Endocrinology (including Diabetes)/Cholesterol & A1C


QUESTION: My A1C was 6.9 3 months ago & my total cholesterol was 270 Triglycerides 255 & LDL 144. CHOL/HDLC Ratio 4.0  Non-HDL cholestrol: 203.

I went on a diet, lost 5 lbs (I am 108 pounds now) and my A1c went to 7.3 on a diet!  Total cholesterol: 218; HDL 57; Triglycerides 133 & LDL 134.  CHOL/HDLC Ratio 3.8; Non HDL Cholesterol: 161 = now my blood tests says my Non HDL is high and when it was 203 it was within the normal range?  

3 months ago was the first time I ever had a A1C test done so I went on a diet and thought may A1C would go down - but instead it went up, I am 61 years old, what am I doing wrong.  I only take Toprol xl for high blood pressure.

ANSWER: Julie,
 There are a number of reasons why your A1C would go up instead of down.  For starters, the lab tests are not exceedingly accurate, so it may have changed less than the results indicate.  What is a more likely explanation, though, is either your diet or the type of weight you lost.  Depending on what you cut back on to lower your calorie intake, you could have actually been taking in a higher percentage of carbohydrates (compared to your total calorie intake), which may cause higher post-meal spikes in blood glucose (especially if you cut a lot of the fat out of your diet, which has a lower glycemic effect).  Are you familiar with the glycemic index (www.glycemicindex.com)?  If you are eating a higher relative amount of carbs, you need to pick them carefullly to minimize their impact on your blood glucose levels.
  As for the type of weight lost, if you lost five pounds without exercising much, you probably lost some muscle mass, which is where your body stores extra carbohydrates.  If you can't store them there because you're losing muscle mass and not exercising much (meaning that the storage capacity has been reached), your blood glucose levels can stay higher after meals.
  Hope this helps.  Sheri

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QUESTION: Thank you so very much for your reply.  It means so much to me.  My stomach started getting bigger and now I am able to wear pants that were too tight a few months ago.  My stomach has gotten smaller.  I cut back drastically on meat:  am eating plain oatmeal for breakfast (100 calories) and about 11:00 AM on weekdays I have a can of sardines (says 1,300 mg of Omega approx 300 calories and lots of protein, zero carbs) in olive oil with a piece of grain bread.  I have been having soup for lunch, and lentil soup for dinner now (but I have cheated and eaten some meat now and then.  My blood sugar fasting was 98 yesterday, and last night I did have 2 bowls of lentil soup (homemade) and pretzel - today my blood sugar fasting was 112.  My blood tests showed my blood sugar fasting at about 109 for years, but no A1C test was order until this year. The only problem is that within 3 weeks of my blood test I was extremely stressed out, thinking that may have elevated my blood sugar?  I am also taking Vit D, fish oil, and cinnamon supplements.  Was not taking cinnamon supplements until approx 3 months go when I had my first A1C test taken.  I will also go to the glycemicindex.com site.  Today I am cheating (only on the weekends) and having spaghetti today with wheat noodles.  I do work, but I am not exercising otherwise, think I should also exercise - at least walk everyday for awhile.  Thanks Thanks Thank you! Julie

ANSWER: It sounds like your diet is actually okay from a glycemic standpoint.  Oatmeal first thing in the morning takes a lot of insulin, so you may want to try cutting back on that a little and adding in nuts and/or fruit.  (For example, I use just 1/4 cup of rolled oats, but cook it with a nut and dried fruit mix--about a handful--and add in part of a pear, banana, strawberries, and/or blueberries.)

If you do nothign else, just add in some regular exercise (and even some resistance training if you can) and see if that helps.  It should also help you keep from regaining the weight that you lost.  I have some easy resistance exercises and more info available for free through my web site at www.shericolberg.com if you need some guidance.  Sheri

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QUESTION: I see a Physician's Assistant next week, and she has been pushing me since my last A1C test was 6.9 to start on diabetes medication.  I was thinking I should see someone who specializes in diabetes (diet, etc) before I commit to medication right now. I would rather try to control my blood sugar with diet, when I figure out exactly what is making my glucose spike higher now that I am dieting.  I was eating 2 eggs almost every morning and a big lunch before the last 3 months.  I actually do not really enjoy oatmeal but thought it would be better than eggs.  I will definitely add some fruit with the oatmeal since I do not have anything else to eat for approx 4 hours after the oatmeal.  I will also push myself to exercise, especially the resistance exercises.  I am going to your site www.shericolberg.com right now, and I have glanced at it, very impressive! It means so much to me that you have e-mailed me back, and for what I see on your site, you are very knowledgeable.  You are a giving person, thank you.  Happy Holidays to you and yours.  Julie

