Endocrinology (including Diabetes)/High HbA1C results


QUESTION: Dear Dr.Sheri,

My name is Sami Hajj. I am 42 year old.

Last august I did a general health test and the results were as follow:
Glucose: 0.96g/l
HbA1C: 5.9%
Triglycerides: 1.95g/l
Cholesterol: 243 g/l (there was no break down into HDL and LDL).
My blood pressure was good

I did a diet were I stop eating any sweet, sugar and reduced fruit to only 3 pieces a day (before I use to eat more than 15 pieces). I change to eat all brown cereals (specially oat and rye bread) (myself I don’t eat fatty foods like hamburger and fried food) and I was doing exercise 5 days a week. i didn't take any medicine

On December I did the test again and got the following results:
Glucose: 0.91g/l
HbA1C: 6.1%
Triglycerides: 0.83g/l
Cholesterol: 1.65 g/l (HDL: 0.56 and LDL 0.92)

How could we explain that although I reduced the sugar intake heavily for more than 3 months, and performing regular exercise the HbA1C went from 5.9 to 6.1 I was expecting this value to drop considerably.

Do you suggest any action to reduce the HbA1C. I don’t have history in the family of Diabetes.


  Getting lab values of 5.9% and 6.1% are not really different at all (probably within the error of testing in the lab).  So, I am assuming it didn't change.  However, your fasting blood glucose was lower and your triglycerides (blood fats) were lower, as was your total cholesterol, and these are both good changes.  Having a primarily carbohydrate-based diet may make it hard for your A1C value to drop much.  While fruit sugar is considered a simple sugar, all carbohydrates (including brown cereals) are primarily made up of carbohydrates that get converted into sugar (glucose) in the body. If you were to cut down on your total carbohydrate intake and continue exercising, you would probably see a decrease in your A1C. Sheri

---------- FOLLOW-UP ----------

QUESTION: Dear Dr. Shery.

Thank you for the valuable information.

i would like to know if based on the results
Glucose: 0.91g/l
HbA1C: 6.1%

am i considered pre-diabetes and do i run real risk of developing full fledged diabetes.

just an extra information on august i tested also the insulin and it was 4.3mU/l while the normal range is between 6 and 27 does this show any indication

  The American Diabetes Association considered the "prediabetic" range for A1C values to be 5.7-6.4%, so you would be considered to have prediabetes by those criteria.  That does increase your risk of developing type 2 diabetes.  I'm not sure what it means that your insulin levels are below normal.  Usually when those are low, people are insulin sensitive and have normal A1C values.  Just make the lifestyle changes that I suggested (with your diet) and try to do resistance training of some sort twice a week, and you will greatly lower your risk.  I have a lot of information on my web site (www.shericolberg.com) that may help you that you can access for free 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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