitely possible to bring it down. Its hovering at the line so a few tweaks should help. Google d-mannose and see if it would be suitable for you. It might manage 2 birds with one stone.

[SnazzyD]

Yes

[gifford7]

re: CRP 4/22 2.9 mg/dL (<1.0 mg/dL) This increase in CRP tends to indicate a flare and I would probably go back to 10mg pred til the CRP drops below 1.0mg/dL.

I had a similar experience tapering down from 80mg pred with my first flare at 11 mg pred; my rheumy then increased pred back to 20mg. [my CRP had increased to 37 mg/L which is equivalent to 3.7mg/dL; factor of 10 difference]. No use taking a chance with further vision loss [initially lost half of vision left eye]

I was diagnosed with GCA Nov 2017, CRP =84 mg/L, ESR=60mm/hr. Am now at 5.5mg pred and CRPhs of 0.8mg/L [equiv to 0.08mg/dL] and ESA 6mm/hr. [CRPhs is high sensitiviy measurement as regular CRP test only measures down to 2.9mg/L]

I get my CRP, ESR, fasting glucose measured monthly.

re: A1c 5.6% typ range 4.8-5.6%. INCREASED RISK OF DIABETES IS 5.7-6.4%

I am borderline diabetic at 6.4%; was on metformin but got off it with diet changes to

low refined carbs and exercise. I'm also in N Calif, near Stanford. Now time for me to request a new Aic test.

[Mstiles in reply to gifford7]

Thank you for your reply. I am still not clear about the decimal numbers.

I was started at 40 mg. I had no visual symptoms, just an occipital headache that didnt respond to anything.

The CRP had been slowly rising for about 6? months?

I’ve had a terrible time finding a good rheumatologist. I’m on my third one now.

I’m about 2 1/2 hours from the Bay Area. Can you recommend one at Stanford or in your area?

[gifford7 in reply to Mstiles]

re: rheumy recommendation at Stanford: Cornelia Weyand MD

profiles.stanford.edu/corne...

She is the one to see for complicated cases of GCA, tho I think your case is relatively simple. I can also recommend David Fischer MD at PAMF.

sutterhealth.org/find-docto...

re: CRP It appears to have jumped [from 0.5] up to 2.9 mg/dL on 4/22, putting it in the danger zone since the maximum normal value is 1.0 mg/dL or less [<1.0mg/dL]. [The symbol < mean less than.] Your blood report should have a check mark in the "flag" column indicating out of bounds for the 2.9 reading.

re: CRP measurement: mg/dL versus mg/L [milligrams per deciliter vs milligrams per liter. There are 10 deciliters in a liter. Hence multiply mg/dL by 10 to get mg/L].

[JanetGarrettN]

Good morning from Sunny Virginia🌞

I spent a lot of time researching the ketogenic diet when I was diagnosed October 2017. I have just passed my one-year Mark in April on the keto diet and had my physical. I have lowered my A1C from 5.6 to 5.2 as well as lost 26 lb which was just a side benefit. I would suggest you give this your full attention as it is attainable. Best of luck to you. Janet

[Rugger]

Try going back to your pre-Christmas regime and see what the next blood results are.

The rising CRP does seem to indicate that the inflammation isn't under control at your present pred dose.

Good luck.

[Mstiles in reply to Rugger]

Thanks Rugger. I’m working on the emotional eating stress thing, which I’m sure is responsible for this.