Reader may have to give up desserts

Dear Dr. Roach: As a 67-year-old male in good health, should I be concerned about a (fasting) A1C of 5.9 percent?

This is the first time I have had this test run. I am 5 feet, 4 inches tall and weigh 122 pounds. I do two hours of strenuous aerobic exercise at least five days each week. There is no diabetes in my family.

Myphysician says Ishould “avoid sweets, desserts and starch in my diet.” I am a vegetarian with minimal dairy consumption; I don’t smoke or drink; and I don’t care to give up one of life’s pleasures. I don’t overdo sweets, but Idoenjoy them. I was thinking of getting a glucometer and tracking my sugar levels. This year, my blood glucose after a 12-hour fast was 93, similar to previous levels.— K.C.

TheA1Clevel is a measure of average glucose over the past few months. A normal level is between 4 percent and 5.6 percent. A level between 5.7 and 6.4 percent is prediabetes, and 6.5 percent or higher is diabetes.

Looking at your case, an average glucose of 93 would correspond to an A1C of 4.9 percent; anA1Cof 5.9 percent is an average glucose of justover120. That’s a big discrepancy. I suspect your sugars after eating are much higher than the fasting sugar level you had measured. The other possibility is that the A1C is wrong; that can happen in unusual circumstances.

I’m afraid I may have to agree with your physician’s dietary advice. I admit that I am surprised that your A1C is as high as it is considering your height, weight and exercise habits, especially with no family history. I certainlywould get the glucometer and check your sugar levels one and two hours after eating.

That way, you can find out whether they really are going up after eating, and you can identify the foods that are the most problematic for you.