  Eating eggs for breakfast is fine and will likely cause a much lower post-meal spike in your blood glucose given that your body is most insulin resistant in the morning and requires the most insulin then to cover any carb intake.  Actually, a recent study showed that eating carbs at dinner is the best time for your body to be able to handle them, but being physically active during the day (especially after meals) can also prevent post-meal rises.  Also, eggs are unlikely to raise your blood cholesterol levels even though the yolks have a lot in them.  Enjoy your holidays as well.  Sheri

Endocrinology (including Diabetes)

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Sheri Colberg, PhD


I am an exercise physiologist with a PhD who specializes in diabetes--as such I CANNOT answer general questions about other endocrine problems as I am neither an expert in all areas of endocrinology nor am I a medical doctor. My expertise lies in answering questions about diabetes (of any type) and physical activity, so please limit your questions to those areas. I can help you if you want to begin exercise or if you're already a diabetic athlete, and I am prepared to respond to questions about physical activity to which even your diabetologist may not know the answer. I can give suggestions about changes in your diabetic medications that differing types and intensities of exercise may necessitate, but I will have to refer you to your regular health care team to get final approval to make such changes. I can also answer questions about physical fitness, exercise metabolism, prediabetes reversal, and prevention of type 2 diabetes and diabetic complications.


I have both personal and professional experience in the areas of diabetes and exercise/physical activity. On a personal level, I have had type 1 diabetes since 1968, and I have been an avid exerciser since I was a child. Professionally, I have been conducting clinical studies on diabetes and exercise since 1992, largely with funding from the American Diabetes Association. I am also the author of 8 books related to diabetes, exercise, and more: The Diabetic Athlete (2001), Diabetes-Free Kids (2005), The 7 Step Diabetes Fitness Plan (2006), 50 Secrets of the Longest Living People with Diabetes (2007), The Science of Staying Young (2007), Matt Hoover's Guide to Life, Love, and Losing Weight (2008), Diabetic Athlete's Handbook (2009), and Diabetes? No Problema! (2009).

I am a Fellow of the American College of Sports Medicine, a professional member of the American Diabetes Association (and professional volunteer for the ADA), and a former member of the Board of Directors of the Diabetes Exercise & Sports Association.

I have published research and review articles in the following journals and magazines: Diabetes Care, Diabetes, Journal of Diabetes & Its Complications, Diabetes Self-Management, Medicine & Science in Sports & Exercise, Journal of Applied Physiology, The Physician and Sportsmedicine, Journal of Clinical Investigation, International Journal of Obesity, FASEB Journal, The Diabetes Educator, Journal of Physical Education, Recreation, and Dance, Clinical Exercise Physiology, Clinical Diabetes Reviews, Insulin, ACSM's Health & Fitness Journal, Biomechanics, On the Cutting Edge, Diabetes Technology & Therapeutics, Microvascular Research, Drug Benefit Trends, ACSM Certified News, Diabetes Health, SportEX Health, Diabetes Focus, Diabetes In Control, dLife-For Your Diabetes Life, Pediatrics for Parents, and My TCOYD (Taking Control of Your Diabetes) Newsletter. I have also been interviewed in myriad other magazines, such as Men's Health, Men's Fitness, Diabetes Forecast, Countdown Magazine, Joe Weider's Muscle & Fitness, Health, Tidewater Parent, Barron's News, Diabetes New Day, and Newsweek International.

I have an undergraduate degree (1985) from Stanford University, a Master's degree in exercise physiology (1987) from the University of California, Davis, and a Ph.D. (1992) from the University of California, Berkeley, in the same field. I also spent two years in an NIH-funded postdoctoral research position in endocrinology (studying obesity, diabetes, metabolism, and exercise) at the University of Pittsburgh School of Medicine (1993-1994).

Awards and Honors
Fellow, American College of Sports Medicine (FACSM) - 1996 Old Dominion University Darden College of Education Young Investigator Grant Award 2003 Honor Society of Phi Kappa Phi, Old Dominion University Chapter 2004-Present Great Women of the 21st Century by the American Biographical Institute 2005 Edition Old Dominion University Darden College of Education Largest Research Grant Award 2006 Old Dominion University Darden College of Education Publications Award (for greatest number) 2006 Saint Louis University, The Max K. Horwitt Memorial Lecture Distinguished Lectureship Award 2008 Old Dominion University Darden College of Education Publications Award 2009 Old Dominion University Darden College of Research Grants Award 2009

Past/Present Clients
I have consulted for numerous groups, including Can-Am Care, Numera|Social, California Commission on Peace Officer Standards and Training(about candidates with diabetes), Animas Corporation (an insulin pump company), Therasense, Inc. (makers of the Freestyle blood glucose meters), Council of Healthcare Advisors, and the City of Chesapeake (Virginia) Health Department.

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