HbA1c — Blog — Healy Chen

Continuous glucose monitoring

Last week I wrote that I scored a 5.7 on the HbA1c test during my annual checkup. That number is just into the range of pre-diabetic, which is rather alarming. With no other levers to pull - my sleep and exercise regiment is on point, the only lifestyle choice I am making is to limit carbohydrates. More so than I’ve already been doing for over a decade. It’s kind of difficult to cut carbs when I hardly eat any sugary products to begin with. I would be cutting into the staple carbs I eat with meals: rice, bread, noodles, fruits, et cetera.

Ideally, I want to be able to see which of those carbs are spiking my blood glucose level. It’s not prudent to cut out carbs completely, because I need some of it for sustenance, especially after workouts. Therefore it would be helpful to see if white rice spikes blood glucose, but a slices of wheat bread does not (or vice versa, I don’t really care). I will then only eat the carbs that do not elevate blood glucose.

Turns out there are devices called continuous glucose monitors (CGM). Exactly as the name suggests, it constantly measures a person’s blood glucose level (every five minutes). An app on a smartphone collates the data, and users can see in real time if it’s normal, elevated, or too low. Originally developed for type one diabetics - they need to check their blood glucose constantly, CGM devices are now broadly used by people (diabetic or otherwise) wanting a clear picture of their glucose profile.

I asked my doctor to prescribe one to me, and she agreed. But there’s a problem: because I am not a type one diabetic - or any form of diabetic, Kaiser Permanente insurance does not cover the CGM. I will have to pay out of pocket (in the American healthcare system, there is no money in prevention). The primary cost driver are the patches that sticks to the skin (for measuring). Those need to be replaced every 10 - 14 days (depending on the brand).

It’s a necessary expense. I need to see if my blood glucose level is indeed higher than what is considered normal. No better method than measuring (kind of) at the source. Sometimes HbA1c results can skew higher by other factors, so I want to check if that 5.7 might be a false positive (if you will). More to come!

Sugar how you get so high

Yesterday was the first time in my life I got the flu vaccine. And let me tell you, I am feeling like crap today. Make sense, right? The vaccine is effectively introducing a small strain of the influenza into my body. Of course it is going to react as if I actually got flu. At least the symptoms aren’t truly on the levels of a real one. The last time I got it - more than a decade ago - I was bed-ridden for two days.

It was a smart decision to not get the latest COVID vaccine at the same time. Despite what the Travis Kelce commercial says, asking your body to fight two invading viruses concurrently might not be the best idea. My coworker got both the flu and COVID vaccine at the same time, and he was down in the energy dumps for two days. I’ve a history of symptomatic reaction to the COVID vaccine (the second Pfizer shot was killer), so I am delaying what would be the fifth shot to a later date.

I also got the annual blood test yesterday: the usual cholesterol and glucose measurements. Turns out I am pre-diabetic? My HbA1c is 5.7, which is barely into the pre-diabetic range. I am kind of dumbfounded at this. I’m rather religious with proper diet, sleep, and exercise - and have been since my early 20s. I don’t drink or smoke, and I avoid added sugar whenever possible. My weight is completely normal for my height. How the French am I pre-diabetic?

Since I already get eight hours of sleep per night consistently, and exercise multiple times per week, any adjustments to be made will not be in those two areas. It will have to be diet. Moving forward I will cut back on carbs as much as possible, and eat more vegetables and fibrous foods. Let’s check back in six months when I get the next blood test.