Time to Take Control

Healthy diet and understanding your A1C level are steps toward managing diabetes

A diagnosis of diabetes can be frightening, but it’s not the end of the world. Especially if you regularly test your A1C level.

Dr. Gianina Usera specializes in endocrinology at Adena Health System.

“Diabetes awareness is very important,” Usera says. “Here in Ohio, there are 1.3 million people diagnosed with diabetes. Every year, 70,000 more are diagnosed. One of the most dangerous things is ignorance.”


Usera notes that Type 2 diabetes is the most common form of the disease and involves insulin resistance. With that in mind, she focused on the importance of testing Type 2 patients for their A1C levels — the measurement of glycated hemoglobin — every three months. In layman’s terms, it’s a blood test that indicates a person's blood glucose concentration over the roughly three-month lifespan of a red blood cell.

This reading gives doctors a better idea how a patient is managing his or her glucose, or blood sugar levels. The lower the A1C number, the lower the blood sugar and the better for the patient.

The range varies, depending on weight and other health issues. According to the American Diabetes Association, an A1C level of 5.6 and lower is considered normal. Between 5.7 and 6.4 signals prediabetes. Over 6.5 is considered Type 2 diabetes.

Exercising 20 to 30 minutes a day, “something that makes you sweat,” does help lower that number, Usera says. Diet helps, as well.

“A well-balanced, healthy diet and daily exercise are still two of the main ways we recommend to help manage a patient’s diabetes,” Usera says.


By keeping A1C lower, patients can realize health benefits, including preventing the progression of diabetes-related complications. These may include blindness caused by retinal hemorrhages, kidney disease, damage to nerves in extremities (neuropathy), and an increased risk of stroke or heart attack.

Eating habits play a key role, she says.

“If a patient’s diet is mostly carbohydrates like pasta, rice and bread, plus sugary drinks, regular soda or juice, this would be considered a poor diet,” she says.

Such a diet would increase one’s risk of developing diabetes or result in poor glycemic control for someone with diabetes, she says. She recommends whole grains, lean meats, fruits and vegetables along with daily exercise.


It is possible for those who are diagnosed with diabetes to lower their A1C through diet and exercise. Some may not need to go on diabetes medication, some may need to test their blood sugars daily and some may not. It varies.

“Keeping a sugar log can help the patients and their medical providers identify patterns and areas where adjustment or attention is needed,” Usera says.

Some people can successfully lower their A1C from Type 2 to pre-diabetes numbers.

“This means their sugar range is no longer in the diabetes range, and they have been able to reverse their disease to a certain degree by making lifestyle modifications and being compliant with their medications,” Usera says.

While carbohydrates can increase blood sugar levels, they should not be avoided entirely.

“Carbohydrates are not evil, and are actually a big part of where we get our energy,” Usera says. “Healthy carbs include fruits, some vegetables and whole grains. An important factor to eating carbs is the amount and portions eaten throughout a day.

“Again, maintaining a balance is key. It is possible to live a normal and healthy life with diabetes.”

For more information, visit adena.org/diabetes.