Well, folks—the old A1C has done its number on me again, reaching 6.3. If you’ve followed this blog for any length of time you know all about my struggles to keep that insidious number at a level below what is considered full-blown diabetes, 6.5. The A1C number is the percentage of your red blood cells that have glucose molecules attached to them. People with diabetic tendencies have higher blood-sugar levels than normal due to a condition known as insulin resistance. You may remember my striking analogy using the idea of a key (insulin) and a lock (on the door to the cell). A person with insulin resistance has cell locks that are hard to turn, needing a good strong key. (Hmmm. This analogy is already going off the rails.) In other words, more insulin than normal is needed to get the glucose out of the bloodstream and into the cells where it can be broken down (“burned”) for energy. Since excess sugar in the bloodstream is toxic, the best thing a diabetes-prone person can do is to avoid much in the way of sugar and other refined carbs in his or her diet. If blood sugar levels are kept stable and relatively low, the pancreas doesn’t get called upon to produce big surges of insulin to deal with the glucose spikes typically caused by ingestion of such foods.
I’ve been noticing more and more that if I do indulge in something sugary I feel just awful for at least an hour or two afterward, with symptoms such as indigestion, head pressure, and heart pounding. It’s hard to explain, but I know it when I feel it. We had a dinner recently with some friends at their house and there were lemon bars for dessert, something I love. I ended up eating a fairly large one (hey, it was offered!), thinking, ‘Oh, I’ve been pretty restrained lately—it’ll be okay.’ Well, it wasn’t okay. On the way home I said to Jim, “I feel so sick!” Sure enough, I was back to normal by bedtime, but it was an unpleasant couple of hours.
And there have been other occasions of (brief) indulgence lately, including several of those re-fashioned brownie cheesecakes that I made for the women’s retreat at my church. (Scroll down about two-thirds of the way through the post for my explanation of how I made them.) I rationalized eating them, thinking that after all they didn’t have that much sugar in them. Really? Why would I think that? And I accepted the dish of ice cream and a brownie at a dinner on Sunday. Just good manners, right? There have been other little treats along the way. I was a bit suspicious that I had perhaps sabotaged myself, and sure enough—when the nurse called yesterday to give me my result it had indeed gone up to the aforementioned 6.3, a .2 increase from just three months ago. I’ve always been able to battle the number back down to something close to 6.0, which used to be the threshold for pre-diabetes, and will almost certainly be able to do that this time.
But note the word “almost” in the previous sentence. I can’t count on always being able to rein things in. It’s especially important that I not stress my pancreas, as it may be that I have what’s called LADA—“latent autoimmune diabetes in adults”—and not just garden-variety insulin resistance. I won’t bore you with too much in the way of medical detail; suffice it to say that LADA is sort of a slow-rolling adult onset of Type 1 diabetes, in which your pancreas doesn’t produce any insulin at all. I do seem to be getting more and more sensitive to sugar ingestion, which may just be a function of age. But my poor pancreas may also be wearing out. I want to preserve its function for as long as possible.
So, as I posted almost two years ago, I’m going to have a no-sugar November with the exception of one piece of pie at Thanksgiving. (Melissa Clark’s brandied butternut squash pie, so much better than typical pumpkin pie–I think you’ll be able to access the recipe at the New York Times.) For December I may even abstain from the annual chocolate tasting that my sister-in-law hosts. I’ll be due back in for a three-month checkup in January, so it’ll be very interesting and helpful for me to see how I do then.
Join me in the joys of abstention!
Here’s the incomparable Melissa Clark making her pie on YouTube. (The screenshot looks like an invalid link, but click on the “play” button and you’ll get it.)